Daily Bulletin 2015

Future of Imaging Interoperability Key to Improved Patient Care

Tuesday, Dec. 01, 2015

If radiology images can't move from the patient to you, "then everything else you learn here is almost useless."

David Mendelson, M.D. announces Image Share Validation Program.

That was the message Monday from David Mendelson, M.D., representative of the RSNA Integrating the Healthcare Enterprise (IHE) Board and member of the IHE USA Board, addressing attendees during the program "IHE Clinical Solutions for Interoperability: Imaging and Beyond, IHE or HIE, Does the Order Matter?"

The session was followed by the official announcement of RSNA's Image Share Validation Program, a conformity assessment program that will set the standard for consistency in the electronic image sharing marketplace. The Image Share Validation Program will test the compliance of vendors' systems using quality standards determined as most effective for accurate and efficient exchange of medical images.

David Mendelson, M.D.

David Mendelson, M.D.

According to Dr. Mendelson, image sharing is essential to give physicians the benefit of historical exams, counteract the growing cost of healthcare, reduce radiation exposure, and expedite clinical care.

Dr. Mendelson likened image sharing to financial institutions. "It's like a banking model for moving images instead of money. You use tokens, a card, a password—and money moves in a matter of seconds," he said.

An effective image sharing network should operate in much the same way, acting as a clearinghouse using IHE standards that moves images over the Web, accessible with a token or password.

Angela Lianos, director of eHealth Ontario, said Ontario is already building an electronic health record and has established four imaging repositories. Currently all major public hospitals have integrated with the system and many digitally enabled private, for-profit clinics that perform digital imaging are coming on board as well.

"The doctors are seeing the benefits of increased response time and reduced number of exams," Lianos said.

Last year alone, 12.5 million exams were loaded into the system, bringing the total to 62 million exams in storage. In this first phase of release, the emphasis is only on loading diagnostic reports through Web portals, with image loading set to begin in 2016.

"A journey, not a destination"

Key elements for developing such a network, according to Mariann Yeager, CEO of The Sequoia Project, an independent convener of industry and government with the purpose to advance interoperability in the U.S., include specifications, best practices, and policies, as well as testing and interoperability.

"Interoperability is a journey, not a destination," she said. "It took the financial services industry 20 years to do it, but the U.S. government thinks it can happen for healthcare in three."

Since 2007, The Sequoia Project has operated the eHealth Exchange, facilitating the sharing of health information. That knowledge will assist in Sequoia's new partnership with RSNA for the Image Share Validation Program.

The Image Share Validation Program was created for vendors of Reporting Systems, Radiological Information System (RIS) and PACS that wish to enable those systems to connect to networks for sharing images with providers and patients, or vendors of health information exchange systems that wish to enhance their systems to exchange medical images and reports.

Starting with a pilot testing program in 2016, RSNA will conduct validation testing of commercial systems for image sharing capabilities based on IHE profiles with the support of the Mallinckrodt Institute of Radiology at Washington University, St. Louis, and The Sequoia Project. Vendors who successfully pass the testing program will be awarded the right to use the RSNA Image Share Validation mark to convey to purchasers that their products have achieved compliance with the capabilities tested in the program.

For the initial pilot program, RSNA will offer validation of four bundles of functionality, based on IHE profiles and actors. These include XDS-I (cross-enterprise document sharing) Document Source and Consumer, XDS-I Registry and Repository, XCA-I (cross-community access for imaging) Gateway and Patient-focused Image Sharing through a personal health record (PHR) system. Test participants can choose to be tested for any combination of bundles.

For more information, visit the IHE Image Sharing Demonstration site in South Building, Hall A, Booth 1345.

Question of the Day:

I want to change the MR imaging parameters for a new protocol based on a research paper I read, but the console says the SAR is too high. What is SAR?

Tip of the day:

Patients who have many follow-up head CTs should be assessed for dose to the eyes as they swiftly become at risk for cataracts.

The RSNA 2015 Daily Bulletin is owned and published by the Radiological Society of North America, Inc., 820 Jorie Blvd., Oak Brook, IL 60523.