Using AI in radiology to improve workflow and efficiency

Dario Arfelli is the World Wide Healthcare IT Marketing Manager at Carestream and is based in Genoa, Italy. He has a special interest in supporting market model changes including EHRs, VNAs, Enterprise Imaging and Cloud computing. He analyzes emerging approaches to integrating PACS within an enterprise-wide healthcare IT platform, as well as the VNA approach to centralizing all clinical data storage, management and access and how it all ties back to the future of the EMR/EHR. More recently he has turned his attention to artificial intelligence in medical imaging and how it will likely be integrated into radiology and medical imaging. He recently published an article defining the terms surrounding artificial intelligence for Carestream’s blog. PARCA eNews talked to him by phone.

AI is the hot topic at RSNA 2018 annual meeting

Missed the meeting? Access to Virtual meeting is avail-
able until April 30, 2019. – image courtesy RSNA

PARCA eNews – Nov. 25, 2018 – More than 50,000 radiologists and imaging professionals descended on Chicago’s McCormick Place Nov. 25-30 for the Radiological Society of North America (RSNA) annual meeting. This year the 104th edition of the group’s meeting focused on Tomorrow’s Radiology Today.

In keeping with that theme, one of the hottest topics in terms of the number of presentations and session attendance was all about artificial intelligence and machine learning, with both an AI and Deep Learning Educations centers.

Is health IT about to catch FHIR?

The Health Level Seven (HL7) Fast Healthcare Interoperability Resources, or FHIR, has been anything but fast in terms of adoption. It has been smoldering on the edges since version 1 draft standard 2 was introduced in 2015, but there are signs that version 2 is about to break out into a heat wave.

FDA and DHS increase coordination to medical device cybersecurity threats

Agreement will facilitate information sharing between agencies on vulnerabilities  and threats involving medical devices

PARCA eNews – Oct. 31, 2018 – The U.S. FDA and the U.S. Department of Homeland Security (DHS) announced a memorandum of agreement to implement a new framework for greater coordination and cooperation between the two agencies for addressing cybersecurity in medical devices.

Health Sector Cybersecurity Coordination Center opens

PARCA eNews – Oct. 29, 2018 – The Deputy Secretary of the Department of Health and Human Services (HHS), Eric Hargan, announced today the official dedication of the Health Sector Cybersecurity Coordination Center (HC3) at an official opening ceremony in the Hubert H. Humphrey building.

“HHS is proud to work with the health community to better protect Americans’ health data and confidential information,” Deputy Secretary Hargan said. “Today’s announcement is a recognition of the importance we place on stakeholder engagement as part of our cybersecurity work.”

ONC releases updated SRA tool

PARCA eNews – Oct. 15, 2018 – The Office of the National Coordinator has published a Security Risk Assessment (SRA) tool the help healthcare providers conduct security assessments as required by HIPAA Security Rule and the Centers for Medicare and Medicaid Service (CMS) Electronic Health Record Incentive program.

FDA clears MaxQ AI’s Intracranial Hemorrhage Platform

PARCA eNews – Nov. The FDA granted 510(k) clearance to MaxQ AI’s Accipio Ix intracranial hemorrhage platform.

The device detects intracranial hemorrhage (ICH), or brain bleeding, in adult non-contrast head computed tomography.

Accipio Ix, which received the CE Mark earlier in the year, uses AI algorithms to identify and mark potential regions of interest related to acute ICH.

Researchers are pushing imaging to extraordinary new limits

CMRR director Kamil Ugurbil, Ph.D., 

stands next to the new 10.5T magnet 

photo courtesy of University of Minnesota

10.5-tesla magnets yield unprecedented imaging detail

PARCA eNews – Nov. 15, 2018 – Armed with a magnet weighing 3 times more than a Boeing 737 along with 600 tons of iron shielding, researchers at the University of Minnesota’s Center for Magnetic Resonance research subjected a human subject for the first time to an hour-long imaging study of the patient’s hips.

New York HIE surpasses 1 million participants

PARCA eNews – Oct. 22, 2018 – New York-based HEALTHeLINK, one of the early organizations adopting the Health Information Exchange (HIE) initiative recently reported surpassing the 1 million mark for patients consenting to have their health information exchanged among treating providers.

Integrating point-of-care manufacturing into radiology

Dr. Anish Ghodadra

Dr. Anish Ghodadra is assistant professor of Interventional Radiology at the University of Pittsburgh and Medical Director of the 3D Printing Program at the University of Pittsburgh Medical Center, which established one of the nation’s first in-house 3D print labs in a medical center, producing more than 200 surgical models a year. With a background in engineering Dr. Ghodadra has a focused interest in using medical innovation including medical device design, 3D printing and image analysis to improve clinical care. He was a speaker at RSNA 2016 on the topic of 3D printing quality control and has been a contributor to ABC News Medical Unit. PARCA eNews spoke to Dr. Ghodadra about the integration of 3D printing into radiology, how it impacts the radiologist’s workflow and the role of PACS administrators in 3D printing.

9 ways to reduce your legal exposure to PACS problems

By Herman Oosterwijk, for AuntMinnie.com

Reprinted with permission

September 4, 2018 -- There is general agreement that "medicine can kill" if a patient gets the wrong medication or treatment, or if unnecessary complications result from a medical procedure. However, people might not realize that technology can kill, too -- including PACS technology.

Disaster preparedness, not a question of if, but when

Photo by NOAA

PARCA eNews – Sept. 5, 2018 – What would happen if your PACS system or organization’s IT systems become unavailable or compromised in such a way as to prevent clinicians from getting the imaging data they need to care for patients?

It isn’t really a question of If, it is a question of when? It might be due to a natural disaster, a technical failure, or malicious activity, but at some point your system will be down, but how you prepare for that will make a huge difference in how well your organization gets through such an event.

UK’s NHS launches program to accelerate development of digital health tools

PARCA eNews – Sept. 5, 2018 – The National Health Service for the United Kingdom announced today a program to spur the uptake and spread of proven innovations that can benefit patients, populations and NHS staff through its NHS Innovation Accelerator (NIA).

The program will focus on key NHS priorities including mental health, primary care, and prevention and early intervention in cancer and cardiovascular disease.

Philips warns of cybersecurity vulnerabilities

Image from Philips Press Release

PARCA eNews – Sept. 12, 2018 – Philips Healthcare issued an advisory warning of a potential security vulnerability in its iSite and IntelliSpace PACS products. The company said that while it has received no reports of patient harm, it issued the advisory last spring as a precaution.

Medical imaging among most shared medical information

PARCA eNews – Sept. 2, 2018 – With all the drive over the past decade to get electronic medical records and then make those records shareable among physicians, specialists and other on the patient’s healthcare team, have you ever wondered what patient information is most often shared?

In a report by the Centers for Disease Control published in National Health Statistics Reports, medical imaging is the third most shared medical data among physicians, just behind referrals and laboratory data

ONC 2018 Annual Meeting to focus on interoperability

PARCA eNews – Sept. 22, 2018 – Mark your calendars! ONC’s 2018 Annual Meeting will be held November 29th and 30th in Washington, DC. The agenda will extend the many discussions and topics from an Interoperability Forum, and will feature the ongoing work by the private and public sectors to promote health IT interoperability and usability. ONC will share more information about the agenda, location, and hotel reservations in the near future.

Enterprise Imaging Teams: Who, What, When and How?

Kyle Henson, Director of Enterprise
Imaging

In past issues, PARCA eNews has touched on governance and security of enterprise imaging implementation. In this issue we look at operations. Who is involved in, and how do you run an enterprise imaging organization. Kyle Henson is Director of Enterprise Imaging for a large multi-hospital system in Texas. Kyle’s 17-year career in healthcare IT began after proudly serving as an officer in the U.S. Army. He began in the payor space before quickly transitioning to the imaging sector, where he has spent the past 15 years expanding his knowledge-base from PACS vendor, to imagining consult, to hospitals. These unique work experiences have allowed Kyle to develop a deep industry-encompassing understanding of current issues, trends and successes. His work passion is finding solutions to the industry’s problems (opportunities!) while always keeping a patient-centric focus. He recently wrote a blog post outlining his own approach to building and deploying an enterprise imaging team. PARCA eNews is reprinting his post with permission.

Healthcare data breaches often most costly

PARCA eNews – July 11, 2018 – In an annual study by the Ponemon Institute sponsored by IBM Security the average global cost of data breaches have nudged up in 2018 to $3.86 million compared to $3.62 million in 2017 but still lower than the nearly $4 million figure in 2016. But in the US the cost spiked 5 percent higher at an average of $7.91 million, or and average of about $225 per compromised record, with healthcare breaches costing an average of $408 per record nearly double the $206 per record for the financial services sector. 

MD Anderson to pay $4.3 million in penalties for HIPAA violations

PARCA eNews – June 18, 2018 – A U.S. Department of Health and Human Services Administrative Law Judge (ALJ) has ruled that The University of Texas MD Anderson Cancer Center (MD Anderson) violated the HIPAA Privacy and Security Rules and granted summary judgment to the Office for Civil Rights (OCR) requiring MD Anderson to pay $4,348,000 in civil money penalties to OCR.

ONC outlines steps to improve EHRs for clinicians and patients

PARCA – June 19, 2018 – The transition to electronic health records (EHRs) has engendered frustration among clinicians who expected computers to make their care more efficient, and among their patients who expected timely access to their information and seamlessly coordinated care.

To address these challenges, ONC will continue to work with stakeholders and federal agencies to implement key provisions of the Cures Act. Specifically,

How GDPR applies to medical devices

PARCA eNews – July 5, 2018 – With the European Union’s General Data Protection Regulations (GDPR) going into effect last May, much of the attention has been on its impact on Internet websites and applications that gather personal information, but in terms of medical devices, while the new regulations primarily impact device makers, users of such devices also may need to know how the regulations impact their organizations.

Certified Health IT Product List (CHPL) is online

PARCA eNews – July 10, 2018 – The ONC Certified Health IT Product List better known as CHPL (pronounced “chapel”) is the authoritative, comprehensive listing of health information technology (health IT) products that have been tested and certified under the ONC Health IT Certification Program. 

The current state of interoperability

PARCA eNews – June 18, 2018 – Most data sharing is based on sharing some data fields with contextual integration or sharing view-only document summaries, said Mohannad Hammadeh, a product owner at Orion Health in Aukland New Zealand, in a provocative article on the HiMSS blog. 

California adopts European-style data privacy law

PARCA eNews – June 28, 2018 – Californians for Consumer Privacy applauded the California State Legislature for the successful passage of AB 375 (Chau, Hertzberg, Dodd), which will provide Californians with fundamental new consumer privacy rights.

We are thrilled that AB 375 has become law. This is a monumental achievement for consumers, with California leading the way in creating unprecedented consumer protections for the rest of the nation,” said Alastair Mactaggart, chairman of Californians for Consumer Privacy

Meeting the challenge of continually growing imaging storage requirements

Andrew (A.J.) Braga

It is the nature of the PACS administrator job to be continually focused on storage. After all storage is part of the job title. Over the last decade, advances in imaging technology and storage solutions have put more pressure than ever before on PACS engineers and administrators to stay ahead of storage needs. To get the perspectives of working PACS administrators on the ongoing challenges of storage, PARCA eNews talked with Andrew (A.J.) Braga, PACS and Interfaces Manager and Alex Marmolejos, PACS Engineer at Southwest Diagnostic Imaging (SDI), a group of radiology practices covering the Scottsdale and Phoenix Arizona area.

SDI includes Valley Radiologist, Scottsdale Medical Imaging and East Valley Diagnostic Imaging. Together they operate 32 radiology clinics with a combined volume of 2.3 million images per year. At SDI Andrew Braga manages a team of six PACS professionals and 3 HL7 engineers serving 150 radiologists.

PARCA certification bootcamp prepares S. Africa PACS admins for the future in medical informatics

PARCA and In2pacs bootcamp participants

PARCA eNews – May 24, 2018 – In2pacs Academy, the leading PACS administrator training organization in South Africa hosted a bootcamp with PARCA founder Herman Oosterwijk April 24-26 at the Hotel Verde in Cape Town. The bootcamp was capped by a proctored exam for CPAS certification.

In2pac Academy principal Clive Daniell said the bootcamp was a great success.

“There were 20 candidates who did the bootcamp and 18 wrote the exam,” Daniell said in a Skype interview with PARCA eNews. “Of those, 10 were certified from S. Africa and 1 from Zimbabwe.”

First woman elected to chair American College of Radiology

Dr. Geraldine McGinty

PARCA eNews – May 18, 2018 – The American College of Radiology (ACR) Board of Chancellors has elected Geraldine McGinty, MD, MBA, FACR , as chair. McGinty is the first woman elected chair of the board in the nearly 100-year history of the ACR.

Also elected were Howard B. Fleishon, MD, MMM, FACR, who will serve as vice chair, James A. Brink, MD, FACR, who will serve as president and Marta Hernanz-Schulman, MD, FACR, FAAP, who will serve as vice president. The new officers took office at the ACR 2018 Annual Meeting held in Washington, DC.

Separating the promise from the hype about artificial intelligence in healthcare

Kismet robot – image via creative commons copyright –
via Wikipedia

PARCA eNews – May 28, 2018 – To cut through the hype, assess the potential realistic implications of AI applications in health and healthcare, and understand the risks, the Office of the National Coordinator for Health IT (ONC) and the Agency for Healthcare Research and Quality (AHRQ), with support from the Robert Wood Johnson Foundation, turned to JASON, an independent group of scientists and academics.

Secure API Server Showdown Winner Announced

Winner helped to find security weaknesses in database

PARCA eNews – May 17, 2018 – The Department of Health and Human Service’s Office of the National Coordinator for Health Information Technology (ONC) today announced the Stage 2 winner of the “Secure API Server Showdown” Challenge. Application programming interfaces (APIs) are technology that allow one software program to access the services provided by another software program. The 21st Century Cures Act calls for the development of APIs that do not require “special effort” for developers to access and exchange health information.

Information Commisioner’s Office clarifies GDPR special category data

PARCA eNews – May 28, 2018 – The Information Commissioner’s Office, the UK’s independent body set up to uphold information rights in the public interest, published an explanation about the General Data Protection Regulation (GDPR) that went into effect May 25 in the European Union (EU).

Companies that collect data on citizens in the EU need to comply with the new regulations governing the collection and security of private data, but concerns over what data was considered special category data has been raised.

HiMSS offers free interoperability environmental scan

The Interoperability Environmental Scan offers a range of details about the method of exchange, the stakeholders and processes involved by a variety of organizations addressing interoperability issues. The scan allows users to select and compare different organizations approach to interoperability for a variety of criteria. For example users can compare the interoperability approaches for, say governance and website for Epic’s Care Everywhere to Community HIE.

KLAS report highlights challenges for medical information exchange in UK

PARCA eNews – May 28, 2018 – KLAS the healthcare IT research organization has issued its report on interoperability, data sharing obstacles and progress of the National Health Service (NHS) of the United Kingdom. 

The report looks at the progress made and the remaining challenges in the NHS’s Five-Year Forward program aimed at improving medical information exchange across the NHS. The report examines how well primary, secondary, mental health, community and social care organizations within the NHS are able to receive patient data with regard to electronic data sharing.

Listen: Key to leading successful transition to enterprise imaging

Paul Pierre, president of DYSIS

Paul Pierre is president and owner of DISYS Consulting an independent consulting firm that has been in business almost 25 years. Over the last 15 years, Pierre has focused primarily on Enterprise Medical Imaging. His expertise in medical imaging informatics and project management has helped healthcare clients in Canada and the US through successful major transitions in medical imaging. He started in consulting primarily in system architecture and infrastructure and focused on healthcare. He has a background in networking and infrastructure and document management. When digital imaging came along in the late 90s and early 2000s, he shifted his focus to medical imaging exclusively after that. He recently co-hosted a SIIM webinar “We’re not in Kansas anymore,” about deployment and integration of other clinical specialties into a VNA. PARCA eNews talked to him about the importance of the change-management aspects of making such a transition.

Are you a DICOM expert?

Image used by permission of DICOM Committee

This past month alone, I got three inquiries from high tech imaging companies looking for seasoned DICOM professionals; two are wanted on the east coast (Boston), two in rural Arkansas, and if you like skiing and hiking, there is a vacancy in Boulder, Colorado.

One of these positions does not even require US residency, as they are willing to sponsor a work visa for qualified applicants. 

SIIM 2018 Annual meeting to focus on collaboration

Learning from your mistakes 

PARCA eNews – March 20, 2018 – Learning from others and sharing your own experience is the theme of the SIIM 2018 annual meeting to be held May 31 to June 2 in National Harbor, MD. SIIM is a conglomerate of different members that range from Physicians, Scientists, Students, Residents, Technologists, Vendors, Consultants, IT Engineers and Developers

HiMSS 2018: IT giants jump into to the emerging healthcare IT business

Photo courtesy HiMSS Media Relations image gallery

HIMSS 2018 saw major exhibits by Amazon, Google and Microsoft, as well as other large IT-based companies all looking to stake out a share of the billion dollar healthcare IT market. The significance of that recognition is that at last healthcare IT may become a focus for innovation in terms of using information technology to improve healthcare delivery, rather than having to always adapt technology to the health IT arena.

HiMSS survey shows healthcare cybersecurity gains, but room for improvement remains

Photo courtesy HiMSS 

PARCA eNews – March 10, 2018 – The number and severity of data breaches has reduced year over year, indicating cybersecurity in healthcare is improving, but no one is breathing easier.

According to the Office of Civil Rights, healthcare organizations reported 4.5 million healthcare records compromised in 270 breaches in 2017. That is down substantially from the 16.5 million records breached in 2016 and the 113 million records reported breached in 2015.

Will FHIR replace HL7?

PARCA eNews – Mar. 20, 2018 – At the February HL7 Working Group meeting in New Orleans in February it was difficult to find people still working on HL7 version 2.X development, according to PARCA board member Herman Oosterwijk.

HIMSS Leadership and Workforce survey reveals 5 key findings

PARCA eNEWS – Mar. 10, 2018 – HiMSS released its annual survey of healthcare leaders about information and technology concerns at its annual meeting, held in Las Vegas, March 5-9.

The annual study seeks to find out the top information and technology and informatics concerns of healthcare leaders from hospitals, ambulatory organizations and Long-term and Post-Acute Care facilities, as well as vendors and consultants. 

HIPAA recommends reviewing security checklist

PARCA eNews – March 16, 2018 – HIPAA requires organizations that have access to protected health information must safeguard the security and privacy of that information. The HIPAA Journal has compiled a HIPAA Compliance checklist for 2017-2018.

The list addresses technical, physical and administrative safeguards that organizations should periodically review to ensure they remain compliant with HIPAA regulations.

Data breach: How do you recover?

NIST issues guide for quick recovery and ensuring post-breach integrity

PARCA eNews – March 19, 2018 – Preventing a cybersecurity breach is the goal of all IT security officers, but with the number, range and frequency of attacks, at some point a breach may occur. What do you do when that happens, and more importantly how quickly and completely you can recover can be critical to your organization’s ongoing operations, particularly in healthcare. 

PACS administrators and enterprise imaging governance

Dr. Christopher Roth, M.D., MMCI

Dr. Christopher Roth serves as the Duke Department of Radiology Vice Chair for Health Information Technology and Clinical Informatics, and also as the Director of Imaging Informatics Strategy for Duke Health. He is also a radiologist in Durham, North Carolina, and is affiliated with Duke University. He received his medical degree from University of Michigan Medical School and has been in practice for 8 years. He is one of 205 doctors at Duke University Hospital who specialize in Radiology. In his unique role as a physician leader for assessing and implementing imaging technologies, clinical decision support, image sharing capabilities across North Carolina, he is working to ensure the usability and integrity of the electronic patient record. He was lead author on the joint HiMSS-SIIM work group collaborative white paper on Imaging Governance. PARCA eNews spoke with Dr. Roth by phone about the role of PACS administrators and analysts in enterprise imaging governance.

What is the future of PACS?

by Herman Oosterwijk

Reposted by permission from OTech blog
I get this question a lot, i.e. where is PACS headed? It comes from different professionals, from people who are decision-makers ready to spend another large sum of money for the next generation PACS, or from those who made PACS a career such as PACS administrators who come to my training and want to make sure that their newly acquired skills and/or PACS professional certification will be of use 5 or 10 years from now.

AI, CAD, virtual currency, and robots highlight 2017 RSNA Annual meeting

The annual gathering of more than 54,000 healthcare radiology and imaging professionals Nov. 26 to Dec. 1 in Chicago remains one of the largest such meetings in the world. With more than 600 technical exhibits covering 411,000 sq. ft. of exhibition space, and presentation of 1700 scientific papers, the annual RSNA meeting can overwhelm attendees.

RSNA 2017: Ransomware to grow to $1 billion in 2018

Jim Whitfill, Chief Medical Officer at
Innovation Care Partners

The growing ransomware market was highlighted at RSNA 2017 in a presentation by Jim Whitfill, CMO of Innovation Health Partners. 

In his presentation HealthImaging reporter Cara Livernois says Whitfill projected the ransomeware market to grow to $1billion a year in 2018, up dramatically from $24 million in 2016.

Whitfill called for a increased effort by healthcare IT professionals to prevent another WannaCry ransomware attack. He outlined shortcomings in healthcare and security improvements needed in both hospitals and medical devices.

Tackling Barriers to Interoperability and Usability

Photo by Peter Ashkenaz, ONC

The 2017 ONC Annual Meeting in Washington, D.C. Nov. 30-Dec. 1, 2017 drew more than 1,100 attendees who came from all over the country to hear about progress being made on the national goal toward interoperability for healthcare information.

In his blog post, Dr. Don Rucker, head of the National Coordinator for Health Information Technology, outlined several highlights of the meeting including:

Kathryn Marchesini named chief privacy officer at ONC

Kathryn Marchesini, JD

PARCA eNews - Jan. 12, 2018 – The Office of the National Coordinator for Health Information Technology, today named Kathryn Marchesini, JD to the post of chief privacy officer.

As chief privacy officer, Marchesini advises the national coordinator on matters related to health information privacy, security, and data stewardship, especially as these issues impact IT development and implementation.

Marchesini is a lawyer who has served previously at ONC as senior advisor where she provided advice and guidance for stakeholders and industry regarding privacy and security implications surrounding electronic health information, technology and healthcare.

Valerie Grey appointed to federal health information technology Advisory Committee

Valerie Grey, Executive Director 
New York eHealth Collaborative 

PARCA eNews – Jan. 17, 2018 – U.S. Senate Minority Leader Chuck Schumer has appointed New York eHealth Collaborative Executive Director Valerie Grey to serve on the federal Health Information Technology Advisory Committee.

“I look forward to working to move our healthcare system forward through innovations and technologies that advance electronic access, exchange and use of health information, resulting in healthier patients and communities,” Grey said in a press release.

Wanted: Instructor in imaging informatics

If you are considering a career change, Fred Prior, PhD, Professor and Chair, Dept. of Biomedical Informatics University of Arkansas for Medical Sciences is hoping you will add The Cancer Imaging Archive to your list of possible new career avenues. Prior is looking for a PACS administrator with an interest in pursuing cancer research.

New technology could bring spectrometry to smartphones

The blue perforated plane is the upper
membrane with the photonic crystal
cavity in it, which captures light of a
very specific frequency. 

PARCA eNews – Jan. 2, 2018 – Could doctors one day perform complex imaging using their smartphones? It is possible given the a new sensor developed by researchers at Eindhoven University of Technology in the Netherlands.

Dutch researchers have developed a sensor that is able to make precise measurements in a novel way using special 'photonics crystal cavity," a kind of trap of just a few micrometers into which light falls and cannot escape. The trap is contained in a membrane, in which the captured light generates a tiny electrical current that can be measured. The Eindhoven researchers published their findings in the Dec. 20, 2017, journal Nature Communications.