HIMSS-SIIM Meetup: Enterprise imaging on an inter-organizational roll

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 - Alexander J. Towbin, MD
Alexander J. Towbin, MD, Director of Radiology Informatics, Cincinnati Children’s Hospital Medical Center
Source: cincinnatichildrens.org

The HIMSS-SIIM Enterprise Imaging Workgroup already had a head of steam to build on when its leaders, members and potential new participants held a “meetup” on March 2 at the airy, sunlit HIMSS Spot during HIMSS16 in Las Vegas.

The workgroup had formed a year and a half earlier, the fruit of a discussion between, among other thought leaders, HIMSS informatics VP Joyce Sensmeier and, representing SIIM, Louis Lannum, director of enterprise imaging at the Cleveland Clinic, and James Whitfill, MD, chief medical officer of Scottsdale Health Partners.

The March 2 meetup brought together the workgroup’s growing membership, now comprised of several dozen enterprise imaging experts whose ranks include radiologists, cardiologists, health IT managers and executives, certified imaging informatics professionals, imaging vendors and others.

The event’s pro-enterprise imaging thrust was concisely characterized by participant Alexander Towbin, MD, director of radiology informatics at Cincinnati Children’s Hospital Medical Center.

“I want to be able to see all the available images because it helps me take better care of patients,” Towbin told imagingBiz in a post-meetup interview. “When I can see the rash that a patient has, it’s going to make me think of findings in the lung a little bit differently. It may make me, a radiologist, think about lupus when I otherwise wouldn’t have.”

“Eighteen months in, it’s very exciting to see the energy and the activity of this group,” Sensmeier added in a separate interview. “People are putting their thoughts and ideas to paper with some really good deliverables that are going to be coming out.”

Aiming high and wide

The deliverables to which Sensmeier refers are at least five white papers in the works from three subgroups that broke out with fresh action items from the meetup.

One subgroup is focusing on defining enterprise imaging. One is homing in on image exchange and sharing. And one is working on identifying best practices around image-acquisition workflow, governance and standards.  

The white papers are to be published, possibly as soon as this summer, in SIIM’s Journal of Digital Imaging. The collective work also may be disseminated via other journals, outlets and presentation venues, the goal being to reach beyond the memberships of SIIM and HIMSS.

Towbin, who is heading up the workflow subgroup and has a hand in drafting its white papers, says workflow is close to his heart because, as a longtime enterprise-imaging evangelist, he knows a complicated workflow is an unfollowed workflow.

“A radiologist lives in the PACS,” he says. “For other specialists, their primary home is the EMR. Instead of making someone log into a different system and do a million other steps, the workflow should be launching through the user’s [familiar interface]. I want to work on building or encouraging workflows that facilitate ease of use.”

“All of this is kind of new territory, beginning with defining ‘enterprise imaging,’” says Sensmeier. “How do we go about sharing images that now are being captured throughout the organization? How do we not only share them within our own organizations that have a need to know, and with patients themselves? What standards should we be using for that?”

Such were the broad-based questions that led to the formation of the HIMSS-SIIM Enterprise Imaging Workgroup, she says, adding that the same questions were in evidence as the three subgroups and five white papers—both of which may grow in number—have taken shape.

“A lot of work is going into getting those white papers published,” Sensmeier says. “The next wave is going to be looking at governance as well as what would be a business model moving forward for enterprise imaging. The third thing will be advancing the value proposition by advocating for and demonstrating the value of enterprise imaging [to provider organizations].” 

Radiology’s role reconsidered

Towbin sees opportunities to turn the many thought exercises underway right now into actionable to-do items in the weeks and months ahead.

For one thing, he says, radiology and cardiology need to speed up the process of shedding their image as the chief keepers of all things imaging.

Further, he says, new enterprise-level jobs are likely to open up, and at every level from desktop support to the C-suite. (Sensmeier seconded that prediction.)

“Just as it doesn’t make sense for radiology and cardiology to be the ones doing all the work in the SIIM-HIMSS workgroups and setting the agenda for the rest of the specialties, it doesn’t make sense for radiology and cardiology to be supporting the enterprise,” Towbin says. “It makes sense for this to start turning into true enterprise IT.”

For that to happen, “there probably needs to be a ramp-up,” Towbin says, “because the people who cover for radiology or cardiology probably cannot cover for the entire enterprise. That’s why I say there are probably new jobs.”

To this Sensmeier adds that image management has traditionally been “sort of owned by radiology, and the model is changing.”

Acknowledging that this kind of change may seem threatening to some, especially where workforce composition is involved, she says her experience watching nursing informatics evolve through the years showed her that such fears are usually unfounded.

“You really don’t get rid of anything,” Sensmeier advises. “You mostly expand the evolving body of work to more people.”

Doing the right things in a BYOT world

Towbin looks ahead by reflecting on how far medical image management has come, and how fast.

“How do hospitals manage an imaging world in which everyone has a camera in their pocket,” he says, “and many of them are doctors taking clinical pictures of patients? How do hospitals manage that effectively? And when I say manage, I don’t mean creating a policy that says you are not allowed to do that. Because then what happens is, people just do it and don’t tell their leadership about it.”

The better question, he says, is how to help medical professionals do the right things in a Bring Your Own Technology world.

“We may need to find ways to enable people to use their phone camera safely, in a way that ensures patient privacy and doesn’t place diagnostic images at risk,” Towbin says. “There are solutions for that. How do we as a community work with our EMR vendors to take and upload images, and to do so in a way that identifies patients correctly and quickly?”

Sensmeier says this is where the shared commitment between SIIM and HIMSS plays into the picture.

“It’s easy to move something forward as a single organization,” she says. “It adds complexity when you work with another organization. But when two organizations have that commitment—and their hearts are really in it, and they put resources into it in an equitable way—it’s really amazing what can happen. I think the HIMSS-SIIM Enterprise Imaging Workgroup is a great example of a cross-group collaboration that can really move healthcare forward.”

To keep members and other interested parties up to date with the collaboration, HIMSS and SIIM maintain a website dedicated to enterprise imaging.