IMAGING Q&A
The Present and Future of Imaging Informatics
When you look at the current state in the evolution of imaging, what do you see as the greatest challenges, and the greatest opportunities, in the current moment, and in the next five
years? We have started seeing demand for healthcare applications to more widely support cloud- native functions or protocols – especially for medical imaging. To overcome regional limi- tations, such as bandwidth and latency issues, designs will require cloud-native protocols for both on-premises and private or public cloud offerings. This could be as simple as writing locally to an object storage array for produc- tion, with the second copy or tertiary copy being replicated to cloud via Amazon Simple Storage Service, commonly known as S3. This is a challenge for most independent software vendors (ISVs) if their application does not offer native support of these technologies, or if they are not cloud-native applications. We imagine this hybrid storage approach will be on the rise in the coming years, but only where it makes financial sense, meets physi- cian performance requirements, and does not delay patient care.
Are we on the verge of a new way of thinking about image-sharing and accomplishing it? Might the sharing of smaller tranches of image sets be realistically possible, and how might things
be accelerated? ISVs have created many good image sharing platforms. Examples include Ambra Health, LifeImage, Medicom, and several others. However, a fundamental problem still exists – how do you share images across multiple providers or healthcare networks when each provider may have their own image-sharing platform? Most often, there is a single enter- prise-wide image-sharing solution selected, but there are still challenges when data is presented from outside their care network or from a separate image-sharing platform. Some enterprise imaging vendors have native forms of image sharing built into their picture archiving and communication system (PACS) or vendor-neutral archive (VNA) solutions. In the end, healthcare organizations are left deciding on a solution that serves them best
but may not be able to address all areas of sharing. There does not seem to be a single standard that allows all healthcare providers to seamlessly transmit data to one another seamlessly with simplicity and ease.
Enterprise-wide imaging informatics has been evolving forward as a concept, but challenges and obstacles remain. What do you see as the biggest ones, and how will they be
overcome? We are still facing a true lack of standardiza- tion across the healthcare continuum. Even with broad adoption of enterprise imaging, there still exists a gap between how ISVs define enterprise imaging and how provid- ers define it. We have the DICOM standard, but under the application management there is no universal standard on how all data is treated and managed. As application pro- gramming interfaces (APIs) and more pro- gressive interoperability standards evolve, we will get closer to the vision of interoper- ability. In the current market, there are still differences in how to store and process both DICOM and non-DICOM data. For example, can the application store digital pathology image data in native formats and also manage patients’ radiology, cardiology and dermatol- ogy information so that these best-of-breed viewers can consume it directly from the archive (in native formats)?
What will imaging informatics look like in hospitals, medical groups, and health systems, five
years from now? With situations like COVID-19 rapidly accel- erating the adoption of telehealth, I think we will see a surge of image vendors adapting to patient-facing design functions. Healthcare cannot afford to lose the human touch, and that does still exist in medical imaging where physicians need to consult with not just tech- nicians but also directly with patients and referring physicians. When executed properly, we can expand past the creation of “teleradiol- ogy” and move towards “teleimaging” where we will have a unified method to connect both patients and physicians who need to discuss their imaging results. What are the biggest challenges, collectively
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hcinnovationgroup.com | NOVEMBER/DECEMBER 2020 Mark Dobbs
Director, Global Healthcare Alliances, Enterprise Imaging
Pure Storage, Inc.
speaking, facing all vendor organizations in this space, in the coming years? How can ven- dors become more responsive to the needs and expressed desires of clinician and non- clinician leaders in patient care organizations? Data management, interoperability, and
optimizing workflows are challenges that healthcare organizations will continuously face in the future. While enterprise software solutions are becoming more open to integra- tions, or practicing interoperability, there will still be the need for best-of-breed solutions. These solutions (e.g., PACS, image sharing, artificial intelligence) need to solve more than a single requirement and should be capable of addressing future requirements that have yet to be discovered. The vendors who will take the lead are those that are able to con- tinuously release software updates to address new requirements or enhance the physicians experience. The current market and climate really drive home the point that we should focus on patient care and customer experience as the primary driver of change. We know physicians are dealing with burnout, partly attributable to the ongoing sifting through large amounts of data. With the addition of AI, physicians should expect to find some assistance to make use of the data more con- sumable. However the AI “user” will become another data consumer and generator that will need to be served.
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