Practical Issues Faced in Radiology – Learnings from RSNA 2012

RSNA 2012 offered a great array of innovations in healthcare which spanned across the entire breadth of radiology today. In addition, the conference also provided a forum for customers to voice their opinions on some of the key pain areas faced in radiology which need to be addressed by vendors or by evolving better healthcare standards.

In this post, we've tried to capture areas which offer the maximum scope for innovation in the coming years. We have also taken the liberty of dropping some of the old chestnuts like radiation dose management, HTML 5 viewers, cloud-based storage, etc. as they've almost become the norm for vendors to showcase every year and we are not seeing truly innovative ideas on these fronts. Without further ado, we’d like to present our list of the key pain areas which require innovation in radiology today:

Standardized procedure codes for imaging acquisition

• Procedure codes are usually site-specific configurations
• Standardized codes can help with tighter integration in the post-acquisition workflow by automating processes
• This can assist with consistent interpretation of data that is shared across multiple clinical sites

Lack of effective clinical decision support systems (CDS)

• CDS needs to provide real-time support mechanism driven by evidence-based medicine at the point of care
• In the radiology workflow, this can be leveraged to prevent unnecessary reorders and manage overall patient radiation dose exposure

Leveraging cloud-based services for processing clinical information

• The current trend in radiology is to move storage of clinical information to the cloud. However, this only leverages the infrastructure aspect (IaaS) of the cloud
• We are now starting to see software services starting to be offered via the could (SaaS). Solutions like Quentry by BrainLab are offering solutions around post processing on datasets through web-based interfaces

Standardized report templates adopted across facilities

• The final consumer of output of radiologists are the referring physicians
• Though radiologists like to customize their reports, it was found that over 75% of referring physicians prefer a standard reporting mechanism
• Standardized report templates would greatly enhance the effective sharing of information across multiple facilities
• RSNA’s reporting initiative is great example of standardized report templates

Understanding practical use cases for mobile devices in radiology

• It is very important to understand how mobile devices in radiology - radiologists do not want to perform primary diagnosis on an iPad/iPhone or an Andriod device
• The key advantages offered by mobile devices are:
  • - Providing access to clinical information at the point of care (e.g., explaining a procedure to a patient)
  • - Facilitating collaboration between peers (e.g., getting a second opinion)
  • - Providing a real-time dashboard mechanism for rounds (e.g., providing patient chart information which can be updated in real-time. This is fairly common nowadays.)

The last one’s a little out of left field, but in addition to everything else, there is a complete lack of any type of social media in healthcare today. The only exception to this rule is the usage of Twitter by Public Health Organizations in the US today for broadcasting epidemic warnings or updates on flu shots, etc. The relationship between social media and healthcare is also a little paradoxical in the sense that social media is all about sharing information while healthcare is inherently confidential in nature. However, we believe that several practices can be leveraged and applied for effective sharing of clinical information in a controlled environment.

There was an interesting example of this at RSNA this year through a company called Accelerad who hosted a PHR like a repository (See My Radiology) which functions similar to a social media network. The UI was extremely intuitive to use and offered some really nifty features. For example, it would help you organize your clinical contacts (general physician, emergency contacts, primary care provider, etc.) akin to the way you would sort your contacts on Facebook. However, this example is just the tip of what social media sharing techniques can bring to healthcare today.