I contributed to an article recently published in the Journal of Digital Imaging. The primary author is Brad Genereaux (@IntegratorBrad). His blog is here.
This article examines the use of a REST API to discover, retrieve and use structured radiology report templates from an on-line report repository.
Check it out and let me know what you think.
As the first calendar year of my blog draw to a close, I thought I would compile a list of my favorite blog posts from 2013. I hope everyone has a safe, happy, healthy and prosperous New Year.
An article I submitted to the Journal of Digital Imaging has been published electronically.
Told from the year 2018, it looks back at the market and technical forces that results in the deconstruction of PACS (and RIS) as we know it.
Check it out and let me know what you think.
I play Fantasy Football. Usually very badly. For those that don’t know about this hobby/addiction, this will explain it.
Why am I talking about Fantasy Football on a blog about healthcare IT? Because an intriguing feature showed up this year (I have been in the same league since 1998) on the site that manages our league.
After each week, an article describing the battle between my team and my scheduled opponent’s team appears. It is well-written, insightful and sometimes entertaining. The thing is: it is not written by a human.
The quality of the writing is what makes this interesting. You wouldn’t know that a trained journalist had not written the article unless you knew that a computer did it. Take a look at the image below and tell me that sounds like a computer wrote the article pictured within it.
(BTW, for those Fantasy Football fans that read the article, I missed the playoffs, so the victory described is hollow …I really am terrible at Fantasy Football).
Considering the uniqueness of the scenario—the odds of exactly my 9 starting players playing my opponent’s starting 9 players are extremely rare considering the hundreds of players to choose from, even considering there are tens of millions of leagues operating on the site (yes, Fantasy Football is that big)—the text of the article is highly personalized.
Back to healthcare IT, and how this relates.
Consider the wealth of structured clinical data and diagnostic findings that could be combined with genomic data to produce an information model of a patient. Now consider that an application could take that information and automatically turn it into a narrative report that is optimized for different consumers—for example, one for the GP, one for the specialist, one for the patient, one for the home-based caregiver, etc.
Hyperlinks could make extended clinical or reference data available with the press of a finger.
Obviously, a qualified healthcare professional needs to review and sign/finalize the results before they should become part of a patient’s medical record, but imagine how the report could become more useful to the reader, if tailored to their needs, and how much typing and editing could be saved.
Once all this patient data is unlocked using secure REST-based APIs, like those defined in HL7 FHIR and DICOMweb, some very powerful applications can emerge and revolutionize how results are created.
The interpretation of the images is the high value add that Radiologist provide, not typing or dictating—why not free them up to spend more time with their eyes on the pixels and let the computer do the typing?
Inspiration for innovative solutions to problems comes from all types of places. You just have to look for it. 🙂
As Meaningful Use criteria advances to require sharing of population information with registries, this article explores some opinions on the readiness of public health agencies to accept and manage this data.
Is Radiology ready now? Check out all the ACR registries.
I posted some thoughts recently about an article on impact of privacy on patient record sharing.
Now, here is an article that discusses the merits of giving the patient control over how they are identified and how their records should be shared.
Fundamental to this are the two approaches:
Some thoughts…
For those of you faced with connecting patient records with different patient ID domains across enterprises, or within an enterprise, this article is worth a read.
Some thoughts…
As this article explains, the rules of accountability need to apply to all parts of the delivery chain, from the healthcare provider to the infrastructure vendor.
It is my experience that the readiness of the vendor to provide the necessary security controls (technical, policy, etc.) is usually not the issue. It is often the healthcare provider staff that lacks the knowledge of appropriate and effective controls that prevents proper security from being in place.
For example, even when proper single sign-on (SSO) methods are available in systems, rather than taking the time to implement this between systems (which often requires some learning), staff will often default back to wanting to simply pass a user ID and password (often a generic one) from one system to the next, because that was all they could do 10 years ago to avoid having the user log into multiple systems.
As I discuss key images with vendor and healthcare provider staff, I have come to the realization that they are not well understood. Let’s see if we can correct that.
In most contexts, they are images within a medical imaging exams that the Radiologist reviewing the exam wishes to indicate for others, such as the referring physician and clinicians, that they are important in understanding the diagnosis.
In other context, they may represent important images for teaching purposes, quality control, surgical planning or other purposes.
In any case, they serve some importance over other images in the exam and the user wishes to communicate this. That’s why they are ‘key’.
In the digital world, any authorized user can mark an image as a key image on any system that supports this function. Typically, this function is restricted to authorized users like Radiologists on systems like PACS; however, they may also be created by Technologists/Radiographers on modality workstations or clinical imaging systems, like an Enterprise Viewer in an EMR.
Key images are normally created in one of two ways:
The latter capability is important as getting Radiologists to take the time to mark images as key is often difficult. And if they are not created, the consumer does not benefit from them.
Special case: In systems that allow the user to create spine labels, these should not result in automatic key image creation.
Presentation by Dr. Alan Kaye (Advanced Radiology Consultants) at ACR 2013 Imaging Informatics Summit, quoting Dr. Rawsson: “It’s hard to put the patient at the center of the universe if you’re sitting there yourself.”
Don K Dennison 