ATLANTA--“Health IT support [within a hospital] may not have the skill set to manage images, and radiology support does not have skill set to manage integration of all hospital information, so we need both groups to work together. I think that both groups together will make a much stronger system,” said Janice Honeyman-Buck, PhD, independent imaging informatics consultant and editor-in-chief of the Journal of Digital Imaging, during her session at HIMSS10.
Honeyman-Buck cited a current “crisis” she sees within the hospital. “There is a lot of emphasis on the new health IT programs at the government level, but maybe not quite the emphasis we need to plan for imaging.”
According to Honeyman-Buck, for years hospital IT support has existed on one side of the line, with the radiology imaging department on the other. “And that still continues today. They do not get along,” she said. “Everybody wants ownership of the network, archives and the data.” However, she noted that with the implementation of the American Recovery and Reinvestment Act (ARRA), this will have to change. “This is a problem that we can’t live with. We need the images, the text and the information about the patient.”
For the health IT department, the main concerns revolve around following the HL7 standard of getting the processing of text data completed quickly, correctly, privately and securely, noted Honeyman-Buck. For the imaging department, however, concerns revolve around image storage and manipulation and obtaining access to the internet for decision support. This department follows a different standard than health IT--the DICOM standard--said Honeyman-Buck, noting that this standard “does not look anything like the HL7 standard.”
Images have a significant impact on communications and can present archiving and network issues, said Honeyman-Buck. “The communication of images from one single source can completely bury all of your messages going across the HL7,” she said. However, she noted that portable imaging equipment may present even larger concerns, as the equipment requires a secure wireless network.
The current healthcare reform demands interoperability, said Honeyman-Buck. “An EHR must contain a way to store images,” she explained. In the near future, patients must be able to have their entire record--including their images from different physicians--follow them wherever they receive care, right at the point of care. Honeyman-Buck said that vendors are now beginning to follow suit and are showcasing solutions that include both images and text, a “sign of success,” she said.
Aside from radiology, there are other sources of images that must also follow the patient, said Honeyman-Buck, including cardiology, dermatology, OBGYN and dentistry. “All of these images are going to be online if they are not already.”
In addition, Honeyman-Buck explained that radiologists and other physicians are going to require decision support, by way of the internet. “They are going to need to be able to get outside of the institution in a safe way so that the records are still protected.”
During her presentation, Honeyman-Buck provided examples of different medical images from various specialties and stressed the importance for physicians to have access to patient images during treatment. “These are the images that radiologists and other physicians want and need,” she said. “And this is why I believe that the two groups have to come together. Radiologists have spent their lives loving images and trying to make them look good and trying to make everything work for them. They really bring a lot of knowledge to the table.”
Noting that imaging has had a significant impact on all aspects of healthcare, and hospitals currently are receiving ARRA monies to upgrade HIT, Honeyman-Buck recommended, “[i]maging has to be considered from the beginning of an upgrade, not as an eventual add-on.”