RSNA Tackles Imaging Informatics & IT

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Lisa Fratt, Editor

2010 has been a whirlwind year in the imaging informatics and IT arena. Radiologists and administrators are balancing multiple considerations that range from high-profile, bleeding-edge technologies (yes, we’re talking about the iPad and now, the BlackBerry tablet, but there are others) as well as emerging federal programs to drive quality initiatives. No matter what the topics, informatics is at the core of many of radiology’s hot topics.

Meaningful use is the most important issue facing imaging informatics, opines Keith J. Dreyer, MD, PhD, vice chairman of radiology at Massachusetts General Hospital in Boston; and the RSNA radiology informatics subcommittee has firmly embraced the issue in the educational sessions of this year’s show.

“Many radiologists aren’t aware that they are eligible for meaningful use incentives,” Dreyer tells Health Imaging News. That’s because initial iterations of the preliminary rule completely bypassed radiologists. Though the parameters have changed and radiologists based at imaging centers now qualify for up to $44,000 in incentives, the specifics are still murky. As a result, radiologists and vendors alike are confused.

McCormick Place is the perfect place to come up to speed with multiple sessions that tackle meaningful use. Vendors can learn more about the certification process during an afternoon session on Sunday, Nov. 28, and RSNA members can learn more about specifics about how to qualify for incentives during a separate session on Monday, Nov. 29.

Although meaningful use, with the prospect of nearly $1 billion in incentives for radiologists, has nearly stolen the spotlight, informatics is a diverse arena that encompasses an array of IT tools—PACS, structured reporting, computer-aided detection and much more.

PACS has reached the commodity stage, and the era of massive productivity gains (10 to 15 percent or more), along with the transition to digital image management, just about over. Practices are left struggling to eke out more modest gains and maximize value. Over the last year, the Health imaging & IT editorial staff has profiled dozens of facilities and practices that have successfully leveraged a variety of strategies ranging from cloud storage to digital dashboards to integrated voice recognition to optimize their PACS investment. Practices are using data to drive productivity and workflow—as well as employing new strategies for radiologists to reach out to referring physicians to ensure they remain a vital part of the patient care team.

On the organizational level, RSNA and the American College of Radiology (ACR) are building an informatics partnership, Dreyer says, and ACR Appropriateness Criteria will be converted to decision support. Clinical decision support how-tos, along with new technologies and workflow, are sprinkled throughout RSNA educational sessions. In fact, insiders are predicting that the next stage of meaningful use will incorporate clinical decision support.

Many IT initiatives—specifically the Patient Protection and Affordable Care Act and decision support—tie back into quality and safety. While recent single institution studies indicate that radiologists’ documentation of critical and discrepant findings has improved, the ACR and Joint Commission continue to push for improvement. IT provides one arrow in the quiver. However, studies indicate that operational changes, like an early morning radiologist shift, also can play a role.

The same is true of another hefty radiology challenge: radiation dose. Technology, from improved reconstruction techniques to dose tracking tools, represents just a partial solution. Technologists, radiologists and medical physicists play critical parts in ensuring that imaging studies have the lowest possible dose with at least sufficient imaging quality.

The success of such operational modifications hinges on effective change management, which brings the conversation back to IT as experts like Ramin Khorasani, MD, director, information management systems at Brigham and Women’s Hospital in Boston, who insists that digital dashboards and carefully selected quality metrics must be employed to inform change management.

The radiology informatics subcommittee has put together an impressive slate of sessions that encompass the entire informatics arena. Along with the more familiar standbys of informatics, don’t forget to slip in some of the newest topics—iPhones, cloud computing