Whitney Palmer

Healthcare. Politics. Family.

Mobile Computing in Radiology: the Challenges and Benefits

Published on the Feb. 12, 2013, Diagnostic Imaging website

By Whitney L.J. Howell

Hospitals and physician practices are full of electronic sounds. The whir and clunks of imaging equipment. The quiet hum of patient monitors. The background buzz of computers. In recent years, though, a new sound has become ubiquitous: the ding of the text message or mobile email. Smart device technology has come, full-throttle, to radiology.

More than 80 percent of physicians own and use mobile devices, according to recent surveys, and, a 2011 Jackson & Coker Associates study reported nearly 25 percent of radiologists were already using them clinically. That number has only grown in the past two years, said Jon DeVries, vice president of product solutions at Merge Healthcare.

“At any industry event or session, every single radiologist comes in with some sort of handheld device. Every single one of them is using mobile technology to some extent. It’s a massive trend,” he said. “It’s changing the way people practice. Diagnostics are still done at work stations, but it’s changed how they collaborate, form partnerships, and provide care.”

A Culture Shift

Radiology has always been the early adopter of technology in health care. But, even among this forward-thinking specialty, introducing and incorporating mobile devices into everyday use required a cultural shift. The biggest factor, said Rasu Shrestha, MD, vice president of medical information technology at the University of Pittsburg Medical Center (UPMC), has been provider age.

“One of the key things we’re seeing is an entirely new generation of clinicians that has always been used to technology, and they’re developing a level of comfort and acceptance of mobile devices in the industry,” he said. “Even other clinicians are getting accustomed to this notion of always being ‘on.’”

The ready-made access to colleagues that mobile devices provide has also helped nurture the spirit of collaboration within the specialty. As mobile devices and apps move from being novelties into mature technologies, Shrestha said, radiologists and other clinicians are more easily able to work together as a clinical care teams. Being mobile has gone from being trendy to being a necessity.

“A little more than a year ago, ‘apps’ and ‘mobile’ were buzzwords,” he said. “Now they’re accepted as part of workflow, and they’re well integrated.”

One of the greatest outcomes of increased provider comfort with mobile technology has been improved communication between provider and patient. Providers can now display images on a tablet for patients to see, and viewing the studies on a smaller, more familiar device — rather than a large, clinical screen — can be less intimidating for the patient.

Improving Communication

Perhaps the biggest way smartphone and mobile device technology has touched radiology is through enhanced provider communication, DeVries said. Whether it’s with critical care or emergency patients, mobile technology has streamlined the way radiologists and referring physicians discuss patient care.

“The big area where we see radiologists using smartphones and tablets is in the way they interact with colleagues,” he said. “These devices give them the freedom to get out of the reading room and out onto the floor so they can have face-to-face interactions with co-workers and patients. It’s enabled them to build better relationships.”

Mobile technology can even help you stay connected when you’re away from your hospital or practice. Various apps for the iPhone, Blackberry, or Android let you quickly look at scans so you can discharge patients or initially evaluate a trauma case. These apps aren’t intended to be used for true diagnostic reads, DeVries said, but they do keep the process of patient care flowing.

Herman Oosterwijk, president of Texas-based health care technology training and consulting firm Otech, agreed that mobile devices are the lynchpin of prompt communication and timely patient care. While reaction time to an email might be slow — often more than an hour — responses to text messages are frequently instantaneous.

“Texting and communication between smart devices is incredible,” he said. “People are always listening for that ‘beep’ or ‘ding-dong’ that alerts them that someone wants to tell them something.”

According to DeVries, Merge’s iConnect product offers you this kind of immediate access. The zero-client viewer can be launched through any electronic medical record system and can pull images from any PACS. Carestream’s Vue Motion software also offers similar capabilities, presenting you with patient information quickly to avoid any slow-down in care.

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/practice-management/content/article/113619/2128049


February 26, 2013 Posted by | Healthcare | , , , , , , , , , , , , , , , , | Leave a comment

Report Offers System to Separate Useful and Wasteful Imaging

Published on the Feb. 20, 2013, Diagnostic Imaging website

By Whitney L.J. Howell

All repeat images are not created equal. Some are good; some are wasteful. So one radiology policy think-tank introduced a classification system Wednesday that could help determine whether a repeat image is necessary.

According to Richard Duszak Jr., MD, CEO of the American College of Radiology’s Harvey L. Neiman Health Policy Institute, “repeat image” is an overused and undefined term that offers no clarity about a scan’s medical necessity. The institute, , which researches medical imaging use, quality, and safety metrics, published guidance about how to categorize the various types of repeat images.

This paper, entitled “Repeat Medical Imaging: A Classification System for Meaningful Policy Analysis and Research,” aims to help quantify how many imaging studies have beneficial diagnostic value and how many can be avoided as wasteful spending.

“This classification system is in response to what we perceive as a global lack of clarity as to what repeat imaging means in medicine and when it applies to imagining,” said Duszak, who is also a practicing radiologist. “We’ve tried to be as thoughtful as we could be in creating something that would work both now and with future research as people have more and more robust data.”

The system divides medical images into four categories: supplementary, duplicative, follow-up, and unrelated imaging:

• A supplemental image — many of which are medically necessary — would occur during the same clinical encounter but utilize a different modality, such as a non-contrast CT scan and a renal ultrasound to identify kidney stones.

• Duplicative images involve the same modality during the same or subsequent clinical session. These images are taken for a variety of reasons, including the unavailability of previous scans or a change in the patient’s condition.

• Follow-up imaging can involve the same or different modalities during later clinical meetings, such as repeated imaging in cancer patients to verify there’s been no relapse of disease.

• Unrelated imaging — scanning of the same body area with any modality — is often an unforeseen event. For example, in its paper, HPI discussed unrelated imaging in a woman who had CT screenings for breast cancer staging two weeks prior to a car accident that prompted identical scans.

In many instances, how well researchers will be able to use this classification system will depend on how integrated and mineable the electronic health records they use are, Duszak said, as well as how standardized radiology reports are.

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/practice-management/content/article/113619/2129299

February 26, 2013 Posted by | Healthcare | , , , , , , , , , , | Leave a comment

Radiology in 2013: The Year of Imaging Software

Published on the Jan. 3, 2013 Diagnostic Imaging website

By Whitney L.J. Howell

For radiologists and radiology vendors, the past 12 months have centered on health care reform – would the U.S. Supreme Court uphold the law, and if it did, what would it all mean? With the court’s decision, at least part of that question has been answered. Now, the industry has turned its focus to what can be done in the next year to make practice more efficient and improve how its providers interact with other specialties.

One of the biggest strategies for accomplishing this goal will be the implementation and use of new software offerings, experts say. The increasing use of more complex information in radiology practice has necessitated intelligent systems to more effectively capture and analyze data. Whether the new products impact work flow or patient care, new software developments will play an integral role in how you obtain, analyze, and share images in the future.

According to Eliot Siegel, MD, diagnostic radiology and nuclear medicine professor at the University of Maryland, the bulk of new software capabilities will target enhanced communication, taking how providers share information to the next level.

“So much effort has been put in during the last 20 years to actually get us to the point of being digital and having images available anytime, anywhere and being more efficient in image interpretation,” said Siegel, also the associate vice chairman of informatics. “But relatively little has been done about communicating radiology findings and information that’s important about the patient and making sure we receive return communication that our recommendations have been acted on.”

Within the next year, he predicted, radiology software will meet provider needs by not only recording when studies are completed, reported, and shared with referring physicians, but also by providing feedback on whether referring physicians acted on any radiology recommendations.

Main Provider Desires

A common provider complaint is the difficulty frequently associated with transferring images from one facility to another. In many instances, CDs are lost or referring physicians can’t download the images. Sharing studies between health care systems is also a particular challenge, Siegel said.

“It would be good to see hospitals and clinics having more universal use of images,” he said. “We should be able to transfer images directly and digitally, like sending an email. Only it would be in a safe, secure way from one facility to another.”

The Image Share Network, launched by the Radiological Society of North America (RSNA), is already moving the industry in this direction. Tested at five pilot sites nationwide, this initiative gives patients access to their diagnostic images via a patient health account, enabling them to transfer images to their physician much like they would in their email accounts.

Siegel also predicted the rise of software that can produce better analytics for radiology, as well as enhance natural language processing for radiology reports. Ultimately, he said, an effective system would summarize pertinent information and allow providers to either agree or disagree with the computer’s interpretation of the data. Such a system would offer improved text and structure capabilities.

What’s Coming in Communications Software

One of the most active areas in communications software development is work around speech recognition and natural language processing. Several companies are working to make these tools smarter, Siegel said.

For example, M*Modal and Nuance are developing software that will be able to understand and discern meaning from, and potentially act upon, information included in reports. Montage is also creating software that can mine current and previous radiology reports for specific words, such as pneumothorax, and correlate them with pathology reports.

“I’m really excited about this next generation of intelligent systems that generates reports and makes sure they’ve been read and acknowledged,” he said. “Computers can be useful tools to understand and extract information from the report, act on it, and allow for follow-ups.”

Additionally, many vendors are tackling improved image sharing software, using RSNA’s Image Share as a model. The most important advancement here is that these products will likely be standards-based rather than proprietary. Having a universal solution will allow health care facilities of all types — both in the same and different systems — to share all types of diagnostic imaging data associated with individual places.

Although the solution isn’t yet standards-based, information technology software developer mPlexus introduced its latest product — DICOM RadiX — at this year’s RSNA annual meeting. This automated software shares images and retrieves them from imaging archives instantly. When integrated with other mPlexus products, RadiX can transfer images between facilities, even those in separate institutions.

To read the remainder of the article in its original location: http://www.diagnosticimaging.com/informatics-pacs/content/article/113619/2121622

February 26, 2013 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , | Leave a comment


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