|
UPMC's Rasu Shrestha, MD, MBA:
Improving the Value Proposition of Imaging Informatics
By Cheryl Proval
The University of Pittsburgh Medical Center (UPMC), with 20 affiliated hospitals and 30 imaging centers in western Pennsylvania, could be seen as ground zero in the effort to digitize medicine. From its innovative financial and development partnership with IBM to a recently announced pact with Google to develop a personal electronic health record (EHR), UPMC is blazing multiple trails for electronic communications in medicine. Radinformatics recently discussed the value of imaging informatics in medicine with Rasu Shrestha, MD, MBA, medical director of digital imaging informatics at UPMC, radiologist, and the steward of imaging informatics across disciplines, as well as the enterprise.
Radinformatics: As a radiologist and the medical director of informatics in one of the nation's most wired hospitals, does radiology get better than average support, or is it fighting just as hard for resources as everyone else? Describe radiology's relationship with information services.
Shrestha: We believe in the policy—or the reality—that there is one bucket. You might take out resources from one place and put them in another, but at the end of the day, it does go back to that one bucket. What is definitely true is that bettering health care starts with first having the right infrastructure and the right tools in place. Overall, whether in the clinical departments or information services division, we are a driven bunch of folks. The relationship between radiology (and any of the other -ologies) and information services is extremely complementary, and it is structured for efficiency and innovation.
I am charged with strategizing for all of digital imaging informatics, including radiology, cardiology, pathology, ophthalmology, and any other -ology that entails imaging, which could mean otorhinolaryngology, gastroenterology, and wound care. It's fairly unique and focused, as opposed to having fiefdoms across the board. The idea here is to have more of a unified strategy for digital imaging.
[Click here for more] | [Return to TOC]
Academic PACS: It's Not Elementary, Watson
By Cat Vasko
In the late 1990s, Yale School of Medicine, New Haven, Connecticut, implemented its first PACS. James Brink, MD, chair of the department of radiology and professor of diagnostic radiology, recalls how radiologists initially adapted to the brave new digital world: "It took some of the more senior radiologists a while to get used to using a cine display," he says. "There's no difference in the way we read anymore, but when we first got PACS, some of our radiologists continued to use a tile display on the workstation so they could read the images the same way they'd been done on film."
Yale's radiology department is on its second PACS, having switched to the Synapse platform from FUJIFILM Medical Systems USA in the early 2000s, and the technology plays an important role in both teaching and research for the 50-radiologist institution. Brink explains that ready access to prior studies for comparison is critical in instructing trainees in the rigors of good clinical work. "I always marvel at how much better our access to comparison exams is with PACS than without," he says.
“Access to prior studies is important for accurate results. It's good clinical care to take that Sherlock Holmes approach to every case: You have to look for clues, and PACS allows you to find more clues, more quickly.”
—James Brink, MD, chair
Yale School of Medicine
In an academic institution, the ability to identify and catalog teaching cases for trainees is critical. Yale's PACS includes a flexible DICOM export tool that makes it easier to link to an electronic teaching file, Brink notes, and FUJIFILM is in the process of developing a conferencing tool to assist in radiologist training. Though the department reads about 415,000 exams annually, Brink explains that cases for teaching must fit specific criteria. He says, "They have to show the findings of interest quite clearly. If they're about anatomy, they need to show that quite clearly; for pathology, same thing. We know from being medical educators the topics and issues that are poorly understood or illustrated and need to be highlighted."
[Click here for more] | [Return to TOC]
Improving Health Care:
There Are Apps for That
By Cheryl Proval
If Dan Hesse had told you, 25 years ago, that you'd be reviewing studies, monitoring patients, and communicating with referrers using Maxwell Smart's shoe phone, you would have thought him delirious. With today's smart phones in play, the pitch from Sprint's CEO did not sound like science fiction.
Addressing an audience of health—care IT practitioners at the annual Health Information and Management Systems Society meeting in Atlanta, Georgia, on March 1, Hesse predicted a coming revolution in wireless communications in medicine. "We believe that there is a historic opportunity for wireless to transform health care by boosting efficiency, raising quality, and reducing costs," he says, but he makes it clear that this will only happen through partnering with health-care providers.
Hesse recently made a presentation to top government officials at the White House on how wireless technology is increasing productivity, reducing costs, boosting customer satisfaction, and increasing competitiveness in manufacturing, transportation, professional services, and government. He identifies health care, however, as the sector with the greatest gap between the need for change and the adoption of wireless technology to support that change.
[Click here for more] | [Return to TOC]
|
