Radiology Information Technology Research Articles

Emergence of teleradiology, PACS, and other radiology IT solutions in Acta Radiologica.

For this historical review, we searched a database containing all the articles published in Acta Radiologica during its 100-year history to find those on the use of information technology (IT) in radiology. After reading the full texts, we selected the presented articles according to major radiology IT domains such as teleradiology, picture archiving and communication systems, image processing, image analysis, and computer-aided diagnostics in order to describe the development as it appeared in the journal. Publications generally follow IT megatrends, but because the contents of Acta Radiologica are mainly clinically oriented, some technology achievements appear later than they do in journals discussing mainly imaging informatics topics.

The 2017 ACR Workforce Survey: Management Trends and Strategic Needs

The 2017 ACR Workforce Survey included questions for group leaders about management trends and areas in which they need more help from the ACR. Respondents identified point of care ultrasound as the area in which they need the most help. Most respondents gave positive or neutral answers regarding their role in the management of radiology allied health professionals and radiology information technology, and most believed their role and influence in decision making in the organization were not decreasing.

Evidence-based Practice of Radiology

Current health care reform in the United States is producing a shift in radiology practice from the traditional volume-based role of performing and interpreting a large number of examinations to providing a more affordable and higher-quality service centered on patient outcomes, which is described as a value-based approach to the provision of health care services. In the 1990 s, evidence-based medicine was defined as the integration of current best evidence with clinical expertise and patient values. When these methods are applied outside internal medicine, the process is called evidence-based practice (EBP). EBP facilitates understanding, interpretation, and application of the best current evidence into radiology practice, which optimizes patient care. It has been incorporated into "Practice-based Learning and Improvement" and "Systems-based Practice," which are two of the six core resident competencies of the Accreditation Council for Graduate Medical Education and two of the 12 American Board of Radiology milestones for diagnostic radiology. Noninterpretive skills, such as systems-based practice, are also formally assessed in the "Quality and Safety" section of the American Board of Radiology Core and Certifying examinations. This article describes (a) the EBP framework, with particular focus on its relevance to the American Board of Radiology certification and maintenance of certification curricula; (b) how EBP can be integrated into a residency program; and (c) the current value and likely place of EBP in the radiology information technology infrastructure. Online supplemental material is available for this article.

Radiology IT: Applications Integration vs. Consolidation

The question of whether Radiology IT systems should be composed of multiple applications integrated using standard data exchange protocols, such as DICOM and HL7, or implemented using consolidation of applications and systems has been debated for the past 30years. The adequacy of the former approach has become a burning issue because the demands on Radiology IT systems have increased greatly. We report here on the experience of the Radiology Information Technology (IT) implementation at the Memorial Sloan-Kettering Cancer Center (MSKCC) over the past 11years; during this time, the weekly image accumulation rate increased from 100,000 to 2,000,000 images. During the implementation period, major difficulties were encountered, largely as a result of the inadequacies of the Radiology IT architecture widely used in the healthcare industry. The approach we chose to correct some of these difficulties has been consolidation of some of the multiple systems and applications. Three examples of systems consolidation are discussed: (1) converting a dual-tier image storage system to a single tier, (2) consolidation of Mammography reading into PACS, and (3) enabling 3D visualization and analysis on the PACS workstation. Nevertheless, substantial research and development are needed in order to proceed with more extensive systems consolidation and, thus, a more manageable IT installation.

Should Radiology IT be Owned by the Chief Information Officer?

Considerable debate within the medical community has focused on the optimal location of information technology (IT) support groups on the organizational chart. The challenge has been to marry local accountability and physician acceptance of IT with the benefits gained by the economies of scale achieved by centralized knowledge and system best practices. In the picture archiving and communication systems (PACS) industry, a slight shift has recently occurred toward centralized control. Radiology departments, however, have begun to realize that no physicians in any other discipline are as dependent on IT as radiologists are on their PACS. The potential strengths and weaknesses of centralized control of the PACS is the topic of discussion for this month’s Point/Counterpoint.

Proactively Monitoring Departmental Clinical IT Systems with an Open Source Availability System

The goal of all radiology information technology (IT) support organizations is excellent customer service through the availability of critical clinical information services, such as picture archiving communication systems and radiology information systems. Despite these goals, IT support personnel often act like firefighters, reacting to each problem, but unable to prevent or predict other problems. Proactive support is always more desirable than reactive support. Warning signs may exist well before a technical issue becomes system wide or the user is affected. The objective for IT support organizations in health care should be to maximize system uptime by using proactive monitoring systems for failures and to automatically detect failures through systems management tools. We report on the implementation of Nagios, an open source monitoring tool, as an availability management system in a diagnostic imaging department and on customized applications and protocols specific to radiology needs.

Audit in radiology

A review of the Audit Commission report on radiology, Improving Your Image, is given. The impact on radiology information technology (IT) strategies and quality within the National Health Service (NHS) are considered.