By Cat Vasko
In 2010, the California state legislature passed SB 1237, mandating that health care providers collect and record CT dose information as part of patients’ medical records beginning July 1, 2012. In response, the University of California Center for Health Quality and Innovation funded the US DOSE grant, empowering a working group of radiologists, technologists, and medical physicists to develop standardized CT protocols for the entire UC system—and, potentially, beyond.
 “Simplifying what we do will empower the technologists to maximize their capabilities while minimizing dose, so I think the information will be taken to heart. Data has been our strongest weapon in this particular fight.”
—Rebecca Smith-Bindman, MD
“The broad goal is to organize the reasons patients go for imaging across the different UC sites, and, when they come in with particular clinical questions, to ensure they get the same kind of evaluation,” says Rebecca Smith-Bindman, MD. Smith-Bindman is a professor of radiology and biomedical imaging at UC San Francisco, as well as the DOSE grant’s principal investigator. “How should we ideally image patients who come in with suspected pulmonary embolism? Can we reach a consensus about what we’re trying to get from these diagnostic studies, and how we can do that with the lowest dose?”
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Is your organization working to standardize CT protocols? If so, how?
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By Thomas W. Greeson, JD, and Paul Pitts, JD
  Radiologists and imaging centers are often asked to make the diagnostic studies they perform available to an ordering physician through the physician’s electronic health records (EHR) system. The difficulty in accommodating these requests stems in part from the sheer variety of EHR and RIS/PACS systems. In most circumstances, some type of software interface, and possibly hardware, is required to connect the two systems. Someone has to purchase
this hardware and software, of course.
While it may make good business sense for an imaging center or radiology practice to provide and pay for software upgrades necessary for the RIS/PACS to interface with the EHR or to install hardware, such as viewing stations, in the ordering physician’s office, these types of arrangements can raise significant regulatory issues. Federal and state laws prohibit radiologists and imaging centers from offering referring physicians something of value in return for ordering diagnostic tests. Because software upgrades and computer hardware provide real value to ordering physicians, these types of arrangements should be carefully considered under the relevant federal and state law.
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Have Stark or anti-kickback regulations prevented you from connecting to referrers’ EHRs? #EHRexemption
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By Cat Vasko
 Archiving and accessing medical images is an increasingly complex issue, and one that touches a rapidly growing body of caregivers—which is why cloud-based archiving, in spite of lingering disadvantages, will be the model of the future. That is the prediction of James Philbin, PhD, senior director of medical imaging at Johns Hopkins University, Baltimore, Maryland. Philbin presented his perspective on the future of cloud-based archiving in a June 8 session at the Society for Imaging Informatics in Medicine (SIIM) 2012 meeting entitled “Next Generation Archives: Local vs. Enterprise vs. Cloud; VNA vs. ANV.”
Philbin notes that “cloud” has become something of an all-purpose term. “Whatever you imagine the cloud is, it seems to be,” he says. For medical image archiving and sharing, however, he narrows down the definition to mean CPU and storage virtualization services provided by a third party from a remote infrastructure. Functionally, he observes, there should be little distinguishing a cloud-based archive from one hosted in an on-site datacenter. “The key differentiator for the long term is who is managing the system,” he notes. With that differentiator, however, come critical questions about data control and security.
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What do you find most advantageous about cloud-based archiving of medical images?
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Forbes Q&A: Future of HIT
As part of a series on transforming business, Forbes discusses the evolution of HIT with Pat Blake and Randy Spratt of McKesson.
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Optimizing Protocols for Pediatric CT
A JACR article offers pointers for reducing radiation dose on the estimated seven to eight million pediatric CTs performed annually in the United States.
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Advanced HIT Correlated With Better Outcomes
HIMSS Analytics research reveals that better hospital performance in quality and safety is linked to the use of advanced health IT solutions.
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EHR Use Growing, MU Standards Not Met: Report
While a growing number of California physicians are utilizing EHRs, most of the systems implemented don’t meet meaningful use standards, says a UCSF report.
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Radiology Benchmarks Collaborative
A vendor-neutral, subscription-based service provides a monthly view of radiology performance benchmarked against three peer groups.
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