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ReadsforRads is Working to Democratize Radiology

Posted on December 14, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

At the RSNA 2016 conference, Healthcare Scene learned about a new platform for radiologists that’s looking to democratize radiology. This new platform is called ReadsforRads. In our conversation with Dr. Phillip A. Templeton, Chief Medical Officer at ReadsforRads, we learned more about ReadsforRads and their mission to democratize radiology. I love the approach they’re taking to make radiology better for both radiology departments and imaging centers. Plus, doing so will ultimate benefit the patients the most.

To learn more about ReadsforRads and the way they benefit the health system, radiologists, and patients, check out our video interview with Dr. Templeton below:

No doubt ReadsforRads has some challenges as they work to scale their platform, but I was impressed by the progress they’ve already made. Their efforts on managing radiologists credentialing was quite interesting. I mentioned the ReadsforRads platform to my radiologist neighbor and his wife instantly said “Yes! Moonlight so we can buy a house.”

While the opportunity for a radiologist to make some extra cash moonlighting is interesting, I was extremely excited about ReadsforRads ability to get the right radiologist reading the radiology image. There are a lot of situations where the radiology image needs to be read by a true expert and that person might be on vacation or small institutions might not be able to afford that type of radiologist expertise in house. ReadsforRads can cover these gaps and make sure the read is done by the most qualified person. That can really benefit all of healthcare.

Bringing EHR Data to Radiologists

Posted on December 2, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the most interesting things I saw at RSNA 2016 in Chicago this week was Philips’ Illumeo. Beside being a really slick radiology interface that they’ve been doing forever, they created a kind of “war room” like dashboard for the patient that included a bunch of data that is brought in from the EHR using FHIR.

When I talked with Yair Briman, General Manager for Healthcare Informatics Solutions and Services at Philips, he talked about the various algorithms and machine learning that goes into the interface that a radiologist sees in Illumeo. As has become an issue in much of healthcare IT, the amount of health data that’s available for a patient is overwhelming. In Illumeo, Philips is working to only present the information that’s needed for the patient at the time that it’s needed.

For example, if I’m working on a head injury, do I want to see the old X-ray from a knee issue you had 20 years ago? Probably not, so that information can be hidden. I may be interested in the problem list from the EHR, but do I really need to know about a cold that happened 10 years ago? Probably not. Notice the probably. The radiologist can still drill down into that other medical history if they want, but this type of smart interface that understands context and hides irrelevant info is something we’re seeing across all of healthcare IT. It’s great to see Philips working on it for radiologists.

While creating a relevant, adaptive interface for radiologists is great, I was fascinated by Philips work pulling in EHR data for the radiologist to see in their native interface. Far too often we only talk about the exchange happening in the other direction. It’s great to see third party applications utilizing data from the EHR.

In my discussion with Yair Briman, he pointed out some interesting data. He commented that Philips manages 135 billion images. For those keeping track at home, that amounts to more than 25 petabytes of data. I don’t think most reading this understand how large a petabyte of data really is. Check out this article to get an idea. Long story short: that’s a lot of data.

How much data is in every EHR? Maybe one petabyte? This is just a guess, but it’s significantly smaller than imaging since most EHR data is text. Ok, so the EHR data is probably 100 terabytes of text and 900 terabytes of scanned faxes. (Sorry, I couldn’t help but take a swipe at faxes) Regardless, this pales in comparison to the size of radiology data. With this difference in mind, should we stop thinking about trying to pull the radiology data into the EHR and start spending more time on how to pull the EHR data into a PACS viewer?

What was also great about the Philips product I saw was that it had a really slick browser based HTML 5 viewer for radiology images. Certainly this is a great way to send radiology images to a referring physician, but it also pointed to the opportunity to link all of these radiology images from the EHR. The reality is that most doctors don’t need all the radiology images in the EHR. However, if they had an easy link to access the radiology images in a browser when they did need it, that would be a powerful thing. In fact, I think many of the advanced EHR implementations have or are working on this type of integration.

Of course, we shouldn’t just stop with physicians. How about linking all your radiology images from the patient portal as well? It’s nice when they hand you a DVD of your radiology images. It would be much nicer to be able to easily access them anytime and from anywhere through the patient portal. The great part is, the technology to make this happen is there. Now we just need to implement it and open the kimono to patients.

All in all, I love that Philips is bringing the EHR data to the radiologists. That context can really improve healthcare. I also love that they’re working to make the interface smarter by removing data that’s irrelevant to the specific context being worked on. I also can’t wait until they make all of this imaging data available to patients.

Olympic Polyclinics – the Future of Healthcare?

Posted on August 19, 2016 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung

The first Olympic Village was built in Los Angeles In 1932. To help ensure the health and safety of athletes, a small hospital was built in the Village and provided care free of charge to the athletes.

Since 1932, every Olympic Village has featured a dedicated 24-hour healthcare facility – now called the Olympic Polyclinic – that provides free healthcare to anyone involved with the Olympics. The Polyclinic at this year’s Games in Rio de Janeiro is once again a marvel of modern medicine, much like the one at 2012’s London Games represented the pinnacle of medicine four years ago.

At 3,500 sq ft, the Rio Polyclinic is the largest ever constructed. It features a state-of-the-art equipment including: MRI scanners, x-ray machines and even cryotherapy pools (for low temperature treatments). All the equipment and the EHR that holds it all together is donated by Olympic sponsors. The staff are all volunteers.

I find the Polyclinics fascinating and the more I read about them, the more I am convinced they are a providing us a glimpse into the future of healthcare.

Health-Aware Patients

The doctors and nurses at the Polyclinics see some of the most health-aware patients on the planet. Olympic athletes track everything from their diet to their sleep patterns to resting heart rates. When they show up at the Polyclinic they often have a very good idea of what is wrong and come armed with lots of baseline health data. The Polyclinic staff expect this and collaborate with their patients when they walk in the door.

As more and more people track their fitness through apps and trackers, we too are becoming more and more health-aware as patients. In the future we will have a lot of digital information about our own health – information that can and should be shared with our care team. Physician practices will have to learn to collaborate as the Polyclinic staff have learned – or they risk alienating potential health-aware patients.

Health-Abstaining Patients

The Olympic Polyclinics also see patients that are at the complete opposite end of the spectrum. For many athletes (and support staff) from developing countries, the Polyclinics are the only opportunity they have to receive quality healthcare.

According to a piece in USA Today the MRI suite, x-ray machines and ultrasound machines at the Rio Polyclinic has been running non-stop. In addition, the Polyclinic has provided:

  • 1,000 dental checks
  • 450 dental x-rays
  • 300 specialized mouth guards
  • 1,730 eye exams
  • 1,410 sets of prescription glasses

…and it’s only the mid-point of the Games.

Due to lack of access and high cost, many Olympians are forced to forgo medical care. This is the same phenomenon that is happening in the United States as high deductible plans and increasing healthcare costs are forcing many to abstain from seeking care. Because of this, staff will see more and more patients with higher and higher acuities – something that the Polyclinic staff see often at the Games.

Completely Autonomous

The Polyclinics are self-contained healthcare facilities. They have an onsite lab, a full imaging suite and a full staff of specialists. It takes less than an hour to get blood test results and image readings. Short of major surgeries, the Polyclinics can handle most patient needs without need to refer them to another facility.

This one-stop approach is what patients want. They want to go to a single nearby facility and have access to all the specialists and equipment they need. It would be impractical to build Polyclinics in every rural town, but through the magic of telemedicine, it may one day be possible to access needed specialists without having to drive hundreds of miles.

With the advances in remote testing and telemedicine coupled with patient preference for one-stop shopping I expect to see more multi-specialty, completely autonomous clinics open in the next few years.

Culturally Aware

Being in the middle of Olympic Village, the staff at the Polyclinics have to be very culturally aware. Instead of insisting on a “Western Approach”, doctors and nurses are encouraged to listen to the patient and take into consideration their religion as well as cultural norms.

It will not be long until smart healthcare organizations realize that catering to cultural differences in their communities is a differentiator. The same has happened in the grocery industry with the rise of halal meats and ethnic food aisles. Being culturally aware will attract more patients.

Admittedly, the Polyclinics, like the Olympic Games themselves, exist within their own reality bubble. There is little concern over finances, there is no shortage of clinicians, they have a completely captive audience and they don’t have to care for their patients for more than two weeks.

Despite this, I see the Polyclinics as a barometer of things to come – especially in terms of the types of patients they see. It’s going to be fun to read more stories from the Polyclinic after the Rio Games end. Now back to watching synchronized swimming.

For an insider look at life inside the Polyclinic, I would highly recommend this post from Trisha Greenhalgh who documented her experience at the London Games Polyclinic in 2012.

Creating Alliances with Large Health IT Vendors – Benefits and Challenges

Posted on June 13, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare Scene recently sat down with Nancy Hannan, Philips Relationship Director at Augusta University Health System (formerly known as Georgia Regents) to talk about their alliance with Philips Healthcare and the impact it’s had on their healthcare organization.

Along with talking about the benefits and challenges of creating a long term contract with a healthcare IT vendor, we also dive into the details of how medical device standardization has impacted their organization. Not to be left out, we also talk about how this relationship has impacted patients and doctors. If your organization is looking at how to standardize your medical equipment, this interview will give you some insight into creating a long term alliance with your vendor.

In the second part of my interview with Nancy Hannan, Philips Relationship Director at Augusta University Health System (formerly known as Georgia Regents) we discuss how they’re taking the lessons learned from the Philips alliance and applying them to their agreement with Cerner. We also talk about how cybersecurity is better having a vendor representative on site like they have with Philips.

A Complete Patient Record and You

Posted on March 9, 2016 I Written By

The following is a guest blog post by Erin Wold, Account Based Marketing Program Manager at Hitachi Data Systems. You can follow Erin on Twitter: @ErinEWold
Erin Wold
So we have discussed the first steps to getting an enterprise imaging facility but what does this and a complete patient record mean for the average patient? If I were to stop someone walking down Las Vegas Blvd (I would shoot for the more sober hours) and ask them “Who owns your medical records?” I am sure I would get the same look and response over and over. The look of confusion and the response of “my doctor’s office?”  This is exactly what enterprise data sharing is set out to change.

A complete patient record for the patient means that a patient can go from their primary care physician to sub specialist without having to call ahead and have their records faxed over. It means that in the case of an emergency room visit they don’t have to worry about leaving with paperwork and getting it back to their primary care physician. It means their records follow them to whatever doctor they (or their insurance) choose.

For example, a couple weeks ago I won myself a trip to the emergency room after cutting a chunk out of my hand while slicing vegetables on a mandolin. (OUCH!) Not knowing my experience in healthcare IT, the resident, who came in first, was checking off all the boxes and asked “do you have a primary care physician?” In my pain ridden and snarky voice I responded “Why does it matter? Your computer can’t talk to hers anyway.” He got a chuckle and said I had a good point and then asked if I was in healthcare. But we have all been there. We have seen one physician only to turn around and have to tell the story all over again with the follow-up care physician because the records just aren’t there.

Not to mention I had pictures of the wound on my phone I had taken right after the incident. My follow-up physician asked that I send her these photos so she could take a look (because she didn’t have access to photos snapped in the ER). I asked her if she could put them into my patient record being my PCP? Her response, “no I don’t have a way to get them uploaded.” Similar to what Alex Towbin, MD, Director of Radiology Informatics at Cincinnati Children’s Hospital, said in his session at HIMSS16, he has multiple pics on his phone and there is nothing wrong security wise with that, but that’s not where the belong.

A complete patient record should include all medical data related to you. This includes images or all kinds whether an X-ray or photo snapped on an iPhone, textual reports (path, lab etc), and even larger data files including genome sequencing data, and digital breast tomosynthesis. I don’t think you would find one physician who would argue that any of your data is unimportant and can be left out.  In the wise words of John Halamaka, MD, CIO of Beth Israel Deaconess Medical Center the next time you ask why your patient record can’t be all in one and they (physicians or IT) respond because there is too much data to store, you should ask them “well how does Google do it then?”

De-silo Health IT

Posted on March 8, 2016 I Written By

The following is a guest blog post by Erin Wold, Account Based Marketing Program Manager at Hitachi Data Systems. You can follow Erin on Twitter: @ErinEWold
Erin Wold
So we have started on the path of enterprise imaging with redefining the EMR, but we can’t stop there. Although, I noticed more familiar faces at HIMSS16, there weren’t enough imaging professionals. We need to de-silo the IT departments within healthcare systems and align them with the strategy that IT is just technology whether it’s radiology, cardiology, mammography etc. The overall IT department should be focused on interoperability and coming together to create a cohesive EMR including enterprise imaging.

Imaging is no longer limited to radiology, yet we still have specific radiology IT staff. This creates more siloes. I have seen it time and time again where the specialty IT departments are at odds with the hospital IT because they want to claim ownership of the data. I can’t blame them though because if something goes wrong with that data they are held responsible. So I don’t blame them, but like redefining the EMR to include all types of data we have to align the IT departments to reflect the whole EMR.

There should no longer be specific departmental IT rather there should be one large IT team with breakout teams that are dedicated to specific departmental (cardiology, radiology, pathology, billing, etc.) software and applications like the PACS or picture archiving system. They should be under the EMR and be tuned into it to create a cohesive team that can complete the patient within the EMR. No more “this is my data and you can’t touch it.” It is now this data belongs to the patient and it needs to be readily available to the patient and all the point of care physicians.

We as vendors and providers need to think of the patient record as the point of documentation rather than each individual department and physician creates their report and then sends it to the referring physician. The patient’s team of physicians and departments where studies and test are completed should be considered team data.

Next time you head into your doctor or head to the ER ask the question: “What is your hospitals standard for sharing?” If they respond with “Well we’ll send you home with a CD or we’ll provide you with a paper print out of a PDF.” RUN and run far away from that place. While a CD may sound like a good idea I am pretty sure you don’t have a DICOM viewer in your basement to view these images. Most likely your point of care physician doesn’t have the same viewer as the images were taken on and what if the CD gets scratched in transfer or even worse lost. If you get my drift, a CD is not the answer. Those images belong in the EMR and so does the radiology software and application support staff.

If you think about it, when you log into an online banking account like Chase you don’t have to log into your mortgage, credit card, savings account, checking account and investment specialists to get all the additional information. You have ONE VIEW of all these accounts as soon as you log in. I don’t know about you, but I consider all my banking information: social security number, credit score, retirement savings as vital as my healthcare information and should be kept as secure. Therefore I see no reason that HIT shouldn’t be aligned more like banking and offer a complete patient record. HIMSS gives us an ideal platform to align all of these departments.

Redefining the EMR

Posted on March 7, 2016 I Written By

The following is a guest blog post by Erin Wold, Account Based Marketing Program Manager at Hitachi Data Systems. You can follow Erin on Twitter: @ErinEWold
Erin Wold
Walking through the HIMSS 2016 exhibit hall, booth after booth I see interoperability this and interoperability that. So I decided to stop and ask the vendors, “When you say interoperability, what do you mean?” Answer after answer I heard, “We integrate with the EMR and other vendors to provide data into the patient record.” When asked to clarify what types of data, the majority mentioned all types of textual data. Never once did anyone respond with images of any sort. I actually got the response of “Why would enterprise imaging be at HIMSS?” when I asked “What about enterprise imaging?”

Here ladies and gentlemen lies our problem. When going to HIMSS vendors and attendees alike aren’t thinking of enterprise imaging for the most part. When you search for sessions, very few pop up when searching for imaging. This year’s HIMSS has seen a few more familiar faces from the imaging scene which is extremely exciting for the future of healthcare and patient engagement.

I was able to sit in on multiple imaging sessions and was lucky enough to go to one that was actually about enterprise imaging but neither were titled or tagged that way in the program. All great sessions with very informative information on why enterprise imaging is a must. It is not only easier for the point of care physician to access the patient record but it will increase patient care and reduce time between study and treatment.

As we move into the era where telemedicine is becoming a reality and anyone can receive care at their corner Walgreens, enterprise imaging is crucial to patient care. How do we get there?  How do we get the EHR gurus to work with the imaging gurus. After sitting through a session led by Alex Towbin, MD, Director of Radiology Informatics at Cincinnati Children’s Hospital; I see how it needs to start.

It started right then and there after he said we must redefine EMR.  We as vendors and providers have defined the EMR as a repository for textual data. We have done ourselves a disservice and we now have to reverse it. The EMR should be a central location where the patients care team can enter ALL data that has been collected on that patient. In essence it should be more like your teenage cousin’s Facebook page where they put everything than your Myspace page from 10 years ago where nothing has been uploaded because you can’t remember the password to gain access.

I was shocked when John Hamlaka, MD, CIO of Beth Israel Deaconess Medical Center, presented that only 50% of pediatric scans are read by the correct sub-specialist. This is in part due to the referring physician, the radiologist and the sub specialist lacking a way to share these scans and therefore the sub-specialist never knew it existed. Enterprise Imaging makes way for this to happen. Other risks that arise because of a lack of enterprise imaging: double exposure to radiation, misdiagnoses, crucial lapse in time between scan and start of treatment, and an incomplete patient record.

A step in the right direction was taken this year at HIMSS by aligning with SIIM or the Society for Imaging Informatics in Medicine and hosting dual sessions as well as a meet-up at the HIMSS Spot. Eighteen months ago they created a coalition of innovative members from both organizations. Moving forward it will take leaders from medical societies: HIMSS, SIIM, RSNA, ACR,  etc. Redefining  is only the beginning. While it seems like a long, hard road ahead we have to start somewhere.

Moving from the Era of Push to the Era of Pull for Healthcare Data

Posted on June 15, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I thought this image and comment were really interesting in the context of healthcare data. Healthcare data has generally been stuck in the push era. I’m excited to see the discussion expanding to the pull era. It’s a very different world when you can just pull the healthcare data you want when you need it. The above conference is from a medical imaging conference. Are they leading the way with pull data in healthcare?