Frectally speaking

Imaging and Health IT.

Imaging has been relatively quietly revolutionizing internationally. We are now largely a film-less speciality, the equivalent of paperless for those more focussed on EPR. Picture archiving and communication systems (PACS) progressed intra- and extra- hospital interconnectivity and our dark rooms have been transported to the clouds for all our colleagues and patients to access. It has challenged how we work and made us change, mostly for the better and for the betterment of our charges.
The next IT step is fascinating and was reflected in this week’s European Congress of Radiology (ECR) in Vienna. The buzz words were ‘Big Data’ and ‘Clinical Decision Support (CDS)’. It was clear, to me at least, that these phrases are about to enter our vernacular just as PACS did so many years ago.

Big data or ‘fingerprinting’ is essentially about moving from the traditional qualitative radiologic interpretation to quantitative assessment of images to provide a more objective bio-maker for disease states and their natural history and response to therapies. This data would feed into the other data points in a particular patient and personalize their disease and its management. If you believe it, cancer will be a particularly big winner here.

CDS, as I understood it, is about applying IT to practice leaner imaging. The world acknowledges the growth in demand for imaging diagnostics is unsustainable and it is only a matter of time before the wheels come off. 30% inappropriate examinations were quoted. In the US use of these tools is becoming a federal law. Insurers are begining to accept their criteria a substitute for their own. Dr. F Sardanelli of Italy explained the fundamentals of CDS, Dr. MGM Hunik of Rotterdam gave the European perspective, Dr GBoland of Harvard gave us his experience and Dr P Mildenberger explored the added value.
In the context of the revised Euratom Basic Safety Standards Directive, this years launch of the ESR iGuide to address imaging utilization is very timely.
It’s about evidence-based practice, it’s about appropriateness, it’s about our responsibility to the payers and at the end of the day it is all about the patients.
Radiology has always been IT-intensive, PACS has led the way in imaging IT innovation and now it is moving into a novel and exciting space which seeks to harness and manage a precious resource for the benefit of all.