ABII exam results in 65 new CIIPs

Sixty-five candidates are now certified imaging informatics professionals (CIIP) after passing the American Board of Imaging Informatics (ABII) exam in September.

The pass rate for first-time candidates was 89.2 percent compared with 87.2 percent for the five previous exams, which ABII began administering in 2007.

Of the candidates who took the exam, three tested in Canada, one (a resident of Saudi Arabia) in Hong Kong, one in Mumbai, India, and the rest in the United States (including two in Puerto Rico).

According to the ABII, there are now 477 CIIPs. The exam tests candidates in several areas, including imaging management, health IT, operations, communications, systems management, clinical engineering, medical informatics, procurement, project management and training and education.

Ramblings: My SIM card went dead (and why it relates to health informatics)

I’d like to share something interesting that happened to me last week – my SIM card went dead all of a sudden (while I was using the phone).

Now my first reaction when that happened was – the phone is faulty and for the record, it’s a brand new phone (My Dopod was functioning fine but the battery is so old that it can no longer last for more than 1/2 a day so I got myself a new phone) and I did what any self-respecting techie will do – try to troubleshoot.

I tested my faulty SIM card with my 2 other mobile phones – didn’t work, I tested my wife’s SIM card with my phone – worked fine. So it was obvious, my SIM card malfunction in the midst of its usage and I had no choice but the wait till the next day to visit the service center to get it replaced.

My visit to the service (for this purpose) was;

1. Time consuming as I had to forgo my lunch, drive to the nearest service centre, queue and wait for quite a fair bit
2. Non-informative as the customer service representative didn’t provide a reason for why the SIM card fail (but he was not even remotely surprised so I suspect this happens quite often)

Now, what does this have to do with health informatics?

Well to reconstruct this scenario in the world of let say, medical imaging informatics;

1. A technical error occurred, the first thing that the end-user will think that the fault lies with the PACS solution, however, it could easily be due to the network, hospital’s HIS, modality, other hardware component failures, anti-virus, firewall  etc. The PACS itself could be functioning properly but it will get the ‘blame’ as it is the main component that the end-user is facing when an error occurs
2. Now it would be unreasonable to expect clinical end-user to perform troubleshooting when an error occurs but simple troubleshooting (e.g. Ping) by supporting staff (maybe the rad-tech) can help quickly narrow the error source
3. Most solution providers / PACS Administrators do not provide the necessary education / information update to the end-user. It is beneficial to have the end-users be informed on what exactly happened, how it was fixed and what could be done to prevent it (e.g. end-user related error) but of course, use non-technical language
4. There is also expectation management, stuff like SIM cards have a lifespan, so does other hardware components like batteries. In the example of medical imaging informatics again, stuff like monitors, keyboard, pointing devices etc have life span too. Things breakdown, set proper expectations to your end-users.
5. Backup Backup Backup. There are some components in your PACS solution that does not have a high availability option. Are you prepared to handle the situation when it fails? Have you done your backup?
   (I can buy spare batteries for my phone, keep a spare phone around, backup my SIM card but if my SIM card fails, I’m kind of stuck with ‘a problem’)

Now its much easier to fix a problem with my mobile phone as the technology is much more consumer friendly but when mobile phones were first release, I’m sure most users had problem and blamed the phone (and the service provider) whenever something went wrong. I’m sure health informatics will evolved to where mobile phones are now – consumer friendly enough for the average joe to perform troubleshooting, till then, let’s do our best to educate and set the right expectation

RT: Radiologic science educators report less burnout than RTs

This article from HealthImaging.com discuss about job burnouts for Radiologic Technologists (or Radiographers) and Educators for Radiologic Technologists. I find it very interesting so do enjoy the article (and think about the PACS Administrators – either clinical or technical, and their supporting staff working in the background ensuring that these images are delivered on time, accurately to not only the radiologists for diagnosis but also to the clinicians throughout the hospitals)

“Although radiologic science educators experience less job burnout than practicing radiologic technologists (RTs), there is a significant correlation between health status and burnout levels among the educators, according to survey results released in the July/August issue of Radiologic Technology.

The Maslach Burnout Inventory (MBI) was emailed to 241 members of the Association of Educators in Imaging and Radiologic Sciences. The MBI is designed to measure the three subdimensions of burnout in various occupations. Also, health status and demographic questions were added at the end of the MBI survey. The survey yielded a 62 percent response rate.

Jeffrey B. Killion, PhD, an associate professor at Midwestern State University in Wichita Falls, Texas, and colleagues measured burnout, or a prolonged response to chronic emotional and interpersonal stressors on the job, by three subscales: levels of emotional exhaustion, depersonalization and personal accomplishment.

The authors reported that the “survey’s results were mixed.”

The MBI survey indicated that radiologic science educators experience average levels of emotional exhaustion, low levels of feelings of depersonalization and average levels of feelings about personal accomplishment, when compared with a national norm group and practicing RTs. However, they noted that based on the self-reported health status of the study participants, there seemed to be a strong correlation between those who reported adverse health effects and those experiencing higher burnout levels.

For purposes of the study, the authors defined the ‘adverse health effect’ as the “characteristic that indicates declining health, such as heart disease, hypertension and gastrointestinal problems.” According to the National Institute for Occupational Safety and Health, early warning signs of the health symptoms that indicate job stress include headaches, sleep disturbances, difficulty concentrating, short temper, upset stomach, job dissatisfaction and low morale.

Additionally, radiologic science educators reported that headaches, heartburn and increased blood pressure were the top three conditions that forced them to take medication, the authors said. Moreover, burnout may also affect the quality of education provided by the radiologic science educators.

The authors acknowledged that previous research has shown that educators who have greater job control experience less burnout. They also said that radiologic science education programs are generally small and the faculty members have a great deal of autonomy in their daily work.

“Still, it is important for educators to be aware of their stress levels, which can adversely affect their health,” Killion said.

The authors recommended further research to follow up on why radiologic science educators experience less burnout than practicing RTs. The study also outlined the need for further research on educators experiencing both high- and low-burnout levels to determine if the students’ quality of education is affected, and to help address the health of radiologic science educators and similar groups”

Intel adds to patient monitoring system

I blog about “Intel enters healthcare arena with patient-monitoring device” back on the 14th Sep 2008 and am happy to provide an update (taken from HealthImaging.com).

“Intel has enhanced the Intel Health Guide by adding additional connectivity options to the patient monitoring system.

The system is now available with multiple connectivity options including cable/DSL broadband, cellular wireless and residential phone service.

In-home care and health services organizations such as Providence Life Services in Tinley Park, Ill., Spectrum Medical in Portland, Maine, and ProActive Healthcare in San Jose, Calif., are incorporating the Intel Health Guide into their offerings, according to the Santa Clara, Calif.-based company.

The Intel Health Guide allows healthcare providers to customize care, gather information about the status of their patients and collect and prioritize patient data. The company said that the system engages patients in their own care by providing them with a way to have interaction with their care providers and receive relevant self-care education.”

Makes sense doesn’t it?

Prospective ECG Triggering During Chest CT Cuts Radiation Dose

ECGs and Medical Imaging (especially Ultrasound and General X-ray) are two of the most commonly utilised procedures for health assessment purposes so it comes as no wonder that the two different ‘disciplines’ can come together to cut radiation does during a chest CT procedure.

According to this article from Imaging Economics.com, when non-specific chest pain is being urgently evaluated with whole-chest multi-detector CT, using prospective electrocardiographic (ECG) triggering instead of retrospective ECG gating can reduce the radiation dose by more than 70%.

Interested in findout out more, surf on to Imaging Economics.com for the full article.

Regards

Viewpoint: The Joining of Two Worlds

I chanced upon this really good article titled “Education closes the gap between radiology’s clinical and clerical staffs” By Arturo Hiyagon.

Its a long article so I will not repost it here, you can read it from RT-Image here.

Citing just the abstract – “Learn from someone who has worked on both the clerical and clinical sides of radiology how better patient care and efficient workflow can be attained through increasing the administrative staff’s knowledge and awareness of radiology techniques, procedures, and terms.”

Sounds familiar? It works for PACS Administrators who are not of a radiology background

Siemens Celebrates First Definition AS 20 CT Shipment

According to this article at www.imagingeconomics.com,

“Siemens Healthcare, of Malvern, Pa., has announced the first installation of its SOMATOM® Definition AS (Adaptive Scanner) 20-slice configuration CT system at Center for Diagnostic Imaging of Minneapolis.

According to the company, the SOMATOM Definition AS is the world’s first adaptive CT scanner, adapting to virtually any patient for complete dose protection.

“The installation of the SOMATOM Definition AS 20-slice CT is consistent with our ongoing commitment to provide high-quality images and care to our patients and physicians,” said Patricia Zadra, CDI Regional VP. “In addition to the lower radiation dose patients will receive, the system’s scalability is important to our business operations. We will now be able to easily upgrade our CT capabilities as demand for advanced imaging services in our community grows.”

The SOMATOM Definition AS platform features a new 20-slice configuration, a 31-inch (78 cm) gantry bore, and optional 660 pounds (300 kg) patient weight capacity. Also available in 40-slice, 64-slice, and 128-slice – AS+ configurations, the scanner offers an Adaptive 4D spiral mode, enabling functional imaging with perfusion capabilities of the brain and other organs and an extended coverage of up to 7 cm.”

Adaptive Scanner…. sounds cool to me.

NHS rolls out radiology kit

The NHS Institute for Innovation and Improvement, a special health authority of the National Health Service in England, has sent a new radiology kit to help trusts improve booking processes and reduce waiting times.

Transforming your Radiology Services Kit: Focus on Booking Processes, intends to reduce the long waiting times often caused by a bottleneck in patient pathways as part of diagnostic imaging exams, according to the institute.

Staff can review and assess booking processes by identifying areas for development, including where technological solutions could be used to improve the system, using the kit.

Resource materials were developed following 12 months of research and pilots by the NHS Institute’s Delivering Quality and Value team, according to NHS.

Pharma Sees a Bigger Role for Imaging in Trials

This is an interesting article and I must say, it came in a rather timely manner because I was doing a fair bit of googling on the co-relation of imaging informatics with clinical trials and data management (I see it as the bridge from healthcare informatics to a branch of bioinformatics).

Acquiring medical images is an art form, especially when those images serve as endpoints for clinical trials. So says Kenneth Faulkner, VP of medical imaging for Perceptive Informatics, a subsidiary of PAREXEL. Proper acquisition of images is gaining importance as pharmaceutical and biotechnology sponsors embrace imaging more frequently in the earlier phases of clinical development as a tool for faster separation of the more promising compounds from less hopeful ones.

To expand the role of early imaging in clinical trials, sponsors are engaging multiple investigative sites, and are recognizing the need for those sites to acquire images in a uniform manner. “In a multi-center regulated environment, the most important thing is consistency. We need to have all of the sites doing things the same way so we can guarantee that any difference in response is due to the drug, and not due to differences in procedure,” Faulkner says.

Kenneth FaulknerTo facilitate greater use of standardized imaging practices in early clinical trials, Perceptive (along with its PAREXEL parent) has established a dedicated early phase investigational unit offering streamlined image collection, comprehensive image management, and independent image interpretation by industry experts. The company uses its network of sites and provides them with the necessary training to acquire images uniformly in compliance with protocol. In addition, Perceptive is working actively with the Society for Nuclear Medicine as well as other organizations to establish guidelines for the use of exploratory imaging endpoints, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), in early phase multi-center studies. Standardized training and procedures are critical as sites can acquire images in various ways, making the task of consistent image compilation and interpretation nearly impossible.
As an added quality control measure, sites are tested periodically throughout studies for competency. The company maintains early phase testing sites in the United States, Latin America, South Africa, Europe, and Asia.

The push toward earlier imaging comes with broader use of techniques such as PET, fMRI, and single-photon emission computed tomography (SPECT). Traditionally, these techniques have been the domain of academic medical centers where they have been used in small studies involving a handful of sites, often as few as one or two. As Faulkner explains, “Expanding the use of PET beyond the realm of the academic medical center has been difficult because of challenges involved in standardizing how procedures are done.”

Consistent imaging practices yield results that are increasingly recognized for the value they bring to the clinical development process. First, they can help sponsors make better and faster GO/NO-GO decisions by detecting early clues of safety and efficacy. Taking this step sooner, rather than waiting until later phases to introduce imaging, cuts time and expense from clinical development timelines. Also, reliable imaging results can do more than identify endpoints that comply with guidelines for regulatory submission. They can actually provide a marketing advantage. “To go to market, you may need other endpoints that are not accepted for regulatory approval. For example, a regulatory endpoint for rheumatoid arthritis might be images of painful swollen joints. But there may be early signals using magnetic resonance imaging (MRI), x-ray, even ultrasound that are not for regulatory submission but can detect when that disease is starting before it progresses to the point of irreparable damage,” Faulkner comments.

By the time the patient seeks help for swollen joints, the disease has already progressed to the point that clinicians can do little more than relieve their pain. If it is detected earlier, there might be a chance of reversing the damage. It is this broader use of imaging as a diagnostic tool that is often rooted in clinical trials and eventually reaches patients the world over as it becomes part of routine medical practice.

Radiology IT ownership in the crosshairs

Radiology IT ownership in the crosshairs, now this is one touchy topic.  I touch on this subject at my last 3 talks and while the message was on Enterprise imaging informatics and trends of PACS (which naturally reflects the real world events and trends) where PACS is moving out of radiology and into the hospital enterprise. You cannot imagine that some radiographers actually took offence to that message (even though I also advocate that neither IT nor Radiology /Cardiology/ etc owns PACS – it is a joint ownership) and if I am not mistaken, they are not PACS Administrators (or related support staff).

The original article rationales that given the products of radiology (diagnostic imaging data and reports) are being more widely distributed across the healthcare enterprise, it has arouse debates  within the medical community over which group is best able to administer and maintain radiology IT systems: the radiology department or a centralized IT group. I’ll say that the mix will get more complicated once they get other imaging disciplines like Cardiology, Endoscopy etc etc.

“Today, more compelling reasons support the treatment of PACS as a component of an enterprise strategy that appropriately falls under the chief information officer (CIO) and the IT organization,” wrote George H. Bowers, a principal at the Baltimore-based Health Care Information Consultants, in a point/counterpoint discussion of radiology IT ownership published online before print (April 23) in the Journal of Digital Imaging.

David S. Channin, MD, from the department of radiology at the Feinberg School of Medicine at Northwestern University in Chicago wrote the counterpoint, holding that “radiology is too large, too complex, too valuable, and too dependant on IT to be treated as an ordinary IT customer.”

According to Bowers, the CIO should manage PACS due to the technical complexity of today’s IT environment, which has been steadily migrating from an application-centric approach to an enterprise-wide approach in response to regulatory and economic requirements.

“As PACS technology becomes more pervasive in the organization, it must be centrally managed to avoid duplication of costs and maintain consistency of service,” he noted.

“Channin observed that all radiology processes depend on IT.“ 

“The information systems in imaging are not generic systems; they require specialty knowledge and maintenance skills,” he wrote. “Central IT often operates in system silos. Radiology IT staff must be cross-trained in their systems. It is a fulltime job that does not end when the ‘go-live’ date passes. The systems must be constantly monitored for correct use, upgrades, and optimization.”

Bowers conceded that the priorities of the radiology department and centralized IT will probably never be the same.

“But radiology is only one component in delivering care to the patient,” he wrote. “Coordinating the care of a patient among all of the diagnostic and treatment options in the most efficient and cost-effective manner must be the priority of our healthcare delivery system. Processes that affect patient care may flow between and among many departments. IT has been charged with delivering the EMR, which focuses on the patient—not the hospital department. The patient must be the priority, even if this means compromises elsewhere in the delivery system. What is best for the patient may not necessarily be the best or most efficient for individual departments.”

Channin acknowledged the healthcare enterprise is the key user of a PACS. However, his belief is that information professionals located in the radiology department are the most qualified to administer and deliver data to those users.

“I contend that radiology understands the requirements and needs better than a centralized IT organization,” he wrote. “Enterprise healthcare providers are our customers.”

Citing the leadership role radiology has played in the evolution of the Integrating the Healthcare Enterprise (IHE)—an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information—Channin argued that radiology “can and does serve as a technology exemplar” for other medical specialties.

“The CIO must lead in the support of standards, interoperability, compliance with policies, procedures, and regulations,” he wrote. “He or she should supply intellectual and financial nourishment to let a garden of innovation grow.”