SIIM helps IIPs to move beyond IT, radiology
The field of imaging informatics is learning interoperability from outside the walls of healthcare, while pursuing a definition that seeks to differentiate itself from health IT or radiology, according to James Whitfill, MD, who made several presentations at the 2008 Society of Imaging Informatics in Medicine (SIIM) meeting in Seattle.

The meeting tackled some of the biggest challenges specific to imaging informatics, Whitfill, chief information officer at Scottsdale Medical Imaging in Scottsdale, Ariz., told Health Imaging News.

“One of the biggest innovations is really trying to learn from other industries that have always had interoperability challenges, such as the banking industry, the finance industry and the airline industry—these industries have largely solved a lot of those issues. Healthcare is finally becoming open to using some of the solutions and technologies that these other advanced IT industries have used, like service-oriented architecture (SOA),” Whitfill said.

Within healthcare, he said that it is important to use the framework provided by the Integrating the Healthcare Enterprise (IHE) initiative as a place “to deal with interoperability and melding that with concepts of SOA.” Whitfill noted that the field is “making incremental progress this year in that area,” but noted how the meeting attempted to tackle these issues through its sessions.

He also mentioned the continued struggle to “push imaging informatics outside of the radiology department into the other subspecialties—not just cardiology, but also within the rapidly growing field of pathology informatics.”

Another perpetual challenge is that imaging informatics professionals (IIP) find themselves caught between two worlds—institutional IT and the radiology department, according to Whitfill. “There is always a struggle between those two divisions or groups for control over imaging informatics, so IIPs are pulled in several directions,” he said.

“The reality is that IIPs are not pure IT and they are not pure radiology. They operate in a separate space, which in the best of cases is comparable to a federated neutral ground. We still have not seen where [imaging] informatics as a whole has become its own domain at most institutions,” Whitfill said. However, he thinks in the next five or ten years, IIPs will have their own domain.

Whitfill said that the root cause for this struggle is that “most IIPs typically come from one of those two disciplines, so they are often times learning on the job a whole different discipline.”

To combat the learning curve challenges, SIIM presented a whole track of University sessions, which Whitfill noted are “designed for someone who is new to the field, and can attend the sessions in order to get up to speed on both the IT and radiology sides.” The SIIM U sessions “start that process and provide individuals with the resources for where they can go for more help,” he added.

This year’s SIIM U curriculum featured 12 sections of introductory, intermediate and advanced lectures, which presented the fundamentals through the advanced applications of PACS, RIS, EMR, computer assisted detection, CR/DR, IHE and transforming the radiological interpretation process (TRIP). 

He also referenced the all-day Imaging Informatics Professional Symposium that began the day before the SIIM conference which specifically “focused on giving the IIP all that information.” The certification exam and the certification IIP board reinforce the importance of separating IIPs from other fields, according to Whitfill.

In a look toward future trends, Whitfill noted that for the last years SIIM and others have “really worked to bring some order to digital mammography workflow, and they’ve made some advances in that field with the creation the IHE profile for digital mammography.”

However, he said that “there is another coming revolution in digital mammography, either involving tomosynthesis or specialized or dedicated breast…which is going to result in a tidal wave of information that is going to hit our systems, which have already been challenged with multi-slice CT and MR protocols.”
“The adoption of some of these new technologies in a screening population is another explosion of data that will be hitting our systems, and that means everything from the network to the storage architecture at the back-end,” Whitfill said. He added that he thinks this will be “a big deal over the next couple years.

To address these issues, session 10 of 2008 SIIM U, “Breast Imaging: Modalities, Procedures, Workflow and Informatics Issues,” detailed the implementation, configuration and impact of digital mammography and other breast imaging modalities in an electronic imaging environment, and focused on the informatics considerations, IHE pertinent integration profiles and outlined suggestions for improving workflow and efficiency.

Whitfill concluded that this year, SIIM had a theme of building bridges to extend beyond the large, academic health systems into the imaging centers, which was represented by sessions, like the three-topic session, “Imaging Center PACS.”

SIIM has embraced the concept of not just focusing on radiology, or even in-patient radiology, but to pay attention to all environments practicing imaging informatics, Whitfill added.