tag:blogger.com,1999:blog-33099575227564799012024-03-05T16:12:18.150-08:00PARCA E-NewsPARCA e-news is provided to inform members of certification updates, member feedback, PACS news and issues.Michael O'Learyhttp://www.blogger.com/profile/16671406613345260617noreply@blogger.comBlogger379125tag:blogger.com,1999:blog-3309957522756479901.post-84435044460984047242021-09-28T05:55:00.000-07:002021-09-28T05:55:25.027-07:00Key to information sharing? Giving patients ownership of their data<span style="font-family: helvetica;"><i><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEja-Z0VX8MYG-v3XM9GoRqCEzreGHamHaF1PuBtF2iwJKR6qQvuxxTo5L-F4pQBnAtk5sSq6c-Hj2QMCUMiJyHm8cAe50hnmvNqxdRDOtOiBLtpgaB4NVoYAEAWwWp1KA0m0YxtbqTTyRzK/s248/Cletis_Earle_PennState.jpg" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="248" data-original-width="186" height="329" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEja-Z0VX8MYG-v3XM9GoRqCEzreGHamHaF1PuBtF2iwJKR6qQvuxxTo5L-F4pQBnAtk5sSq6c-Hj2QMCUMiJyHm8cAe50hnmvNqxdRDOtOiBLtpgaB4NVoYAEAWwWp1KA0m0YxtbqTTyRzK/w247-h329/Cletis_Earle_PennState.jpg" width="247" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><div style="text-align: left;"><span style="font-size: small; font-style: italic;">Cletis Earle, CHCIO, VP, CIO Penn State <br />Health </span><span style="font-size: small; font-style: italic;">Image courtesy – Penn State Health</span></div></td></tr></tbody></table>When Cletis Earle, CHCIO, stepped into his new role at Penn State University as senior vice president and chief information officer he was hit with the major disruption in plans with the COVID-19 pandemic. Instead of implementing information technology (IT) initiatives across Penn State Health and Penn State College of Medicine, Earle led his team of professionals in developing an agile fast response to the challenging IT needs of the institutions caused by the pandemic. Previously Earle had served as VP and CIO for Kaleida Health and St. Luke’s Cornwall Hospital in Newburgh/Cornwall, NY. He began his healthcare IT career as a support manager at Brooklyn Queens Health Care Inc. in Brooklyn, NY, eventually taking on roles as director of technology and vice president and chief information officer and privacy officer within the organization. Earle is a member and former chairman of the College of Healthcare Information Management Executives and is a frequent speaker at healthcare IT conferences. He also serves as an ambassador on the HIMSS Global Health Equity Network Advisory Task Force. PARCA eNews spoke to Mr. Earle by phone to get his perspectives on future directions healthcare information technology.<span><a name='more'></a></span></i><br /><span style="color: #960000;">Q. I want to talk about the interview you did for HIMSS and delve into a couple of points on that a little more deeply but before we start could you just give me a brief description of your current position as senior VP and CIO at Penn State Health<br /></span><br />And as you can imagine as a CIO you come in with objectives around technology but unfortunately, a lot of that was thwarted because of the pandemic. For a lot of the last year- and-a-half at least, I've been really focused on the pandemic and working from home developing the systems you know for testing and then vaccine administration. Just as things began to ramp down and started getting back to the world of regular IT work the Delta variant came down the pike, I guess this is the new norm where </span><span style="font-family: helvetica;">down the road </span><span style="font-family: helvetica;">we're now going to be ramping back up. So it has been a roller coaster and that's where my career has been regarding in particular, the last year and change, dealing with pandemic related things and regular IT operations.<br /><br /><span style="color: #990000;">Q. Going back to an interview you did with HIMSS, you said, there are now countless scenarios to use a gold mine of data to provide people with the best results. Tell me first about that gold mine of data. What are you talking about there, and in your view what are one or two of the most likely scenarios for mining that data?</span><br /><br />Yes. What I mean by the gold mine is that the healthcare information that we have is the most complete data sets that we have on the human. It is not only everything about you, and we’re not just talking about your demographic information, we're really talking about all of the elements associated to your being. That’s important in that we can go down to the genomic level, right? For organizations such as ours that have significant amount of data over a course of years, we are really talking about a scenario where we have more tangible information in a digital form about the human being than at any other time. <br /><br />From that perspective, that's great. Then when you think about it even further, now you also have the data available that family members, your kids, your aunts, uncles, your niece, your grandmothers, and your mothers, which can inform your doctor about your family health history. All that information is also aggregated to form a clearer picture of a community health. </span><div><span style="font-family: helvetica;"><br /></span></div><div><span style="font-family: helvetica;">Again, at no time have we ever had this kind of repository available, and the key here is we now have the ability to work it and do something really good with this data. As we start to develop machine learning and other technology, we will be able to look at this information, be able to extract the details in correlations that we were not able to find on a manual basis. <br /><br />We're really talking about, at Penn State University and Penn State Health, and our College of Medicine where we have a major research arm, we're really talking about the ability to have redacted or de-identified information that is truly a culmination of years and years of physiological and clinical content that can help predict and prevent disease in the future. <br /><br /><span style="color: #990000;">Q. So are clinicians or researchers using that data to ask questions that they never able to answer before? </span><br /><br />Yes, researchers and clinicians are asking, and again this is de-identified data all right, so they are able to ask and look for access to all this information to pursue a wider range of research directions, at other times they are coming in with concrete ideas and concrete initiatives to pursue research. And then sometimes they're looking at this to say, hey how do we have better access to this information so that we can put it through some algorithms to be able to abstract information in different ways.<br /><br /><span style="color: #990000;">Q. Are we just talking about electronic clinical outcomes assessments or more broadly about all kinds of clinical research? </span><br /><br />I think it's all kinds. Whether its imaging, whether it's electronic text, you're really talking about tapping into this information in different ways in order to have machine learning and artificial intelligence being able to identify some areas of opportunity to improve the health of our patients.<br /><br /><span style="color: #990000;">Q. Can you just give me a little example of a question a researcher came to you and said, how can we get this out of the data we have? </span><br /><br />You know, whether they need the data to look at a program around say, endocrinology and diabetes studies they want to be able to look at data information that is deep and robust, so that they can actually start to see where there may be some opportunities to provide better care based on their research studies.<br /><br />I can mention hundreds and hundreds of scenarios, but I think the endocrinology piece or the diabetic portion is probably one that comes to mind because there are also opportunities to not only connect to the data but then connect to patients’ mobile devices so that we can have a real-time data and really abstract information continuously so that we can provide real-time care.<br /><br /><span style="color: #990000;">Q. I am assuming that a lot of this is coming out of electronic medical records, including medical imaging data. Now what are some of the keys to getting access to that gold mine of data? What do you think are the obstacles into tapping into that?</span><br /><br />First and foremost, we have to de-identify it because that information cannot be tied back to a specific person. So the biggest challenge is always making sure that you are making it available for the researchers so that it cannot be traced back to resources. I think that's the single most important challenge, and then providing access, general access for our researchers so that they have better access to this information. De-identifying and providing access is by far the biggest lift we have in order to provide the information as quickly as possible. <br /><br /><span style="color: #990000;">Q. A lot of clinical research is conducted by collaborations across multiple academic institutions. Do you have to be able to find ways to allow researchers to share data across different health systems.</span><br /><br />Are you talking about health systems or research because universities tend to share data amongst themselves by default. That's what they tend to do. If we are talking about the Cure Act component of the data, we have Federal legislation out there that really talks about the fact that there's data blocking and that nobody should block data from others. <br /><br />As a competitor we adopted the strategy that the data belongs to the patient. We were one of the first organizations that took up Open Notes, so we believe in pushing out the data to the patient, allowing the patient to take that data anywhere. We have patient portals, we have all of the things that allows the patient to be able to share that information with another provider regardless if it's with a competitor or not so that the outcome can be the best possible.<br /><br />Depending on the scenario again, if it's clinical, then yes the answer is yes, we share data but it's more of the patient sharing his or her data, right? Because again, it's in their hands. If we are talking about researchers they tend to share data and their results of that data inherently in common.<br /><br /><span style="color: #990000;">Q. You mentioned machine learning a little bit ago. How does this machine learning help providers determine better pathways to care? <br /></span><br />If you use a current examples, such as the IBM’s Watson solution, Memorial Sloan Kettering, has some really good information that indicates that machine learning has been extremely efficient in in being able to show providers that their data and their images have potential scenarios for cancer where artificial intelligence is screening through tens of thousands, if not millions of images and seeing where there are anomalies that can then be reviewed and provide feedback to clinicians in a much more comprehensive fashion. <br /><br />I think inherently that's one of the most recognized ways where machine learning has made an immediate impact in being able to be able to say look, we know the technology can help facilitate the doctor in finding information faster because the speed of a computer can't be matched. So I think that's a great example on the imaging side.<br /><br /><span style="color: #990000;">Q. The ability to share data across or between different hospital systems, and I'm talking about large integrated delivery networks, such as Penn State Health, is that something that's becoming more common? Or is it still a problem or are there barriers, policy barriers, technical barriers to doing that? </span><br /><br />Yes, it's becoming more common I can tell you at Penn State Health and State College of Medicine on the health system side, we've adopted that approach, we use CommonWell, we've been a proponent of HIE, we continue to extend ourselves in HIE, Health Information Exchange, areas so that we can share data with our colleagues. Our goal is to share as much information as possible in HIE so that information is accessible to anybody in the state and then potentially anybody who would connect from a national side. <br /><br />We’ve found that having a robust data sharing program, particularly around clinical information and clinical content is essential to the best outcome for the patient. And we use these components like CommonWell, and our HIE as the catalyst to make that happen successfully.<br /><br /><span style="color: #990000;">Q. Has the interoperability problem been solved?</span><br /><br />No, no no, that's not quite there yet. Again, from that interoperability side we are using the HIE as the clearing house, right? But there are times where, you know, EPIC needs to connect with Cerner and Cerner needs to connect to MediSite, and Allscripts and all of those others, so </span><span style="font-family: helvetica;">still </span><span style="font-family: helvetica;">there are some challenges. Again, it all boils down to sometimes the technical capacity and capabilities of the EMRs. Some are better than others around that, but it also boils down to the organization's willingness to share that information.</span></div><div><span style="font-family: helvetica;"><br />Although we have decided to share everything to the HIE, not every organization feels the same way because they're, in my opinion, stuck on an old model. They may keep the data of their patients in the belief that in doing so they have more power. We’re choosing to compete on the quality of our care. So, we've looked at that as an approach and we have an amazing leader in Steve Massini (CEO of Penn State Health) who continues to push that narrative and we just continue to strive forward that way.<br /><br /><span style="color: #990000;">Q. So that's kind of a policy barrier that is up to each individual Institution? </span><br /><br />Yes. Hopefully one day everybody starts to feel the same way. Right? It all comes down to who owns the record that's all it is, and again if you finally get back to this concept that it belongs to the patient, then I think that's the game changer, and then these technology barriers that these EMRs have will come down over time, and once they come along, and they're coming along slowly, I think we're going to be in a much better place when you get those two components done right. <br /><br /><br /></span><br /><script>
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</script></div>Medical Digest Publicationshttp://www.blogger.com/profile/00463721708558629724noreply@blogger.com0tag:blogger.com,1999:blog-3309957522756479901.post-61228345421754116152021-09-28T05:52:00.001-07:002021-09-28T05:54:43.426-07:00Registration for now open for RSNA 21 <h3 style="font-family: Helvetica; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; text-align: left;"><span class="s1" style="font-kerning: none;"><span style="color: #990000; font-size: medium;">Annual Meeting Nov. 28-Dec. 2</span></span></h3><div><span class="s1" style="font-kerning: none;"><span style="color: #990000; font-size: medium;"><br /></span></span></div><span style="font-family: helvetica;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDx6EDsehb1_UZUjgZCMXh42L9FHAN6INIrj2j0GwJMigauoxdgzu4Y98DheXMzRWpKW0T1PvpFdYRCTVLwYstORbCuk7vdC9IPsxXTBx3JuAQcipn43DJiK6lOVtRFD6SsDt4SwBvxgWM/s1164/RSNA+2021.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="1164" data-original-width="1118" height="283" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDx6EDsehb1_UZUjgZCMXh42L9FHAN6INIrj2j0GwJMigauoxdgzu4Y98DheXMzRWpKW0T1PvpFdYRCTVLwYstORbCuk7vdC9IPsxXTBx3JuAQcipn43DJiK6lOVtRFD6SsDt4SwBvxgWM/w271-h283/RSNA+2021.jpg" width="271" /></a></div>PARCA eNews – Sept. 21, 2021 – The 107th Scientific Assembly and Annual Meeting for the Radiological Society of North America is set to kick off Nov.28 at the massive McCormick Place convention center in Chicago, IL. </span><div><span style="font-family: helvetica;"><br /></span></div><div><span style="font-family: helvetica;">The in-person conference will continue through Dec. 2, while online attendees will have until April 30, 2022 to view any and all of the meeting programs.</span></div><div><span style="font-family: helvetica;"><span></span><br />Unlike years past, the Covid-19 pandemic has changed things a bit. All attendees will be required to show proof of vaccination and wear a mask for all exhibition space and meeting rooms. <span><a name='more'></a></span></span></div><div><span style="font-family: helvetica;"><br /></span></div><div><span style="font-family: helvetica;">Safety requirements will be adjusted during the conference to reflect CDC guidelines and can be monitored on the organization’s <a href="https://www.rsna.org/annual-meeting/RSNA-2021-health-and-safety">health and safety webpage</a>.<br /><br />With the lifting of restrictions on International travel, the RSNA organizers are hoping for robust attendance that is safe and informative for all who attend. With more than 2,000 presenters and more than 300 live educational courses, the meeting promises to deliver an outstanding program with a multitude of science, education and CME opportunities for radiology professionals and support personnel from around the world. <br /><br />Registration for radiology support personnel is online via the <a href="https://www.rsna.org/annual-meeting/pricing-and-registration">registration webpage</a>.</span><script>
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</script>Medical Digest Publicationshttp://www.blogger.com/profile/00463721708558629724noreply@blogger.com0tag:blogger.com,1999:blog-3309957522756479901.post-22468362958986952622021-09-27T07:28:00.006-07:002021-09-29T06:46:45.218-07:00Providers planning for permanent deployment of telemedicine<span style="font-family: helvetica;"><div class="separator" style="clear: both; text-align: center;"><a href="https://upload.wikimedia.org/wikipedia/commons/thumb/7/7f/Telemedicine_in_rehabilitation_2.jpg/1600px-Telemedicine_in_rehabilitation_2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="450" data-original-width="800" height="184" src="https://upload.wikimedia.org/wikipedia/commons/thumb/7/7f/Telemedicine_in_rehabilitation_2.jpg/1600px-Telemedicine_in_rehabilitation_2.jpg" width="327" /></a></div>PARCA eNews – Sept. 2, 2021 – As the pandemic grinds on the use of telemedicine is emerging as a mainstay for healthcare delivery among many providers and patients. Health systems are beginning to incorporate it into planning beyond the emergency implementations spurred by the pandemic.<br /><br />A group of Stanford Department of Medicine researchers looked into their own institution’s implementation of telemedicine and published their findings in the Aug. 30, 2021<a href="https://academic.oup.com/jamia/advance-article/doi/10.1093/jamia/ocab145/6359597"><i> Journal of the American Medical Informatics Association.<span><a name='more'></a></span> </i></a><br />The researchers outlined its limitations and weaknesses and made nearly a dozen recommendations for extending telemedicine into the health delivery system to address more complex healthcare issues and to ultimately improve care delivery.<br /><br />"To optimize patient and provider experience through telemedicine, stakeholders need to focus on enhancing technology interoperability and usability and providing sufficient training for efficient telemedicine use," they wrote. "While in-person visits are essential in many conditions, telemedicine may be a viable alternative for certain patient populations and care needs; understanding and prioritizing patients who are most appropriate for telemedicine and in which clinical situations are important future steps."<br /><br />Among the recommendations for making telemedicine a sustainable part of healthcare were:<br /><ul style="text-align: left;"><li><span style="font-family: helvetica;">Support team science and exchange of patient information across care teams and settings</span></li><li><span style="font-family: helvetica;">Enhance disease management with remote monitoring technologies and AI algorithms to alert escalated care needs</span></li><li><span style="font-family: helvetica;">Improve telemedicine usability to accommodate diverse workflows and provide positive care experience for patients and providers</span></li><li><span style="font-family: helvetica;">Implement telemedicine training in medical health informatics education programs</span></li><li><span style="font-family: helvetica;">Apply a systematic approach for telemedicine implementation and evaluation involving multiple stakeholders</span></li><li><span style="font-family: helvetica;">Deploy telemedicine kiosks at community centers or retail pharmacies to ensure all patients have access</span></li><li><span style="font-family: helvetica;">Leverage AI-enabled tools to design a hybrid care delivery model that will identify the appropriate form of care delivery for each patient and each episode of care</span></li><li><span style="font-family: helvetica;">Automate systematic monitoring and evaluation of care delivery via telemedicine based on the Donabedian framework to build the evidence for quality, efficient, and effective care delivery </span></li><li><span style="font-family: helvetica;">Facilitate patient engagement and capture of patient-generated health data, such as patient-reported outcomes</span></li></ul><div><span style="font-size: x-small;">Source: <a href="https://academic.oup.com/jamia/advance-article/doi/10.1093/jamia/ocab145/6359597" style="font-family: Helvetica;"><span class="Apple-converted-space"> </span><span class="s2" style="font-kerning: none;"><i>Journal of the American Medical Informatics Association.<span class="Apple-converted-space"> </span></i></span></a></span></div></span><script>
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His career parallels the digitization of healthcare information, and his pioneering contributions at the likes of Philips, AGFA and Siemens were key to major technology shifts in the digital imaging. He worked on the early implementations and product launch of Philips digital subtraction technology for angiography, the creation and launch of the Gyroview 2000 MRI advanced visualization system, and the first rollout of an archive CD product that featured “SPI” or standard product interconnect, a pre-DICOM interface that allowed Siemens and Philips MRI workstations users to share MRI images. At AGFA he worked on the creation and product launch of IMPAX the first PACS system that was using common off-the-shelf hardware (COTS). His 20-year career at Siemens included 10 years as chair of the Imaging Informatics Division for NEMA - (National Electrical Manufacturers Association) in addition to his work on strategic relationships with universities, consultants, and regulatory bodies in the realm of digital technology and transformation. Today, he is an independent consultant to major imaging informatics clients and serves on a number of HIMSS-SIIMS Enterprise Imaging collaborative workgroups. PARCA eNews spoke to Mr. Primo by phone about his remarkable career and </span></i><em><span style="font-family: helvetica;">and what to look for in a consultant.</span></em><p></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span></span></p><a name='more'></a><p></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q. You’ve got more than 40 years in healthcare IT and medical imaging. Can you tell us a bit about your path that has led to your current role as a consultant?</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">I started working in a hospital in the 70s, a 500-bed hospital in Belgium. I was the first medical engineer coming into the hospital, so I started the Biomedical Department. I collaborated closely with equipment vendors, but when the hospital got busier, they realized that they needed to reduce turnaround and response time for repairs and maintenance.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">I started to work with the vendors and introduced the concept of using a maintenance contract with vendors as opposed to working on a time and material basis and to train the biomed department as super-users of medical devices so they can provide expert support for the hospitals’ healthcare workers.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">That reduced user errors, which by itself reduced significantly equipment downtime since very few repairs were needed because people were using the equipment in the right way. </span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">That resulted in a huge savings with maintenance contract costs going down by a factor of 30 percent because the hospital could prove to the vendor of the maintenance contract that they didn't have to dispatch staff to the hospital as often as they normally would have because a 90% decrease of equipment problems due to correct use and ample user training.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">A couple of years after that the hospital asked me to start the digital transformation of the hospital's admission and registration process. This was in the 1970s so very early on. The computers we had were PDP-8 and PDP-11 from DEC (Digital Equipment Corporation). I started with automating the hospital’s laboratory and then automating the patient reception and registration.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">I was working with a great biomed team in the hospital when Philips came to me and hired me away. I started at Philips working with their teams in rolling out digital subtraction angiography, which was kind of the early digital imaging modality besides CT. After that, I started to work in product development for MRI where I created the advanced visualization workstation of the Gyroscan MRI replacing the previous VAX computer with a SUN workstation with Digital Processing Units (DSP).</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Very few people had DSP, but an important subcontractor was familiar with it. Advantages of DSP over the then popular array processors (AP) was that DSP didn’t need to store the code in the chip’s hardware as APs required. You don't have to burn all the code in the DSP so you can change the software on the fly. Our team embraced this DSP project and 2 years later, the team launched the Gyroview 2000 HR, which was an advanced visualization system specifically for MRI. This team a was close-knit community, and it was a honor to be part of this team.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">I was then very much involved with early implementations of the standard product interconnect SPI Some people called it, the Siemens-Philips interface. It was like an early version of DICOM, but it was still based on the seven layers of the ISO model and made available by the end of the 80s. The result was that we had a system that was kind of a predecessor to DICOM and allowed MRI users of MRI systems made by Siemens and Philips to share images.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Now in 1990 there was a company called AGFA who came to me and they said, “we believe, that over time, digital imaging will replace film and we want you to lead that evolution.”<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">I hired a digital imaging team in the USA when the demands for digital was rising, and that team was great. I made sure that the team was screened off from all kinds of management bureaucracy so they could work and do what they thought was the best. And in 1994 we came out with the first IMPAX system, the AGFA PACS, and it was one of the first PACSs that was based on non-proprietary hardware. It was all running on SUN Microsystem boxes, which were one of the first common off-the-shelf hardware (COTS). Just add the licensed software and voila, you had a PACS. It was not quite that simple but pretty close. AGFA had a fantastic market share, and actually, the product survived until like the mid-2010’s.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">In 1998, I went to work for Siemens Medical Systems USA, Inc., I started as their PACS division manager, and after a short time moved on to other opportunities in the company. I worked in market research and then went into regulatory and standardization work assignments required for various organizations.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Then Siemens also opened the door for me to NEMA, the National Electrical Manufacturers Association where I became chair of the Imaging Informatics Division and remained chair for 10 years. In the meantime, at Siemens, I was combining all the above with working on strategic relationships, with Siemens end-users, consultants and regulatory bodies.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">And after 20 years, at 70, I decided to retire. I want to get in my hobbies. After three or four months, I got bored.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q. You had to get a bit busy?</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">It was not good sitting in a chair watching TV and commenting on everything my wife did and what I heard on radio or TV.., so my wife told me to get busy and I started my consulting company.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q. How long have you been doing this consulting then?<br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Since the end of 2018.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q. Talk about your approach to working with a client. How do you like to work with them? What do you look for in terms of the relationship with an organization?</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Actually, I have very few clients, most of my clients are temporary clients, like a healthcare organization that has certain question regarding what they should purchase. I never tell them that, what I do is give my clients an overview of what is available in the market, who is offering what with what conditions and with what technology, and where is this technology going in the next three years A crystal ball doesn't work beyond three years, especially in IT. So that's one thing that I do, but that's occasional. These are like one or two or three-day engagements</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Then I have other engagements such as “a consultant for consultants”.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">These large consulting organizations have great resources in project management, they have great legal counsel, and they know healthcare. However, when it comes to enterprise imaging or PACS or advanced visualization, they often don't have the in-depth knowledge in-house and so they outsource to me.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">And that's basically what I'm doing. Occasionally I have an OEM that asks me, what do you think about the necessity to include this kind of capability, or this kind of feature in our PACS or in our advanced visualization system? I also follow the blogs but that I don't charge for that.<span class="Apple-converted-space"> </span>I really love it when I can teach people something, and while teaching I often I learn more from the conversation than I can teach. Also, I keep up with online information portals and with print journals to stay current with the evolution in imaging informatics.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Lots of things going on these days. We see expansion in office-based labs, we see an expansion of the independent diagnostic testing facilities, which is a growing trend. Patients don’t like to go in hospitals when they can find the same tests in smaller facilities.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">When the hospital moves the patients to ambulatory locations, the patients are less afraid to come into a small facility than to go into the hospital with the risk of infection, and the cost is lower, instead of being a thousand dollars, maybe they pay $700. If you do not have the best health insurance, that's important because it limits your out-of-pocket cost.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">At the same time, the hospital is lowering costs because the maintenance of the equipment and the staffing for that equipment is lower. They contract with an independent diagnostic testing facility, which remains independent, although being part of the IDN infrastructure. That's going to change our whole paradigm in the next few years. It will be slow but it's going to happen because it is the only way to provide sustainable healthcare.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q. What is that paradigm shift? What, what do you see there?<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Well, I see that hospitals will continue to expand, but it will be an expansion that doesn't require investing in new skills and new technologies that will be an expansion that enables a third-party service, but with service line providers to do what a hospital needs. Think about big organizations that are outsourcing their radiology service line. Of course they still need their lab services, and of course they still need a CT scanner in the hospital but a lot of testing will be farmed out to independent diagnostic test facilities, and to ambulatory surgery centers. Why go the hospital for a procedure that can be performed as an outpatient without having the risk of contracting a hospital infection.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q.<span class="Apple-converted-space"> </span>Backing up a little bit you mentioned you advise clients on purchase decisions, when you're advising about which vendors and equipment, what are some of the things that organizations may get wrong when they're shopping for a PACS or enterprise imaging system?<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">You have to make sure that they understand a PACS or whatever enterprise imaging system they are considering is not going to be like the PACS that they used to purchase in the past, where it was a departmental system.<span class="Apple-converted-space"> </span>Today it needs to be closely integrated with the EMR. And not only the EMR, but if you have a document management system, it needs to be integrated with the document management system as well. And that integration is something that is easily drawn on a whiteboard, right? One block for EHR, and another block that it's the Enterprise Imaging, or PACS system, and you write on one side of the block IF (interface), then you draw a line to the PACS and you draw a little square that interface and now you're done.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">In reality it is a little more complicated, all care providers have one source of truth, the EMR.<span class="Apple-converted-space"> </span></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">They don't have time during their busy day to run to yet another workstation to open the document in the documentation system or the EMR, or the imaging system, they can't do that. They want to see it on the same screen or the same screens that they use for the EMR. If you implement an interface system that is based on a point-to-point connection, then you build in your first mistake.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">You have to be flexible in what you can access and how you can access data. There are mechanisms like APIs, an application program interface and standards organizations are working on standardizing APIs for interfacing with an EMR. You have another standard called FHIR (Fast Healthcare Information Resources) and that’s the way to go.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Another thing you have to think about is what am I going to do with all that hardware three years from now when I have to store all these images with gigabytes of information. What am I'm going to do with all that storage infrastructure in five years, it will be obsolete. What I'm going to do then, decommission it and pay a lot of money to buy another system? The question to ask: have you considered the cloud? That's the whole goal of a consultant, helping a client make an informed decision, but ultimately, it's the client’s decision, it's not a consultant’s decision.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q. I read a 2019 paper that you were the lead author on about building and implementing an Enterprise Imaging System. It was a white paper for the HIMSS and SIIMs. Since then, there's been a pandemic, and I was wondering if you were to update that paper, have you seen any changes in the way organizations are configuring their medical imaging systems in the wake of the pandemic?</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Last year we did not see much at all, when it comes to enterprise imaging because everybody was very preoccupied with COVID-19, they didn't know what would happen the year after and they still don't know. I've seen renewed uptick in, and it may be a good idea to revisit the paper and see what we've learned in the meantime and see what should be updated.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">The same thing applies to white papers I wrote on cybersecurity for HRA (human reliability assessment). We wrote it just at the beginning of ransomware attacks so that probably will need an update. But anyway, last year we didn't see much happening at all because of COVID-19 with tragic developments and resources were all focused on that.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">This year however, I already see changes. I see that hospitals are looking more into enterprise imaging, especially the large ones because they realize that in order to get to the triple aim, (improving the healthcare experience, improving the health of populations, and reducing per capita costs) they will need enterprise imaging.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">How can you decrease costs, by eliminating silos, right? Enterprise imaging will get rid of the silos. How can you improve patient care? How can you improve quality of care? One way is if you have more information at your fingertips, you probably can make better decisions. How can you improve customer satisfaction? If you can communicate with your patients with increased confidence that there is nothing else that they should be worried about or that they may need to come in for therapy or intervention, if you communicate with your patients based on facts and science, they probably will be very satisfied. They become more satisfied if they can have the procedure performed in an ambulatory surgery center or if you can do the test, in an IDTF<span class="Apple-converted-space"> </span>(independent diagnostic testing facility) then they will also be very satisfied. Now to do that you have to make sure that all these departments can collaborate, and enterprise imaging is going to be a big piece of making that collaboration possible.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">You know things are always about people, processes, and technologies but if you want to enable the triple aim, you will need enterprise imaging strategies. Now, how do you get there? The first thing to do is governance, bring the stakeholders together and make sure that they have governance. Otherwise, you will see what's happening today with IDNs, where they have 20 hospitals and 12 different PACS systems that don't communicate. So governance will be absolutely required.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q. One of the good things to come out of the pandemic is the rise of telehealth.<span class="Apple-converted-space"> </span>I saw statistics from MAYO Clinic that showed pre-pandemic telehealth visits made up about 6% of their clinical encounters. And then during the pandemic telehealth visits comprised 50% of clinic visits. And now as the pandemic eases, they're probably doing 25% of their healthcare visits by Telehealth, which is an amazing increase in the use of telehealth. How is telehealth affecting enterprise imaging?</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Well, I think that as I said already that you have, what is called the new requirements for the triple aim. Telehealth helps with improving patient experience, and to improve quality of care the provider will also have to see an image and possibly share that image with his or her patients, which is going to promote the concept of image sharing.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Now that doesn’t necessarily mean that image sharing will happen between different IDNs, but it's not because it's impossible or difficult it is because hospitals don’t want to share patients with other IDNs. But within the IDN they will share and you know if they have the resources in the clouds, that's the best place to share and you have a web-enabled user interface that works through your mobile device and the radiologist or the clinician that is conducting the Telehealth visit is sitting in his or her office, while the patient is sitting in their home. It will be necessary to access all images and all information and all of the EMR from there.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">The patient can even take pictures and send them back like for a dermatology care or for wound care. You will be able to compare over a period of time how the wound is healing without the patient, having to come into the hospital or clinic. If it gets worse, you can call the patient into the ambulatory surgery center or into the hospital if needed.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p3" style="color: #c00000; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Q. I guess the last question is what are the main benefits an organization can expect from hiring a consultant? What should they expect? What should they not expect?<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">What I often see is that an external consultant goes hand-in-hand together with governance. If you have your internal consultants there always will be a bias, there will be certain preference of one of the board members, there will be certain personal things such as they may like that lady or hate that lady but these human factors are definitely present.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">When the consultant comes in, you know, I think it is amazing. Everybody has a tendency to listen because they know they're paying good money for the consultant. And so they want to get the maximum value. And instead of arguing, they will listen to the consultant.<span class="Apple-converted-space"> </span></span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p><p class="p1" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px;"><span style="font-family: helvetica;">Therefore, I always advise my customers to make sure that your consultant is not paid by an OEM or by a vendor. The consultant should be independent, that’s the point.</span></p><p class="p2" style="font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; margin: 0px; min-height: 13px;"><span style="font-family: helvetica;"><br /></span></p></div><br /><script>
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Whether you go for the educational programming, the networking or the vendor exhibits, HiMSS21 promises to be the healthcare IT industry’s most influential conference and trade show of the year.</span></div><div><span style="font-family: helvetica;"><span></span><br />As of this writing, COVID-19 safety protocols will require each attendee, exhibitor, and HIMSS staff member will have to complete a two-step process to gain access to the HIMSS21 campus – either provide proof of vaccination, or validate vaccination status in one of three on-site stations. Currently, Masks will be supported but not required on the HIMSS21 Campus. Further updates to the protocols will be provided via the online <a href="https://www.himss.org/global-conference/health-and-safety-hub">HiMSS 21 Health and Safety Hub.</a><br /><br />Some of the exciting topics on the program include: <br /><ul style="text-align: left;"><li><span style="font-family: helvetica;">Applied Artificial Intelligence and Machine Learning,</span></li><li><span style="font-family: helvetica;">Bioinformatics or Healthcare Informatics Research</span></li><li><span style="font-family: helvetica;">Change Management</span></li><li><span style="font-family: helvetica;">Cybersecurity, Information Security and Privacy</span></li><li><span style="font-family: helvetica;">Health Information Exchange or Interoperability</span></li><li><span style="font-family: helvetica;">Telehealth, Connected Health and Virtual Health</span></li></ul>Featured speakers include such luminaries as Michael Rogers, former director of the National Security Agency, Alex Stamos, former chief security officer for Facebook and former governors Chris Christie (New Jersey) and Terry McAuliffe (Virginia). The closing keynote will be given by ex-Yankee A-Rod Alex Rodriguez.<br /><br /><br />To <a href="https://www.himss.org/global-conference/registration-info-pricing">register online use the online registration forms</a>.</span></div>Medical Digest Publicationshttp://www.blogger.com/profile/00463721708558629724noreply@blogger.com0tag:blogger.com,1999:blog-3309957522756479901.post-22292913326723989952021-07-30T06:59:00.008-07:002021-08-03T07:31:21.343-07:00Patient ID Now coalition applauds House action calls on Senate to follow suit<span style="font-family: helvetica;"><div class="separator" style="clear: both; text-align: left;"><span style="text-align: left;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQwi5jvPg0EnAmNbmrQeetMta3eDWgn66K3dVpA96lb-k_c_NXkkF651smMC2eT-rENChqGh-pog-OpZHI6CY_962v_KFOZsx8kTI00KsrQvSM8SL7viwb5cgNGSkyT9jTd98aGTpAL7du/s245/PatientID_framework.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="245" data-original-width="245" height="245" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQwi5jvPg0EnAmNbmrQeetMta3eDWgn66K3dVpA96lb-k_c_NXkkF651smMC2eT-rENChqGh-pog-OpZHI6CY_962v_KFOZsx8kTI00KsrQvSM8SL7viwb5cgNGSkyT9jTd98aGTpAL7du/s0/PatientID_framework.jpeg" width="245" /></a></div>PARCA eNews – July 29, 2021 – The US House of Representatives removed the ban on research into developing a national patient ID for the third year a row. A move that the Patient ID Now coalition praised as a bi-partisan step toward greater patient safety.</span></div><br />In a press release, the coalition used the passage in the House to call on the US Senate, where the bill has floundered each of the past three years, to follow suit and pass the bill.</span><div><span style="font-family: helvetica;"><span></span><br />The coalition is made up of major healthcare organizations including American College of Surgeons, the American Health Information Management Association (AHIMA) the College of Healthcare Information Management Executives (CHIME), Healthcare Information and Management Systems Society, Inc. (HIMSS), Intermountain Healthcare, and Premier Inc.<span><a name='more'></a></span><br />The coalition noted that the bi-partisan movement gained strength over the past year as the COVID-19 pandemic highlighted the challenges of tracking the virus with patient misidentification causing duplicate records for screening and vaccination. In a strongly worded letter to the Senate Appropriations Committee the coalition made the case for single patient ID as a critical piece in improving patient safety.<br /><br />"Without the ability of clinicians to correctly connect a patient with their medical record, lives have been lost and medical errors have needlessly occurred," the letter stated. "These are situations that could have been avoided had patients been able to be accurately identified and matched with their records. This problem is so dire that one of the nation’s leading patient safety organizations, the ECRI Institute, named patient misidentification among the top ten threats to patient safety."<br /><br />The coalition thanked the steadfast leadership of Representative Bill Foster (D-IL) and Mike Kelly (R-PA) in shepherding the bill through the House, and House Appropriations Committee Chair Rosa DeLauro (D-CT) and Representative Katherine Clark (D-MA) for their continued support to advance patient identification.<br /><br />Source: <a href="http://patientidnow.org/wp-content/uploads/2021/07/FY22-House-Passage-of-Labor-HHS-Bill-Patient-ID-Now_Final.pdf">Patient ID Now press release</a></span><span><!--more--></span><span><!--more--></span><span><!--more--></span><script>
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</script><div><span style="font-family: helvetica;"><br /></span></div><div><span style="font-family: helvetica;">Source: CISA <a href="https://us-cert.cisa.gov/ics/advisories/icsma-21-187-01" target="_blank"> </a></span><a href="https://us-cert.cisa.gov/ics/advisories/icsma-21-187-01" target="_blank"><span style="font-family: helvetica;">ICS Medical Advisory (ICSMA-21-187-01)</span></a></div></div>Medical Digest Publicationshttp://www.blogger.com/profile/00463721708558629724noreply@blogger.com0tag:blogger.com,1999:blog-3309957522756479901.post-40141186244065493602021-07-30T06:59:00.000-07:002021-07-30T06:59:02.144-07:00Historic agreement allows healthcare collaboration between UAE and Israel<span style="font-family: helvetica;"><div class="separator" style="clear: both; text-align: center;"><a href="https://assets.wam.ae/uploads/2021/07/1298116469884048945.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="534" data-original-width="800" height="267" src="https://assets.wam.ae/uploads/2021/07/1298116469884048945.jpg" width="400" /></a></div>PARCA eNews – July 11, 2021 – The United Arab Emirates and the Department of Health for the capital city Abu Dhabi announced in a <a href="https://www.wam.ae/en/details/1395302951722">press release</a> a strategic agreement with Israel’s Sheba Medical Center aimed at creating a framework for developing and improving healthcare services in the country.<br /><br />In a memorandum of understanding the Abu Dhabi Department of Health and Sheba Medical Center will enter into collaborations for the exchange of knowledge, best medical practices and methodologies.<span><a name='more'></a></span><br />The agreement will enable both sides to explore opportunities in the field of health and medical research. Both entities will also cooperate in conducting cutting-edge research and improving healthcare services for patients in several aspects, including telemedicine and the use of artificial intelligence.<br /><br />"The DoH continues to devote its best efforts to improve healthcare sector outcomes and provide the most advanced healthcare services," Under-Secretary of Abu Dhabi’s Department of Health Dr. Al Kaabi said in the press release, "in line with the highest international standards, reflecting its keenness to establish effective partnerships with leading local and international medical institutions."<br /><br />The agreement was made possible by the Abraham Accords signed between Israel, the United Arab Emirates, and the United States, reached on August 13, 2020. The agreement marked the first public normalization of relations between an Arab country and Israel since that of Egypt in 1979 and Jordan in 1994.<br /><br />Source: <a href="https://www.wam.ae/en/details/1395302951722">Emirates News Agency press release</a></span><script>
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</script>Medical Digest Publicationshttp://www.blogger.com/profile/00463721708558629724noreply@blogger.com0tag:blogger.com,1999:blog-3309957522756479901.post-3279926507541901592021-07-30T06:58:00.000-07:002021-07-30T06:58:33.628-07:00PARCA founder Herman Oosterwijk featured on new SIIM podcast<span style="font-family: helvetica;"><div class="separator" style="clear: both; text-align: left;"><div class="separator" style="clear: both; text-align: center;"><a href="https://scontent-sea1-1.xx.fbcdn.net/v/t1.6435-9/43713000_10156624172267510_3074695825109024768_n.jpg?_nc_cat=103&ccb=1-3&_nc_sid=730e14&_nc_eui2=AeGbZDJLQ0nNDI7GY9mhgR9xqpcl5_uc3CaqlyXn-5zcJqqLueuOi857QyUshZNkWco&_nc_ohc=CpLSEOwy_wcAX_milG7&_nc_ht=scontent-sea1-1.xx&oh=3eb278aed960d37ce38279c62d5bc169&oe=6129CC53" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="539" data-original-width="800" height="216" src="https://scontent-sea1-1.xx.fbcdn.net/v/t1.6435-9/43713000_10156624172267510_3074695825109024768_n.jpg?_nc_cat=103&ccb=1-3&_nc_sid=730e14&_nc_eui2=AeGbZDJLQ0nNDI7GY9mhgR9xqpcl5_uc3CaqlyXn-5zcJqqLueuOi857QyUshZNkWco&_nc_ohc=CpLSEOwy_wcAX_milG7&_nc_ht=scontent-sea1-1.xx&oh=3eb278aed960d37ce38279c62d5bc169&oe=6129CC53" width="320" /></a></div>PARCA eNews – July 12, 2021 – Herman Oosterwijk has been instrumental in the development of medical imaging as it is used in clinical practice today. <br /><br />As an engineer/technologist, Herman has served as educator and ultimately as an advocate in developing and guiding the standards that make storing, archiving and sharing of medical images such a dynamic part of current day medical practice.</div><span><a name='more'></a></span><br />Over his 45 year career he has taught thousands of people who manage and maintain PACS systems and medical informatics. He campaigned for the establishment of the profession of PACS administrator by establishing PARCA to certify and advocate for professional recognition of the skills and expertise needed to manage medical imaging. <br /><br />If you are interested in hearing about the fascinating history of PACS and the profession of managing them, a new SIIM podcast by Mohannad Hussein and Jason Nagels features an in-depth interview with Herman Oosterwijk.<br /><br />The podcast is available on the <a href="https://directory.libsyn.com/episode/index/show/siimcast/id/19765775">Libsyn podcast library</a> or through Apple or Android podcasts.<br /></span><br /><script>
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</script><div><span style="font-family: helvetica;"><br /></span></div><span style="font-family: helvetica;">You can read HIMSS Cybersecurity Survey on their website and <a href="https://www.himss.org/sites/hde/files/media/file/2020/11/16/2020_himss_cybersecurity_survey_final.pdf">download the report in a PDF</a>.</span>Medical Digest Publicationshttp://www.blogger.com/profile/00463721708558629724noreply@blogger.com0tag:blogger.com,1999:blog-3309957522756479901.post-33061142233448272012021-07-30T06:56:00.002-07:002021-07-30T07:02:51.024-07:00ONC announces timeline for TEFCA going live in 2022<span style="font-family: helvetica;"><div class="separator" style="clear: both; text-align: center;"><a href="https://www.healthit.gov/buzz-blog/wp-content/uploads/2021/07/tefca-timeline-1.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="273" data-original-width="800" height="194" src="https://www.healthit.gov/buzz-blog/wp-content/uploads/2021/07/tefca-timeline-1.png" width="569" /></a></div><br />PARCA eNews – July 13, 2021 – The Office of the National Coordinator for Health Information (ONC) announced its timeline for the Trusted Exchange Framework and Common Agreement (<a href="https://www.healthit.gov/topic/interoperability/trusted-exchange-framework-and-common-agreement">TEFCA</a>), which aims to develop a nationwide network for the exchange of health information.<span><a name='more'></a></span><br />The project is being led by the Sequoia Project, which developed the Trusted Exchange Framework to guide the linking of regional Health Information Exchanges (HIEs) across the country. While such regional networks have made great strides in recent years in facilitating the secure exchange of millions of clinical documents, some significant gaps remain.<br /><br />Cross-network exchanges remain difficult with a number of friction areas that need to be overcome to have a truly seamless national network for health information exchanges.<br /><br />Funded by the 21st Century Cures Act the TEFCA project has now reached a point of publishing a timeline with specific deliverables leading to the establishment of the national health information network. <br /><br />Beginning this fall there will be public engagement webinars, work group sessions leading to a final agreement for the technical framework. In the first quarter of 2022 the Final Trusted Exchange Framework and Common Agreement v.1 will be published. Later next year the Qualified Health Information Networks (QHINs) will be selected and begin sharing data.<br /><br />QHINs are networks that agree to the common terms and conditions of exchange with each other as specified in the Common Agreement, which includes functional and technical requirements.<br /><br />The ONC is encouraging stakeholders to participate in future information sessions. You can keep apprised of these meetings by adding your name to the RCE’s contact list at <a href="https://rce.sequoiaproject.org/">RCE.SequoiaProject.org</a>.<br /><br />For detailed background on TEFCA, please visit: <a href="https://www.healthit.gov/topic/interoperability/trusted-exchange-framework-and-common-agreement">HealthIT.gov/TEFCA</a>.</span><script>
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</script><div><span style="font-family: helvetica;"><br /></span></div><div><span style="font-family: helvetica;">Source: <a href="https://www.healthit.gov/buzz-blog/health-it/tefca-will-be-live-in-2022" target="_blank">HealthIT Buzz blog</a></span></div>Medical Digest Publicationshttp://www.blogger.com/profile/00463721708558629724noreply@blogger.com0tag:blogger.com,1999:blog-3309957522756479901.post-29103981003237737462021-05-21T06:22:00.001-07:002021-05-21T09:42:21.113-07:00Taking the plunge into independent consulting<script>
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</script><table cellpadding="7" cellspacing="7" class="tr-caption-container" style="float: left;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNW8SPgT-32dBnvlJ1kMBoWrxef-zSFumCYd5qY1Zzmq8o83h3W1masGPAB391atknAiqYdI29c3L2FqRkOgRokHMEjsg9K3HMUQPhyT0Xd3POGxvpaBdm-RzQhrE5xDPqo8twae7f9dvL/s568/Mohannad_Hussain.jpg" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><span style="font-family: helvetica;"><img border="0" data-original-height="568" data-original-width="390" height="425" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNW8SPgT-32dBnvlJ1kMBoWrxef-zSFumCYd5qY1Zzmq8o83h3W1masGPAB391atknAiqYdI29c3L2FqRkOgRokHMEjsg9K3HMUQPhyT0Xd3POGxvpaBdm-RzQhrE5xDPqo8twae7f9dvL/w292-h425/Mohannad_Hussain.jpg" width="292" /></span></a></td></tr><tr><td class="tr-caption" style="text-align: left;"><span style="font-family: helvetica;"><i>Mohannad Hussain, Medical Imaging</i> </span></td></tr></tbody></table><span style="font-family: helvetica;"><i>As the second in a series looking at leveraging PACS administrator skills and expertise into new career possibilities, PARCA eNews talked with Mohannad Hussain, who took his expertise in DICOM, HL7 and PACS at both AGFA and Philips to launch a consulting business on his own. Having started in software development and project management, he later became focused on medical imaging informatics and found that to be a career calling. He has worked on a number of award-winning products, bringing innovative solutions to solve problems in healthcare and beyond. One of his passions is integrating systems in healthcare such as EHR/EMR, RIS, PACS, VNA, Universal/Enterprise zero-footprint viewers, VR/Reporting, AI/ML algorithms, Business Intelligence and Analytics to simplify workflows, automate steps, drive quality improvement for healthcare providers. Mohannad has spoken at a number of conferences in North America and overseas on a range of topics related to software development and health/imaging informatics. He is an evangelist for standards such as FHIR, DICOMweb and IHE profiles. He is the project manager for the annual SIIM Hackathon. His other passions include knowledge sharing/training and contributing to open-source software. While he has been consulting for 14 years, it was only recently that he made the plunge to full-time independent consulting. He began his company <a href="https://www.techiemaestro.com/">Techie Maestro</a> in 2008 and went full-time in 2021.<span><a name='more'></a></span></i><br /><span style="color: #990000;">Q. Let’s start by telling us a little bit about how you got into medical imaging?</span><br /><br />In 2010, I stumbled upon a local company here in Waterloo, Ontario that is into medical imaging and of course, PACS people would know it as Agfa. So that was kind of my introduction to medical imaging. <br /><br />It’s funny because as someone who has created software in multiple domains, you come to medical imaging you're a little surprised by how complicated medical imaging can be at times when it comes to certain things. I remember when I was being interviewed at Agfa, in 2009 before I actually started at Agfa in 2010 and the interviewer was telling me about this super secret project, which was a web-based medical imaging viewer, and at that time I was just thinking to myself what's the big deal of being able to view images in a web browser like every other industry has been doing for years?<br /><br />It was only until I actually started at Agfa that I realized all the nuances behind the scenes to displaying those medical images. They're not just your typical picture. There's a lot more to it, you know with DICOM and all that stuff. I always joke with people that when you get into medical imaging there are two life-changing events that you look forward to in that career. Well, I guess you don't really look forward to because you kind of just get hit with those events and your life is never the same.<br /><br />The first life-changing event is the first time you see a DICOM header, you know, the actual metadata inside DICOM and then the other life changing event is the first time you see an HL7 v2 message. So that's basically how I got into this so I started with PACS and you know initially when I started, it was essentially just another job but it didn't take long for it to actually be a lot more meaningful and purposeful, and a couple years into it, I decided that medical imaging was my purpose. I decided to stay in it and as my career progressed I became more focused on medical imaging. Nowadays, software development is still a big part of my life and I do a lot of that in medical imaging but again, I do it with a focus on medical imaging.<br /><br />I always tell people, especially when I talk to software developers in training, that medical imaging is not a field that you choose for the money. If you are looking for money go to financial services or things like that. That's where the money is. You choose medical imaging because there's this noble purpose behind medical imaging, you feel like you're leaving a good legacy, you're contributing to making people's lives better. Actually shouldn't say people I should say patients’ lives. Patients can be our “countrymen”, our family, or our friends, even ourselves at times.<br /><br /><span style="color: #990000;">Q. So as a developer, where did you work first and then how long did you work at Agfa? And what was your position there?</span><br /><br />I was at Agfa for nine years or so total. For six years I spent doing pure, what they call R&D development. R&D is when you're creating new products and or new features for existing products. So most of my time there was actually spent working on a universal web viewer the web-based viewer. Then afterwards my last three years were with the service department at Agfa but within that there's a team that did customization. So this is not a customization where they change the configuration of the product, these customizations were developed as what we call last-mile products. So, you sell a PAC system or a viewer that is solving 99 percent of the problem for the customer but there's one percent left. So that was the team I was part of, we developed a solution for that last one or two percent.<br /><br /><span style="color: #990000;">Q. As you went through all of that 10 years at Agfa, what did you feel was the strongest assets or skills that you developed over that time?</span><br /><br />A number of them. So one of them is generally you develop an appreciation for medical imaging. You see how medical imaging is a weird mix between forward thinking and kind of being stuck with some older technologies because you know when medical imaging had things like interoperability in the early 90s when DICOM came out, that was pretty cutting edge at the time and when radiology went digital that was very advanced at the time.<br /><br />But you know somewhere along the line things kind of fell behind and the innovation pace slowed down considerably. So that's good news and bad news. The bad news is innovation can be a little bogged down, but the good news is that it's ripe ground for innovation and you're certainly seeing that. For example with this new wave of excitement and the hype over artificial intelligence you can see how radiology is ripe for Innovation. It (AI) has got its kinks but there is some really cool stuff emerging. So that was one thing an appreciation for where medical imaging is. Then there are a number of skills that are also very interesting as you know, when you get into medical imaging you kind of have to get involved in things that are specific to medical imaging like DICOM and HL7, that you probably wouldn’t use anywhere else.<br /><br /><span style="color: #990000;">Q. Was there a specific event or a project that kind of tipped the scales for you and convinced you that you should go out on your own as a consultant. </span><br /><br />That's a good question. So a little background on being on my own. I actually have run my own consulting business on the side for the past 13 maybe even 14 years now. So what I did is I actually ran it on the side with three different employers and my employers always knew that I was doing this but to avoid conflict of interest, I always had my side business running in different domains. For example, when I was working for Agfa, I built a product for a supplier of technology for the mining industry, which was very different from what I was doing for Agfa. <br /><br />So I've kind of always had what you might say is an entrepreneurial side of me in a sense. A couple of things that tipped the scale where I decided to quit my job and go full time, I've always kind of imagined myself going on my own full-time at some point. I didn't realize it would be this soon in my life. I kind of assumed it would be when my kids were bigger and they had little to do with me at some point and I had a lot more time on my hands. Two things came about that tipped the scale. Number one there was an opportunity I was presented with to work with a local hospital, but it was a contract based opportunity. That was one thing, and then the other one was that just generally over the past couple of years I've had a lot of people come to me and say hey, we've got work that we need your help with, and I've had to turn them down because I wanted to avoid conflict of interest with my employment. So in order to avoid that conflict I decided to just go out on my own to be able to accept such opportunities. <br /><br /><span style="color: #990000;">Q. It sounds like you had things kind of rolling already. You had a client and you had prospective business coming to you, so you didn't need any financing or funding to get started?</span><br /><br />I was luckier than most people in that sense. Most people who go out on their own may not have the same safety nets I was very lucky to have, so in my case, you know being able to plan for this for a few months in advance actually allowed me to put together a little bit of savings on the side as a safety net. Also the last event that kind of triggered me going out on my own was the contract with the local hospital was actually a year long. So that actually gave me a runway until the end of the year. Additionally, the other safety net is being married and my wife actually works full time. So we figured if worse comes to worst we could survive on one salary for a little while.<br /><br /><span style="color: #990000;">Q. You mentioned planning, and I looked at your website and it looks like you're a very big believer in thorough planning. What was your own plan for going into this business? <br /></span><br />That's a really good question. You're absolutely right. I'm generally a big planner but believe it or not going out on my own wasn't actually one of those things that I planned. I actually got asked that a lot, people would ask me ‘you're on your own now what are you going to do? And I always tell people I don't know, I'm going to see what I can do with anything where I can apply my skills and interest. That was really the big plunge. It's not really very specific, it is very general. <br /><br /><span style="color: #990000;">Q. So you had clients you had a one-year contract to keep you going, and you've been doing this for a while as you said, 13 or 14 years what do you know now that you wish you had known when you first started?</span><br /><br />I haven't actually had a moment to pause and reflect on that, so I don't really have an answer but off the top of my head, it's probably a number of things. I might blabber here a little bit, so stop me if I go on for too long, but I'll try and answer the question. <br /><br />Probably the top one is the positive side of stepping out on your own. It is actually a lot of fun. I really am enjoying myself. That's not to say that I didn’t like my jobs when I was employed full time. I definitely liked them, but being on your own is just different, you know, there's a bit of satisfaction that when you're on your own and being your own boss is satisfying. <br /><br />But there are also negatives not everything is of course straightforward from a financial point of view. It takes a little bit of discipline as your income is not as predictable as being employed. You've got your salaries being deposited into your bank account, you know twice a month or every two weeks, right? With consulting your payments are kind of sporadic in that sense so you have to be pretty good with financial planning. <br /><br />Also all those years when I ran the business on the side, I ran it as a sole proprietorship and now I realized the need to be an incorporated business and I underestimated just how much work was actually involved in incorporating and getting all these requirements done. Now the good news is a lot of this work is foundational work you do it once and it's done, but nonetheless there was definitely a chunk of time getting a business Incorporated, having to find an accountant, find a lawyer, getting things like liability insurance.<br /><br />The contrast is interesting, as a consumer, I've always just bought consumer Insurance, like car or house you basically give the insurance company your money and boom, you're done! Getting liability insurance for an incorporated business was definitely not straightforward. I've actually talked to a number insurance companies that flat out refused to give me a quote because they didn't want to touch anything with healthcare. They thought it was too risky to begin with and the ones that did give me a quote had me fill out forms that were like 10 or 11 pages long.<br /><br /><span style="color: #990000;">Q. Where do you want to go with your business say in the next five years or so?</span></span><div><span style="font-family: helvetica;"><br />A really good question. And again another question that I get but I haven't fully figured out yet. It goes along the same lines of you know, what is my plan now that I'm on my own? The obvious answer is of course I want to grow the business, and I hope that the business will become stable enough and sustainable. It's still very early stages. So nothing is guaranteed at this point. I've had people asking me if I’m going to have employees, and my answer is let me see if I have enough work to keep me busy and then we'll worry about having employees but that's definitely on the table.<br /><br />I've had people ask me if I’m going to launch products and I tell them. Well, I don't really have anything right now, but if I come up with something I'd be open to that. So yeah, the plans are a bit in flux. You know, I like I said, I generally tend to plan things. This one thing wasn't so well planned.<br /><br /><span style="color: #990000;">Q. You’ve been doing this a while. You have clients. You've kept them on your roster, what is the key to sustaining your client base? </span><br /><br />Yes, there are a number of things. First of all, I've been very lucky that I've rubbed shoulders with amazing people, who opened up doors for me throughout my career, starting with my very first boss at Agfa and my boss's boss also at Agfa (Bill Wallace and Don Dennsion) who are downright amazing people. <br /><br />Secondly, one of the very first things that got me involved in the (medical imaging) community was being sent to the SIIM conference, the Society for Imaging Informatics in Medicine. That opened up a lot of doors for me and it wasn't like, you know going for the purpose of rubbing shoulders to get work and sell products and services. Honestly it wasn't, it was just that I was told to go to SIIM because it was “interesting” and that was pretty much all the context I was given. I did go and it was an eye-opening experience because at the time having worked for a vendor, you're basically in a bubble. There's a lot you don't know about the general workflow the general challenges within the domain and so on and so forth.<br /><br />So I went to SIIM and I learned a lot that first year and then when I came back that first time there was no plan for going back again, because as a developer it was understood that I would only be sent once in a lifetime kind of thing, but it just so happened that there was a need for someone to conduct some technical training at SIIM the next year, or it may have been a couple of years later, and I got volunteered to do that and that actually put me on a path that I'm still on.<br /><br />So I went again to SIIM and I have never missed a meeting since then. Again, it's not that I go with the purpose of marketing myself or my services, absolutely not. I go in with a purpose of just meeting up with amazing people, learning from them, rubbing shoulders talking about problems thinking about solutions together and the rest is a byproduct. Finding work out of the community or making connections, that kind of stuff that is all a byproduct.<br /><br /><span style="color: #990000;">Q. In terms of the medical imaging would you say that you became a PACS expert or a DICOM expert or what's your field of strength?</span><br /><br />I get asked that question a lot, especially now being on my own, as far as services go, the question is what's your major area of expertise? My answer usually is that I am a jack of all trades and master of none. I actually like being a generalist. I love being able to dabble around, that being said, there are definitely areas where I think I know quite well. I know PACS systems very well, I'm pretty good with DICOM, I know that stuff pretty well. I have done a lot of work in integrations, especially front-end integrations, so like connecting two applications on the desktop rather than just connecting them on the server side, some people call that desktop integration. That's another area. I know very well. I've also done back-end integration.<br /><br />Another area of expertise, I don't know if I called myself an expert, but I think I know enough about newer standards, that also is an area of interest for me. So, you know, everyone talks about DICOM but there's DICOMweb, which is amazing. It's a major development and works really well in terms of making things easier. On the HL7 side, you have things like FHIR and the FHIR standard. Other standards keep coming out of IHE. There's a brand new standard that just came out. I think it was last year on AI workflow and AI results. These are all very interesting and you know important for someone to be sort of the evangelist for a lot of these standards.<br /><br /><span style="color: #990000;"> Q. Is that primarily what you're doing now in consulting is working on those technologies or those standards or are you involved in other things as well?<br /></span><br />I'm involved in a plethora of things. I can tell you as an example, my contract with the local hospital here is actually got me working on essentially two things, an innovation and research project as number one and number two is helping to improve operational efficiency, such as helping them with improving workflows, integrating systems that kind of stuff is taking the bulk of my time and working on those, but that's my focus for now. Among my other hats, I've done work on these new standards, and one of the other things I do is I also work as the technical project manager for the SIIM hackathon and have been for the last six years. <br /><br /><span style="color: #990000;">Q. I was going to ask you about that so yes this is a good time to talk about that. </span><br /><br />You know the SIIM hackathon is essentially a place where we evangelize these new standards and the development of these standards because of course these standards are living things in a sense. They're always being iterated and always improving and adding new features. So that's a major area of work for me. I also volunteer and have done training on some of these standards both at SIIM and other conferences. If you <a href="https://www.youtube.com/results?search_query=mohannad+hussain">look me up on YouTube</a> you're going to find a bunch of sessions that are recorded from as an example, the FHIR DevDays conference. <br /><br /><span style="color: #990000;">Q. So what advice do you have them for PACS administrators or IT professionals that might be considering going out and consulting.</span><br /><br />Honestly, this is more generic advice and not specifically about consulting but even if you want to stay current in your job, and you just want to grow, whether you want to grow just because you want to be promoted and get paid more, or you genuinely just want to grow and learn, I think the number one thing is to get out and meet people and talk to people about the challenges they have, the challenges you have, and the solutions to things you've done. That's probably the biggest appreciating factor in my career, just being a part of the community.<br /><br />SIIM is a near and dear community to my heart. So that's the one I would recommend to most people but of course people may have other interests, or other communities like RSNA or ACR and so on, HRA could be more applicable for some of these people and everybody's a little different. I've been part of the SIIM community, and it's made a major difference in my professional life and I love being part of the community<br /><br />Previously, being involved in something like SIIM generally meant going to the annual meeting, but there were other things you could do like volunteering as part of a committee and things like that, but generally that's what it boiled down to, is you have to go to the meeting, which wasn't always easy, you know money restraints timing etc.<br /><br />The silver lining of COVID is now a lot of SIIM meetings have gone virtual, meaning they are usually more accessible, a lot cheaper, but also allows more variety and more selection. You can “go” to the annual SIIM meaning that is now virtual, so it's a lot cheaper. I think the rate this year's $199 or $299 something along those lines, which is very affordable. But even if that's not an option, whether it's for money or timing, there are events happening throughout the year.<br /><br />SIIM puts on these webinars and that are free for members, quite informative and eye-opening and very low overhead as far as sparing an hour once or twice a month. SIIM recently started a new initiative, which is really cool. It's the SIIM member meet up. So the idea is when you had SIIM events in person, you could run into people in the hallways. Now with everything going virtual you don't have those chance meetings, instead what they're doing is they're having these monthly meetups. It's about an hour long. And usually there will be a theme but not like a specific topic or a hard agenda. So people can just show up and you know talk about things really whatever you want to talk about.<br /><br /><span style="color: #990000;">Q. Is there any anything else you'd like to add or talk about that I have missed?<br /></span><br />I'm sorry. I rambled on that last point which is the point is to get out and meet people. The second point I do want to make is to always look for ways to upgrade your skills. There are multiple ways to do this. You can go and attend courses, you can pay money for these courses, but there also many free resources that you can also try. So for example SIIM, you know, I'm heavily involved with the SIIM hackathon as I mentioned, and as shameless plug here, the SIIM hackathon is great, but I don't just say that because I'm the technical project manager for the hackathon. I say it because when we created the hackathon, it was created the SIIM way vs. the usual hackathon way. Your average hackathon is for super technical people and usually super competitive. <br /><br />The SIIM hackathon isn't either of those, the SIIM hackathon is focused on collaboration and education above all. It is not focused on competitiveness and it is also geared for anybody. You don't have to be technical; you don't have to be an expert in coding or for that matter, you don't even have to know how to code to attend the hackathon because it's all about bringing people together and educating people.<br /><br />So we get people who are technical, we get people who are clinical, and we also get people that PACS administrators and we match everybody into teams so they can actually work together and learn from each other. And of course we have mentors who are happy to help them.<br /><br />Now, that's the actual hackathon event, but there's also another not so well known aspect of the hackathon, which is the fact that we have our servers running in the cloud 24/7 365 days a year. So these servers along with the documentation we have produced over the years also present a learning opportunity that anybody can use. To use the server's you don't actually have to have a SIIM member, it is completely free. The guides are behind a SIIM membership login, but the reality is the membership isn't actually all that pricey so you can on your own time go in and learn some basics of something like DICOM web or something like FHIR.<br /><br />The thing is not everyone wants to learn DICOM to be an expert or FHIR to be an expert from day one, some just want to know the basics, e.g. what is available out there and you know what options you have to maybe make your day-to-day life easier is one thing, but also in general just being able to know how to troubleshoot when somebody is stuck on a DICOMweb then can say, yeah, I know what that's like I've done that. </span></div>Medical Digest Publicationshttp://www.blogger.com/profile/00463721708558629724noreply@blogger.com0tag:blogger.com,1999:blog-3309957522756479901.post-15402695886901090232021-05-20T08:57:00.001-07:002021-05-21T06:22:35.162-07:00Volunteer for SIIM – Accepting Applications Until June 2<span style="font-family: helvetica;"><span style="font-size: medium;">SIIM recruiting volunteers for a variety of opportunities</span><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://siim.org/resource/resmgr/banners/Volunteer_at_SIIM_2000x587.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="235" data-original-width="800" height="128" src="https://siim.org/resource/resmgr/banners/Volunteer_at_SIIM_2000x587.png" width="436" /></a></div><br />PARCA eNews – May 18, 20221 – Are you looking to enhance your career, learn more about medical imaging and informatics, or just want to connect with others in the medical imaging field, then the Society for Imaging Informatics in Medicine (SIIM) is looking for you. The organization is accepting applications for volunteers through June 2.<span><a name='more'></a></span><br />There are opportunities to get involved in committees, developing educational content, networking, hackathon participation and more.<br /><br />Invest in the future of healthcare in imaging informatics and in your own career, volunteer with SIIM today.<br /><br />Questions? contact <a href="http://molek@siim.org/">Meggan Olek</a> <br /><br />or <a href="https://siim.org/page/volunteer_at_siim_2021">Apply now</a>.</span><script>
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