Radiology goes down to the informatics crossroads

Radiology helped pioneer clinical informatics over the past three decades. But by now, the new ways have become everyday operating procedures across the enterprise. The present reality offers radiology some developing opportunities—and poses some pressing questions.

To wit:

• What will happen to the informatics expertise within radiology’s domain?
• Will radiologists’ current and future concerns be heard and their needs be addressed?
• How can radiologists prepare for whatever informatics challenges the next decades will bring?

Those are among the points to ponder taken up in the April edition of the American Journal of Roentgenology.

“For radiologists to best shape our informatics infrastructure and influence the greater health care informatics framework, we must understand our goals, create and promote pioneers to guide us, and forge relationships with chief information officers and the greater health care IT community in our own enterprises, as well as sponsors, industry, legislators, and agencies,” write authors Marc Kohli, MD, of Indiana University Health, Keith Dreyer, MD, of Massachusetts General Hospital and J. Raymond Geis, MD, of the University of Colorado.

Their article traces radiology’s ascent as a tech-savvy innovator before noting that, currently—despite extensive IT experience and domain knowledge among radiologists and imaging informaticists—radiology IT is getting harder rather than easier. Why?  

“Radiologists may have overestimated our technologic advances to date on the basis of dramatic productivity results from PACS,” the authors write. “Decades from now, radiologists may look back on radiology’s informatics advances merely as the application of existing technologies, maturing through larger consumer markets and intelligently applied to serve our evolving needs.”

Meanwhile, at the precise moment in time when radiologists could be rapidly expanding their expertise with clinical and imaging informatics, the whole of healthcare is facing unprecedented strains. Money is tight, information security regulations are complex and FDA compliance is onerous. Provider consolidations add to the sense of uncertainty about what comes next. One result of all the change and financial pressure is the slowing of innovation and adoption throughout healthcare, the authors explain.

In such a setting, the ubiquitous and critical nature of IT and informatics means that radiologists, physicists and radiology executives “need to become more IT savvy,” write Kohli, et al. “The actual function of IT hardware and software may remain the domain of IT specialists, but innovating, planning and developing strategy around informatics need to be addressed by radiology leadership”—and those leaders need to understand the challenge inside and out.

“Currently, much of healthcare IT is simply about managing the technology, choosing which vendor’s product to buy and struggling to integrate each product,” the authors note. “This is where other IT-savvy industries were years ago.” By now many of those industries have shifted IT’s role to reusing existing data and allowing individual areas to regain local control with domain-specific informatics solutions.

To hasten that process for radiology, “radiologists must get a seat in the enterprise C-suite, the decision-making body with the chiefs of all enterprise sections, to influence enterprise IT decisions and provide the radiology-specific IT knowledge needed to drive IT solutions that optimize radiology quality and efficiency,” the article concludes. “Radiologists need to plan for a future where ‘whoever has the best data wins,’ understanding that operational needs and the healthcare IT landscape have forever changed.”

The article offers a succinct and thought-provoking overview of radiology’s info-technological past, present and future. Read the whole thing.