Clinical Imaging Informatics Newsletter - Q1 2016

Clinical Imaging March 2016 Informatics NewsletterDepartment of Clinical Imaging within the resources produces theAga Khan University desired results.Karachi Introduction Extracting “information” from dataInside this Issue and utilizing it for effective Radiology Informatics encompasses operations, planning and research1 Introduction provides an edge that differentiates2 Recent initiatives concepts touching every aspect of the value-driven environments.2 VRS dictation tips computing in a radiology3 New developments environment. The value of imaging3 Insights can be enhanced through seamless4 How technology integration of information technology. The use of support calls are informatics managed? concepts, thinking, design, implementation and analyses will enable patient- centric, evidence based healthcare delivery environment that promotes and enhances patient safety as well as the quality and efficiency of care. Value Addition An Integrated Radiology Informatics adds value to the With such a computationally workings of the department to intensive clinical setting, it is important to aim for an integrated achieve optimal levels of efficiency Radiology environment where all the and quality by utilizing technology and modalities, RIS, PACS, VRS and all information. Using the most related systems are woven together appropriate technology to address into a seamless fabric. Healthcare the requirements while keeping Informatics aims to bring all systems together to provide the best patient care and efficiency of operations.

State of ARDs. Their goal was to determine if the The operating system was upgraded departments were ready for the ongoing for better management and support.Integration transition to value-based health care. In addition to these, the reportingPACS, I.T. Systems Varying Thirty-four (26%) of the 132 members Worklist software was also upgradedIntegration in U.S. Academic responded, representing a broad to provide better functionality thatRadiology Departments spectrum of ARDs in regards to location, not only helps in facilitating the size aspects, year of PACS introduction, reporting process but also improvesAku Clinical Imaging is an integrated and filmless production. The the flexibility in adopting the researchers found that the most notable workflow dynamically so that as theenvironment with the Radiology findings included widespread high-level workflows evolve, theInformation System (RIS), the Image integration of PACS with dictation worklist can dynamicallyrepository platform (PACS) and Voice systems (more than 90%), low adapt to support theRecognition System (VRS) are all tightly penetration of integration between requirements.integrated into an eco-system to provide PACS and critical notification systemsoptimal service. Our core Clinical (15%), and an overall better integration The upgraded VRS system nowImaging systems are integrated in a of PACS and radiology information provides a much improvedmanner to exchange information. All systems (82%) than of PACS and recognition engine that recognizesthese systems are tied together through electronic medical records (47%). various different accents andDynamic Reporting Workflow inflexions and provides a very robustManagement system which is a These results showed that some facility to bring the recognitioncommon interface between all these aspects of integration are going well, accuracy above 95% after a brief initialsystems. The data from these system is such as supporting radiologists’ use.also integrated together to provide an personal productivity, but other aspects,analytical environment which can aid in such as integration between PACS and Although it supports all Englishdata driven decisions and research. critical notification systems are low and accents, the VRS system primarily need improvement.” supports the British English model asA recently published report in the well as well as Indo-Pak voice modelJournal of the American College of Voice Recognition System for better recognition. Even thoughRadiology lists the state of integration Upgraded the U.S. English model is not availablebetween various systems in U.S. outside U.S., but the system providesacademic radiology departments Voice Recognition System was equally good recognition accuracy for(ARDs). Following are excerpts from the this as well.report (source: Diagnostic Imaging) upgraded in the first quarter 2016. Taking advantage of this opportunity, The system front-end interface hasI“ ntegration between PACS and U.S. the upgrade of the system was also changed and is much more accompanied by an upgrade of the organized and well laid out. The Auto-academic radiology departments (ARDs) reporting environment as well. text feature is more powerful andis advancing, but there is still room for simple.improvement in some areas, according Changes were made to theto an article published in the Journal of workstation hardware where more The overall upgrade now offers betterthe American College of Radiology. powerful desktops were introduced. utilization of these services to improve productivity.Researchers from Case Western Internal memory of the workstationsReserve University and University was expanded to handle the display ofHospitals Case Medical Center in large series.Cleveland, OH, conducted an onlinecross-sectional survey of members ofthe Society of Chairs of AcademicRadiology Departments to investigatethe state of integration between PACSand other IT systems relevant toradiologists’ routine work across U.S.

Optimizations – Value of VRS Dictation TipsInformatics Follow these guidelines to improve the way your speech is recognized whileOptimizations in radiology workflows dictating:as well as the processes of data  Speak in continuous phrases. Using this approach provides contextual cluesacquisition, visualization and about what you said and helps the software choose between homophones like “:”reporting have a positive impact on the punctuation mark, and “colon” the body part.productivity. There has been a  Speak naturally at your normal rate, not too quickly or too slowly.precipitous rise in the number of CT,  Do not Dictate. Only. One. Word. At. A. Time.MRI exams, etc. cases over the years.  Fast dictation is acceptable as long as the words are spoken clearly and notWithin limited resources, informatics slurred.helps in managing the productivity  Avoid clearing your throat and yawning while you are dictating. Do not talkdespite high volumes. through a yawn or when you clear your throat; please stop dictating.  Eliminate utterances (urs, ahs, coughing) and similar sounds.To get an idea of the impact, consider  Speak naturally, without pausing between words.a hypothetical example where a  Speak at a normal rate. If you speak too quickly or slowly, PowerScriberadiologist reads about 20 studies per Workstation might mis-recognise you.day. With an average of 900 images  Pronounce words as you normally do. Do not over enunciate.per study and having 3 planes and 3  Be careful not to let your voice drop when you say small words such as the,window/level settings, with a current that, a, or an.and a previous study, that’s a total of  When pronouncing the word a, pronounce it as in say, rather than as in uh.0.32 million images. The radiologist  Speak as you would to someone sitting across a desk from you. Do not speakwould have to look at 3.75 images persecond for 24 hours without eating or too loudly or too softly.sleeping in order to be able to keep upwith that number. (Eliot L. Siegel , their functionality available from any Adapt to Specialty based or ServiceApplied Radiology) Informatics helps workstation, these resources can be Line based reporting model wherein managing advanced visualizations setup so that one does not need to studies can be assigned to Specialtyas well as in reinventing ways to look physically sit at the console. groups or Service Line basedat the information and report in a reporting teams and the team cancomprehensive manner with full Reporting Worklist then view their group bin to pick upadherence to quality; all that in a studies for reporting.limited resource, high volume patient The Reporting worklist has beencare environment. Individual user based study upgraded to provide better assignment model where studies canAccessing VIMS and MIRADA from functionality as well as provide the be assigned to individual radiologistsanywhere in Radiology flexibility to adapt the system for reporting. The Radiologists can dynamically to support variousRadiology has limited licenses for reporting workflows. The next version will have more functionsVIMS and Mirada. In order to have added to it to provide an optimal, integrated reporting environment. Some of the features will be:

view their individual bin to report the Insights Data Miningassigned studies. Where Radiology Informatics deals A birds-eye view of the informationUsers can view the time elapsed sincethe study was received in PACS and with the various computing aspects of and the ability to dig down into thecan prioritize their reporting. radiology systems, the data details and view information in management part is also a very relation to variousUsers can filter out studies based on important function. The huge volume criteria provides atheir workflow requirements. The rich miningfiltration can be done on Stat studies, of data hides environment.study source (ER, OSR, etc.), age important piecesgroup. of information Analytics and knowledgeRadiologists can mark studies that that can help in Extracting hidden trends andthey have reviewed and have so far operations, research, financialnot drafted or finalized them. This planning, etc.. The newsletter will also information in the volumes of datainformation then appears along with contain the initiatives to organize the and to view information in relation toeach study so that others may be able huge datasets, turn data into various different business dimensionsto see if a study has already been meaningful builds up an effective analyticsreviewed even though its status may environment.still be undrafted. It will also facilitate Information, building dynamicin identifying the radiologist who had dashboards and the use of data Information – as it happens in realreviewed the study whenever a mining and analytics for delivering timephysician needs to consult on it. value. The entire environment enablesTo facilitate acquisition of images of Data Repositoryinterest during reporting, a facility has utilization of information in real timebeen added to capture an image from The key foundation for effective through updated reports, dashboards,the workstation’s monitors and can emails, web pages, etc.launch and imbed the image into information management is a central This is a significantPowerPoint right from the Worklist data repository with semantically paradigm shift andinterface. linked data from all relevant Radiology makes information systems. Millions of data pieces reside actionable and increases its intrinsicDirect links to StatDx and RadPrimer here and can be extracted based on value for better patient care,have been added to launch them from various user efficiency and optimization.within the Worklist environment. defined criteria.An extensive list of resources havebeen added for quick reference during From Data to Information tothe reporting process. 57 resource Knowledgelinks like Radiopolis, Radiopedia, ARRSGold Miner, Radiology Atlases and Determining the requirements,multiple Radiology Journals areavailable. planning effective data models and then extracting meaningful information holds the key towards knowledge management.