Health Management Information Systems

1. Health Management Information Systems Medical Imaging Systems Lecture a This material (Comp 6 Unit 7) was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024. This material was updated by Normandale Community College, funded under Award Number 90WT0003. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

2. Medical Imaging SystemsLearning Objectives • Examine the purposes, processes, and management issues • Understand the economic and technological factors associated with digital displays • Describe the major challenges • Describe the future directions

3. Biomedical Imaging “The science and the branch of medicine concerned with the development and use of imaging devices and techniques to obtain internal anatomic images and to provide biochemical and physiological analysis of tissues and organs.”

4. Medical Imaging “Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy.”

5. Medical Imaging Informatics Relatively new multidisciplinary field • Intersects with the biological sciences, health services, information sciences, medical physics, and engineering • Touches every aspect of the imaging chain

6. Why Use Imaging Systems • Detection and diagnosis • Assessment and planning • Guidance of procedures • Communication • Education and training • Research

7. Imaging Systems and Health care Processes • Acquiring/managing images • Image creation and acquisition, image distribution and management, image storage and retrieval • Interpreting images • Image processing, analysis and understanding, image visualization and data navigation; image interpretation • Communicating the interpretations • Image reporting and communications

8. Image courtesy of Keystone Medical Technologies http://www.keystonemedicalus.com/Multi-Modality-PACS/pacs-configurations PACS Configuration

9. Format Standards • Digital Imaging and Communications in Medicine (DICOM) • Standard for the electronic exchange of medical images • Data associated with the images • Health Level Seven (HL7) • Message standard

10. Management Issues • Storage concerns • Film versus digital • Image modalities differ • Contrast and spatial resolution requirements • Number of images or the size of the data sets • Raw or processed data • Use of data compression

11. Management Issues • Image integration • Viewing stations • On-line image databases • Image-management systems • Networks

12. Management Issues • Technological and human engineering factors • Radiologist • View and interpret • Referring clinicians • Review and consultation • Economic factors

13. Major Challenges • Image integration • Hospital Information System (HIS) • Contains all the clinical, administrative, financial, and demographic information

14. Major Challenges • Medical imaging system • Radiology Information Systems (RIS) • Standalone • Components of HIS

15. Integration Example • PACS integration • Hospital information system • Radiology information system • Benefits to integration • Economic • Rapid access enhances the quality of patient care

16. Major Challenges • Reporting methods • Dictation/transcription • Speech recognition • Structured • Tools for entering data • Defined data elements • May use predefined list or vocabulary

17. Future Directions • Advances in medical imaging technology • Increase in imaging studies • Increase in imaging data

18. Future Directions - 2 Development of standards • DICOM medical image exchange standard Supplement 145 • DICOM requirement in EHRs

19. Future Directions - 3 • ARRA • HITECH Programs • Meaningful use of interoperable health information technology and certified EHRs • Expansion of meaningful use • Ability to link to images in an external system, such as a PACS

20. Medical Imaging SystemsSummary • Definitions • Purposes, processes, and management issues • Factors related to storage concerns and image integration • Future directions

21. Medical Imaging SystemsReferences References AHIMA e-HIM Work Group on Speech Recognition in the EHR. (2003). Speech recognition in the electronic health record. Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_022107.hcsp?dDocName=bok1_022107 American Health Information Management Association. (2012). Pocket glossary for health information management and technology (3rd ed.). Chicago, IL: Author. Arenson, R. L., Andriole, K. P., Avrin, D. E., & Gould, R. G. (2000). Computers in imaging and health care: Now and in the future. Journal of Digital Imaging,13(4),145-156. Abstract retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11110253 Bhachu, D. (2005, September 1). The medical digital imaging revolution. Retrieved from http://www.hospitalmanagement.net/features/feature681/ Branstetter, B. F. (Ed.), Practical imaging informatics: Foundations and applications for PACS professionals (pp. 429-442). New York, NY: Springer Science + Business Media. Centers for Medicare and Medicaid Services. (2011, November 7). EHR incentive programs overview. Retrieved from https://www.cms.gov/ehrincentiveprograms/#BOOKMARK1 College of American Pathologists. (2010, September 16). Medical imaging standard extension for pathology will help advance health information interoperability. Retrieved from http://tinyurl.com/2elpbvh Goedert, J. (2010, October 14). Advanced imaging app approved. Retrieved from http://www.healthdatamanagement.com/news/health-care-technology-news-imaging-nasa-mammogram-analytics-41165-1.html Greenes, R. A. & Brinkley, J. F., (2006). Imaging systems in radiology. In Shortliffe. E. H., & Cimino, J. J. (Eds.), Biomedical informatics: Computer applications in health care and biomedicine (3rded) (pp. 626-659). New York, NY: Springer Science + Business Media.

22. Medical Imaging SystemsReferences References Health Level Seven International. (n.d.). About HL7. Retrieved from http://www.hl7.org/about/index.cfm?ref=nav Krupinski, E. A. (2010). Viewing images. In Branstetter, B. F. (Ed.), Practical imaging informatics: Foundations and applications for PACS professionals (pp. 99-108). New York, NY: Springer Science + Business Media. National Electrical Manufacturers Association. (n.d.). DICOM. Retrieved from http://medical.nema.org/dicom/geninfo/Brochure.pdf National Library of Medicine. (2004, August 24). Biomedical imaging. Retrieved from http://www.nlm.nih.gov/tsd/acquisitions/cdm/subjects15.html National Library of Medicine. (2012). Diagnostic imaging. Retrieved from http://www.nlm.nih.gov/cgi/mesh/2012/MB_cgi?mode=&index=3786&field=all&HM=&II=&PA=&form=&input= Ralston, M. D., & Coleman, R. M., (2010). Introduction to PACS. In Branstetter, B. F. (Ed.), Practical imaging informatics: Foundations and applications for PACS professionals (pp. 33-48). New York, NY: Springer Science + Business Media. Society for Imaging Informatics in Medicine. (2012). Imaging informatics. Retrieved from http://www.siimweb.org/index.cfm?id=324 van Bemmel, J.H., & M.A. Musen, eds. (1999). Handbook of Medical Informatics. Vol. 3.3. Rotterdam, Netherlands: Erasmus University and Stanford University Images Slide 8: PACS Configurations: Facility-wide solution [image on the Internet]. (n.d.). Retrieved from http://www.keystonemedicalus.com/Multi-Modality-PACS/av-advanced-visualization-3d-4d

23. Medical Imaging SystemsLecture This material was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024. This material was updated by Normandale Community College, funded under Award Number 90WT0003.