MIIT20 – Don’t Miss This Year’s Program!

Now Virtual! No Travel! CE & CME Credits!

See updated info in this post!

Medical Imaging Informatics and Teleradiology (MIIT), the one-day educational meeting on imaging informatics, returns to beautiful Liuna Station in Hamilton, ON on Friday May 15, 2020. MIIT has been going for 15 years and this year has a great program with speakers from leading Canadian and U.S. institutions speaking on a range of timely topics, including hot topics like AI, multimedia reporting, change management, and building effective teams, as well as a panel discussion.

We are excited to have Drs. Tessa Cook from UPenn, Vamsi Narra from BJC, Cree Gaskin from UVa, Les Folio from the NIH, Adam Prater from Emory, as well as Michael Toland from UMMS and Dr. Christian van der Pol and Ted Scott from HHSC, providing talks in person or remotely, along with Kevin O’Donnell providing an update on the DICOM standard and MIIT’s own Britt Tomlin providing a talk on the Alberta province-wide Connect Care EMR project.


Check out the full program here.


Information on sponsoring MIIT is here.


To register as an attendee or sponsor, click here. All prices are in CAD$.

Standard Physician registration are $200, and healthcare professionals are $150.

Early-bird registration has two deadlines with discounts for early registration. The dates and discounted rates are:

  • Physicians: By 25-Mar-2020, $150; By 27-Apr-2020, $175
  • Healthcare Professionals: By 25-Mar-2020, $100; By 27-Apr-2020, $125

A group discount rate is available to help teams attend.

  • 3-4 registrants: 10% discount
  • 5+ registrants: 20% discount

The above discounts may be applied to the early-bird rates, resulting in big savings for groups that register early.

The registration fees make MIIT very affordable, especially considering the quality of speakers and talks available in a great, easy-to-get-to venue.

IHE Buyers’ Guide – Updates for 2018

The annual update to the free, online IHE Buyers’ Guide tool has been completed.

Interactive IHE Buyers Guide

Check it out here!

Not many changes to the tool content itself for this year, but several important edits to the notes about pending integration profiles were made.

A special thanks to Kinson Ho (@kinsonho) and Brad Genereaux (@IntegratorBrad). Without their help and patience, this tool would not be possible.

Medical Imaging Informatics and Teleradiology (MIIT) 2016 Conference


Genady Knizhnik (@genady_knizhnik) and I (@donkdennison) will be speaking at the 11th annual MIIT conference on Friday June 17th, 2016 in Hamilton, ON, Canada (Liuna Station, 360 James Street).

I am moderating a panel discussion in a session titled “Longitudinal Patient Imaging Record in a DIR” and presenting a talk on “Breast Tomosynthesis: Impact on IT Systems”.

Genady is presenting on “PACS Consolidation and Imaging Record Quality Policies”.

More information, including the complete program, is available here.

Register to attend here.

Developing an Enterprise Imaging Strategy—What is the best approach?

In my last post, we explored the current state-of-the-art of the Enterprise Imaging (EI) industry. In this post, I will zoom in on storing and managing non-DICOM images and videos. This can be ambiguous and may confuse providers who are trying to procure an EI solution. It also results in different schools of thought among vendors.

Currently, EI content can be stored and managed in one of the following formats:

  • Original object (e.g. jpg) stored in a solution’s database and/or filesystem using the vendor’s API (Application Programming Interface)
  • Original object (e.g. jpg) stored using the IHE Cross-Enterprise Document Sharing (XDS) integration profile in a solution’s XDS Document Repository component
  • Original object (e.g. jpg) stored in a solution’s database and/or filesystem using HL7’s FHIR® Media Content specifications
  • DICOM object stored in a solution’s Image Manager/Archive component; for example, using the IHE Web Image Capture (WIC) integration profile
  • DICOM object stored in a solution’s Image Manager/Archive and XDS Document Repository components using the IHE Cross-Enterprise Document Sharing for Imaging (XDS-I) integration profile

The following diagram depicts the main steps that take place during information capture activity for each method.

storage methods

All of the above methods have corresponding pros and cons, which leads to the current divergence of opinions regarding the best option to use. Having said that, it is clear that, irrespective of the chosen method, there is a need to properly collect and manage patient, administrative and clinical context (aka metadata) for the acquired EI content.


Each of the above methods offer different levels of metadata rigidity and extensibility which impact the interoperability:

  • DICOM, FHIR and XDS-I based methods offer a level of certainty for the vendors with respect to what information should be captured and how it should be encoded.
  • XDS takes an approach of developing specific content profiles that address specific types of content; for example, the IHE XDS-SD (Scanned Document) integration profile. At the moment, there is no content profile that is specific to the Enterprise Imaging domain. Additionally, XDS allows the original object to be wrapped in a CDA Document to capture additional metadata in case the specified XDS Document Entry attributes are not sufficient.

Is there one “right” answer?

There are two overarching clinical reasons to capture EI content:

  1. To enrich patients’ clinical record
  2. To provide reliable, authorized access to it across the enterprise (and beyond)

As the following diagram suggests, the way EI content is stored is less important then the flexibility of an EI solution’s “Capture” and “Discovery and Access” components, because it is hidden behind those interfaces.

EI Access

It seems that, currently, there is no single answer for the best EI content format given the informatics complexity of healthcare provider’s enterprises. In order to adapt and compete, vendors will be pressured to support multiple inbound and outbound methods (such as FHIR, DICOM, DICOMWeb, XDS, proprietary APIs, etc.) and only time will tell which approach will become a de-facto standard.

Working on an Enterprise Imaging project? Leave us a comment with your thoughts, or contact us.