SIIM: Image sharingIHE vs. cloud computing
WASHINGTON, D.C.—Just as PACS liberated studies from their confinement to hard film, so CDs and cloud computing are enabling image sharing across institutions, communities and beyond. But as the cloud buzz grows louder, a group of presenters at the 2011 meeting of the Society for Imaging Informatics in Medicine (SIIM) argued on Thursday that the technology may be green—and ultimately inferior to Integrating the Healthcare Enterprise (IHE) initiative.
Image sharing in radiology effectively began 15 years ago with standardization of images to DICOM, noted David S. Mendelson, MD, professor of radiology and chief of clinical informatics at Mount Sinai Medical Center in New York City. Images soon became available to all physicians within the same institution, and soon thereafter across institutions via CDs. The next round of problems quickly followed.
The challenges of CDs’ compatibility with operating systems are no secret to radiologists and laymen alike. CDs with patient priors commonly arrive at radiologists’ offices with errors of patient information and varying, non-standardized viewers, making diagnoses greatly time consuming, explained Bradley J. Erickson, MD, PhD, from the Mayo Clinic in Rochester, Minn.
Erickson estimated that 1.2 percent of Mayo’s CD imports contain incorrect patient information (commonly spelling mismatches for names), which result in several data integrity issues each day. In addition, practices commonly struggle with who should control the CD—the patient, radiology or another physician. As a patient passes between hospitals, providers and departments during the course of his treatments, CDs commonly get lost and damaged, all the while tacking on more image viewing applications which physicians must navigate.
As a result, following other industries and at the urging of vendors, practices have begun to look to cloud computing to share images. “Cloud providers say the cloud makes all the issues go away…[but] I remain cautious,” said James T. Whitfill, MD, CIO of Scottsdale Medical Imaging in Scottsdale, Ariz.
Privacy and security remain key points of angst for Whitfill, who also worries that as the number of cloud vendors grows, the problem of too many cumbersome image viewers may simply resurface.
The Radiologic Society of North America (RSNA) and the National Institute of Biomedical Imaging and Bioengineering (NIBIB) have piloted a different approach. Beginning in late June, the NIBIB/RSNA Image Sharing Project will start enrolling patients in a two-year trial image sharing IHE.
According to Mendelson, the project is modeled on banking. Just as individuals can control their money and transfer their funds electronically between most any ATM around the world, Mendelson and colleagues aim to “empower consumers to own their images.”
Patients enrolled in the NIBIB/RSNA IHE trial will be given an eight-digit ID number and a patient-selected PIN, by which they can choose one of two personal health records (PHRs) to access and transfer their images and reports. The HIPAA-compliant PHR allows patients to view their images without downloading applications, and to send their studies to physicians via email.
“The first question a radiologist asks if there is an abnormal finding—‘Is there a prior?’ That’s the root of this, to prevent duplicate studies … [and] prevent harm from radiation,” Mendelson affirmed. “We believe half of Americans could benefit from this service.”
The presenters emphasized that cloud computing could offer great benefits for image sharing in the future. However, they offered no illusion: CDs will be around for many years; equally, it may be some time before cloud computing finds the appropriate balance between convenience and privacy.
According to Mendelson, IHEs may be the answer for providing more complete diagnoses and reducing utilization. “Employ IHE institutions whenever possible,” he insisted.
Image sharing in radiology effectively began 15 years ago with standardization of images to DICOM, noted David S. Mendelson, MD, professor of radiology and chief of clinical informatics at Mount Sinai Medical Center in New York City. Images soon became available to all physicians within the same institution, and soon thereafter across institutions via CDs. The next round of problems quickly followed.
The challenges of CDs’ compatibility with operating systems are no secret to radiologists and laymen alike. CDs with patient priors commonly arrive at radiologists’ offices with errors of patient information and varying, non-standardized viewers, making diagnoses greatly time consuming, explained Bradley J. Erickson, MD, PhD, from the Mayo Clinic in Rochester, Minn.
Erickson estimated that 1.2 percent of Mayo’s CD imports contain incorrect patient information (commonly spelling mismatches for names), which result in several data integrity issues each day. In addition, practices commonly struggle with who should control the CD—the patient, radiology or another physician. As a patient passes between hospitals, providers and departments during the course of his treatments, CDs commonly get lost and damaged, all the while tacking on more image viewing applications which physicians must navigate.
As a result, following other industries and at the urging of vendors, practices have begun to look to cloud computing to share images. “Cloud providers say the cloud makes all the issues go away…[but] I remain cautious,” said James T. Whitfill, MD, CIO of Scottsdale Medical Imaging in Scottsdale, Ariz.
Privacy and security remain key points of angst for Whitfill, who also worries that as the number of cloud vendors grows, the problem of too many cumbersome image viewers may simply resurface.
The Radiologic Society of North America (RSNA) and the National Institute of Biomedical Imaging and Bioengineering (NIBIB) have piloted a different approach. Beginning in late June, the NIBIB/RSNA Image Sharing Project will start enrolling patients in a two-year trial image sharing IHE.
According to Mendelson, the project is modeled on banking. Just as individuals can control their money and transfer their funds electronically between most any ATM around the world, Mendelson and colleagues aim to “empower consumers to own their images.”
Patients enrolled in the NIBIB/RSNA IHE trial will be given an eight-digit ID number and a patient-selected PIN, by which they can choose one of two personal health records (PHRs) to access and transfer their images and reports. The HIPAA-compliant PHR allows patients to view their images without downloading applications, and to send their studies to physicians via email.
“The first question a radiologist asks if there is an abnormal finding—‘Is there a prior?’ That’s the root of this, to prevent duplicate studies … [and] prevent harm from radiation,” Mendelson affirmed. “We believe half of Americans could benefit from this service.”
The presenters emphasized that cloud computing could offer great benefits for image sharing in the future. However, they offered no illusion: CDs will be around for many years; equally, it may be some time before cloud computing finds the appropriate balance between convenience and privacy.
According to Mendelson, IHEs may be the answer for providing more complete diagnoses and reducing utilization. “Employ IHE institutions whenever possible,” he insisted.