Article – SIIM Hackathon gives DICOMweb a coming-out party

Check out this article in Radiology Business Journal on the recently concluded Hackathon at the SIIM 2014 Annual Meeting in Long Beach, California.

Here are my other observations on SIIM 2014, in case you missed it.

Article – The time is now for deconstructed PACS

Here is another article (on Aunt Minnie; you likely need an account to access, but it’s free) predicting the deconstruction of PACS (and workflow management systems, like RIS). This mirrors many of the same predictions made in the article titled PACS 2018: An Autopsy, published in JDI recently.

The author’s observations on the lack of recent innovation in PACS is likely attributable to the saturation of PACS in mature markets. Would you invest the same amount in R&D on PACS in today’s environment as you would before the PACS “gold rush” of the mid-2000’s? I touched on this in a blog post a year ago after attending the SIIM 2013 Annual Meeting.

SIIM 2014 Hackathon – Registration Details

I am co-chairing the first Hackathon at the SIIM 2014 Annual Meeting along with Chris Meenan. Check out participation details here.

If the initial interest expressed is any indication, it is going to be an awesome event. I hope that you can join us.

JDI Article Published – REST Enabling the Report Template Library

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.

Favorite Blog Posts of 2013

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.

  1. 100th Blog Post: What I know about Software Development and Crisis Management
  2. The rise of the mobile-only user …and how this helps the underpriviliged
  3. Review of Stage 2 Meaningful Use Test Procedure for Image Results …and other MU tests
  4. Quebec EHR …the difference 2 years makes
  5. Video – Empathy: The Human Connection to Patient Care
  6. Designing for the ‘Public’ and the ‘Pros’
  7. Articles on Mobile Health Applications and FDA Regulation
  8. Plug-ins vs. APIs
  9. Article from HIMSS: PACS will not remain a self-contained data silo
  10. Blog posts on SIIM Web site (Part 1 and Part 2)

JDI Article Published – PACS 2018: An Autopsy

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.

How Long Before a Computer Writes the Radiology Report?

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. 🙂

Figure 1 – Rare example of A Fantasy Football victory

FF Auto-created article example

Apps for Health 2013 at Mohawk College


I had heard good things about this one-day conference, so I decided to take the drive down to Hamilton, ON to check it out. I am glad I did.

Apps for Health has 3 tracks. One focused on Technology, one on Health, and another on Education. They also had keynote speakers to open and close the day of sessions.

To be honest, I was fearing that the recurring trend was going to go something like this: “Healthcare is broken! I love the App Store! Why can’t we get more apps faster!?!” …but the speakers were polished and came with insight and data.

Topics ranged from the needs for a “prescription” for a set of apps for different patient conditions, different levels of safety and risk that apps represent (for physicians and patients), regulatory challenges, privacy, security, and development approaches.

A collection of small and not-so-small vendors had table top displays set up, and attendees (and students) seemed to be routinely interacting with the vendor staff.

Having never been to Mohawk college before, I have to admit that I was quite impressed with the facilities. The buildings are very modern. Everywhere you look, you see technology—on the walls, in the classrooms, in the library, in the hands of the students …everywhere.

One of the more enjoyable parts of my excursion to The Hammer (nickname for Hamilton), was a tour of the Mohawk MEDIC lab. The students demonstrated a complete workflow of a patient’s journey through a referral from her family doctor, to an exam with a specialist (an allergist), and an unfortunate skiing accident in a remote area.

They showed how an EMR—in this case, the open source OSCAR EMR—could accept the referral and share it with the specialist by using an IHE XDS infrastructure. They then showed how the specialist could perform the exam and share the results back to the EMR using the same methods. They also showed the use of mobile technology by EMT and ER staff to review the patient’s records before administering treatment, thus avoiding a potential adverse incident (the allergist report found her allergic to penicillin and other drugs).

Mohawk is serving its students well. They are not only learning about the real world challenges facing healthcare, they are learning about how to build and apply open solutions, and use the latest tools to do it. And they are doing it in a fantastic facility. If you know someone thinking of going there, at least go for the tour—you won’t regret it.

Article – DoD yanked from health records project

This article is intriguing (and a bit depressing).

First, because it shows once again that the amount of money (say like, US$1 billion) that you throw at a problem does not assure success. Aligning goals and system design principles—and getting firm commitment from all stakeholders—is critical, and it doesn’t seem like that happened here.

Also, there is no mention of the use of commercial HIE technology for record exchange. The article mentions the exploration of commercial EMR technology vs. a custom (“home grown”) EMR, like the VA’s VistA. How is the ONC—a government agency—promoting the use of HIE solutions as part of their patient record evolution, but the VA and DoD not looking at the same approach?

Finally, the vision of an open system is not flawed. And by open, I mean interoperable with modern Web-based APIs. It could even mean open source.