Join us Online (and get your CE credits) for the First Virtual MIIT Meeting on Fri May 15!

Now Online!

Why MIIT Went Virtual

As someone that has mostly worked from home for over seven years, I understand the value of digital communication and collaboration. In healthcare, we have had many digital tools for more virtual experiences, but have been slow to adopt them. The COVID-19 pandemic has caught many organizations with paper-based and analog processes flat footed.

Education is no different than healthcare and other organizations that have heavily depended on in-person settings. While there is no doubt an in-person conference is more personal and provides social networking opportunities, content can easily be delivered online (the slides and audio are all digital, right?).

This year’s Medical Imaging Informatics and Teleradiology (MIIT) meeting was scheduled to take place in-person in Hamilton, Ontario, just like it has for well over a dozen years. Given the current situation we are all facing, my Co-Chair Dr. David Koff (@koff14) and I were faced with a choice: cancel or try to continue with an online version. As we believe strongly in the importance of imaging informatics education, and the value in this year’s excellent program, we chose the latter.

The first virtual MIIT will take place on Friday May 15, 2020. We have lowered attendee and sponsor rates in consideration of the lower costs of operating a virtual meeting.

Program

We have a great program this year with Dr. Tessa Cook from UPenn, Dr. Vamsi Narra from BJC, Dr. Cree Gaskin from UVa, Les Folio from the NIH, Dr. Adam Prater from Emory, Michael Toland from UMMS, Ted Scott from HHSC, along with Kevin O’Donnell providing an update on the DICOM standard at MIIT 2020 and MIIT’s own Britt Tomlin providing an update on Alberta’s province-wide Connect Care CIS program.

Review the full program here.

Costs

At only CAD$80 per person (which, at the current exchange rate, is only US$57 for our American friends), and with accreditation for CE credits, it is very high value. There are no travel costs and imaging informatics professionals can join from anywhere in the world.

Register using the “Register Now” button at miit.ca.

Sponsorship

Sponsorship of MIIT is still available, starting as CAD$1,000 (~US$715 with today’s exchange rate). Higher tier sponsors are given high visibility with attendees and the opportunity to give a brief talk during the lunch hour.

Be sure to stay top-of-mind among imaging IT decision makers and influencers (from anywhere now) to make up for lost contact at cancelled meetings, conferences, and trade shows!

More information is available here.

More Information

If you have any questions, email us at info@miit.ca.

AXIS Imaging Interview: Four Options for Image-Display Architecture: A Deep Dive

How diagnostic images get from server hard drives to the screen is a topic of great interest to both industry and buyers of imaging IT solutions. Speed of image access is critical for quality of service and care, along with productivity and user satisfaction.

Different solutions take different approaches to optimize image delivery over varying networks. Many solutions combine more than one software design method to achieve the best possible performance. In many cases, industry or buyers will use jargon, like “streaming”, to apply a simple term to these sometimes complex technical methods.

In a recent article by AXIS Imaging, I describe four common techniques that are used in (and occasionally between) different imaging IT systems to maximize image display speed. The article length limit prevented coverage of additional methods and intentionally excluded IT infrastructure optimizations (for example, faster networks, CPUs, and drives) and the use of irreversible lossy image compression of the images on disk.

Important Article Corrections

Although I followed up with the author about some transcription errors they made in preparing the article language, they were not corrected (at least at the time of posting this), so I am going to note some corrections here.

  1. Where the article states “…radiology practices and departments have options when designing high-speed image display…”, it should state “…radiology practices and departments have options when choosing the solution for high-speed image display…”. Radiology practices choose a solution and that solution will use one or more of the design methods (or additional ones not listed), but the Radiologists don’t choose the methods within the solution.
  2. In subsection #3, the second bullet refers to a condition where pre-caching is typically not possible (the article states the opposite). If the worklist is a separate application from the image display application, the image display application often has no method of knowing which exams listed are in the worklist, so is unable to pre-cache the images to the workstation. This is not always true, as some worklist applications can expose this information to the image display application through an API, but this is not a universally available capability and does require that a specific integration be developed to support this across the applications.
  3. In subsection #4, where it states “visual design infrastructure”, it should instead state “virtual desktop infrastructure”. People commonly refer to it as VDI.

The State of RIS Today

A lot of attention is paid to imaging IT systems, like PACS and VNAs, and EMRs these days, but Radiology Information Systems (RIS) play a very important role in the success of the Radiology service line within an enterprise.

The industry and market for RIS has changed a lot since their introduction, with two core markets (with different needs) evolving.

I recently wrote an article for HealthCare Business News, titled A tale of two kinds of RIS solutions, on the subject. The article is here.

AXIS Imaging Interview: How to Prepare a Successful Vendor RFP

AXIS Imaging recently interviewed me to get three tips on preparing for a Request for Proposal (RFP). The article is here. Enjoy!

There are obviously a lot more recommended practices when doing an RFP, but these three are always good to consider. I tried to provide guidance that applies to both IT and equipment purchases.

SIIM19 – Will I See You There?

In less than two weeks, the SIIM Annual Meeting will be taking place at the newly opened Gaylord Rockies Resort in Aurora, Colorado. I am looking forward to catching up with old friends and meeting new ones, along with learning lots of new information.

This year, I am (co-)chairing three sessions and participating in a fourth. Here is a summary (my role). All times are in local MT.

If it is your first annual meeting, I recommend you go to the First Time Attendee Meet-up on Tue 25-Jun at 6:15 pm in the Adams C/D Lobby room and attend the New Member Orientation: Intro to SIIM session on Wed 26-Jun at 9:45 am. Jim and Rick are great educators and mentors.

Also, be sure to check out the pre-conference sessions, the Hackathon and Innovation Challenge events, as well as the #AskIndustry, Learning Lab, and Scientific sessions. And be sure to put the SIIM 2019 Reception on your calendar. It is great to connect with peers and review the scientific posters.

While you are on-site, don’t forget to share information and activities (and selfies!) using the SIIM Twitter handle @SIIM_Tweets (remember to follow SIIM for great info on imaging informatics throughout the year!) and the official 2019 Annual Meeting hashtag: #SIIM19.

I hope to see you there!

MIIT 2019 – An Overview

On Friday, May 10, I once again have the pleasure of co-chairing the Medical Imaging Informatics and Teleradiology (MIIT) conference at Liuna Station in Hamilton, ON.

The program for the 14th annual MIIT meeting is stellar, we have a record number of sponsors, and—thanks to lower registration fees and new group discounts—many people are already signed up to attend.

Program Highlights:

  • AI Strategy of CARRoger Tam will enlighten us on the Canadian Association of Radiologists’ strategy for AI.
  • Cloud Services for Machine Learning and Analytics – Patrick Kling will reveal how cloud-based solutions can address the challenge of managing large volumes of data.
  • Patient-Centered Radiology – Dr. Tessa Cook (@asset25)will provide insight into their progress on this topic at UPenn.
  • Collecting Data to Facilitate Change – Dr. Alex Towbin of Cincinnati Children’s Hospital (@CincyKidsRad) will show us how to use data to support change management.
  • Panel on the Future of DIRs in Canada – In this interactive session, we will discover what has been accomplished with Diagnostic Imaging Repositories (DIRs) in Ontario, and what’s next. I will moderate a panel with leaders from SWODIN and HDIRS.
  • Practical Guide to making AI a Reality – Brad Genereaux (@IntegratorBrad), with broad experience working in hospitals, industry, standards committees, and technology, will help attendees prepare for this new area.
  • Healthcare IT Standards – Kevin O’Donnell, a veteran of healthcare standards development and MIIT, will provide an overview of developments within the DICOM and HL7 standards, and IHE.
  • ClinicalConnect – Dale Anderson will provide an update on this application (@ClinicalConnect), used by many organizations in the local region.

If you can attend, I am sure you will find the event educational. There are lots of opportunities to interact with our speakers and sponsors. If you are not from the region, you may find a weekend getaway to the nearby Niagara on the Lake wine region enjoyable.

And don’t forget to follow MIIT (@MIIT_Canada) on Twitter!

Enterprise Insight in Today’s Consolidated Enterprise

As health systems acquire or partner with previously independent facilities to form Consolidated Enterprises, and implement a Shared Electronic Medical Record (EMR) system, they often consolidate legacy diagnostic imaging IT systems to a shared solution. Facilities, data centers, identity management, networking equipment, interface engines, and other IT infrastructure and communications components are also often consolidated and managed centrally. Often, a program to capture and manage clinical imaging records follows.

Whether the health system deploys a Vendor Neutral Archive (VNA), an Enterprise PACS, or a combination of both, some investment is made to reduce the overall number of imaging IT systems installed and the number of interfaces to maintain. An enterprise-wide radiation dose monitoring solution may also be implemented.

While much has been written on strategies to achieve this type of shared, integrated, enterprise-wide imaging IT solution, there are several other opportunities for improvement beyond this vision.

In addition to imaging and information record management systems, enterprise-wide solutions for system monitoring, audit record management, and data analytics can also provide significant value.

Systems Monitoring

Organizations often have some form of enterprise-level host monitoring solution, which provides basic information on the operational status of the computers, operating systems and (sometimes) databases. However, even when the hosts are operating normally, there are many conditions that can cause a solution or workflow to be impeded.

In imaging, there are many transaction dependencies that, if they are not all working as expected, can cause workflow to be delayed or disabled. Often, troubleshooting these workflow issues can be a challenge, especially in a high-transaction enterprise.

Having a solution that monitors all the involved systems and the transactions between them can help detect, prevent, and correct workflow issues.

Audit Record Management

Many jurisdictions have laws and regulations that require a comprehensive audit trail to be made available on demand. Typically, this audit trail provides a time-stamped record of all accesses and changes to a patient’s record, including their medical images, indexed by the users and systems involved.

Generating this audit trail from the myriad of logs in each involved system, each with its own record format and schema, can be a costly manual effort.

The Audit Trail and Node Authentication integration profile (ATNA), part of Integrating the Healthcare Enterprise (IHE), provides a framework for publishing, storing, and indexing audit records from different systems. It defines triggering events, along with a record format, and communication protocol.

Enterprises are encouraged to look for systems that support the appropriate actors in the ATNA integration profiles during procurement of new IT systems and equipment. Implementing an Audit Record Repository with tools that make audit trail generation easy is also important.

Data Analytics

Capturing and analyzing operational data is key to identifying issues and trends. As each system generates logs in different formats and using different methods, it often takes significant effort to normalize data records to get reliable analytics reports.

Periodic (for example, daily, weekly, or monthly) reports, common in imaging departments for decades, are often not considered enough in today’s on-demand, real-time world. Interactive dashboards that allow stakeholders to examine the data through different “lenses”, by changing the query parameters, are increasingly being implemented.

Getting reliable analytics results using data from both information (for example, the EMR and RIS) and imaging (for example, modalities, PACS, VNA, and Viewers) systems often requires significant effort, tools to extract/transform/load (ETL) the data, and a deep understanding of the “meaning” of the data.

Enterprise Insight

Implementing solutions that continuously and efficiently manage the health of your systems, the records accessed, and operational metrics are important aspects in today’s Consolidated Enterprise. Evaluating any new system as to their ability to integrate with, and provide information to, these systems is recommended.