With a focus on hands-on interaction and direct communication between vendors and customers, the annual meeting of the Society for Imaging Informatics in Medicine, held May 15-18, attracted a mix of radiologists, technologists, IT administrators, physicists, and company executives to surprisingly sunny Seattle.

When compared to previous years, the meeting has experienced an evolution, a tremendous growth that Curtis Langlotz, MD, PhD, has observed during his 2-year tenure as society chair. In the spring issue of SIIM News, Langlotz noted that when he assumed the position, SIIM was in the stages of “a period of rapid growth that had transformed it from a small group of intrepid PACS pioneers to a larger and stronger organization of scientists, developers, users, administrators, purchasers, and vendors—all interested in the systems that support electronic medical imaging. Everyone knew the organization was poised to do great things. The question was: What will SIIM do with its newfound strength?”

This year’s meeting sought to tackle the issue with a bevy of scientific sessions, posters, demonstrations, and discussions, in addition to an exhibit hall filled with approximately 140 vendors.

Advancing the Profession

During a press conference that discussed highlights of the annual meeting, Langlotz joined Bradley J. Erickson, MD, PhD, Katherine P. Andriole, PhD, Eliot Siegel, MD, and George Bowers, MBA, in a conversation about the advancement of not only the society, but the industry as a whole. This year, the quality of topics covered in presentations and scientific sessions was markedly enhanced, the panel said. Subjects explored included image distribution and experiential, vocabularies and ontologies, image processing and analysis, infrastructure and administration, image acquisition and quality assurance, GUIs and quality/safety, standards and security, productivity and workflow, and CBIR and data warehousing.

This year’s meeting capitalized on the growth seen in SIIM over the last few years.

Intimate learning labs encouraged hands-on exploration of various IT solutions, such as medical interface development, host and service monitoring, and display calibration via the DICOM Grayscale Standard Display Function. An Open Source Plug Fest gave participants an opportunity to bring in their laptops and test out open source software, such as ClearCanvas, dcm4che, Mirth, OsiriX, and XNAT.

A live demonstration of advanced processing and visualization processes allowed attendees to witness the enactment of an imaginary, but realistic, radiology department’s workflow and the problems associated with ordering, scheduling, acquisition, interpretation, and reporting. According to the presenters, inefficiencies typically arise from a lack of communication between departments and disparate schedules. Common difficulties routinely expressed by IT users stem from a need for automation, orchestration of tasks, large data sets, and selection of images to be sent to PACS.

These frustrations were brought up during the closing general session, when users and vendor representatives came together to talk about the strengths and weaknesses of various products.

A New Gold Standard

An emerging trend that Siegel predicted will eventually become “the standard in the industry” involved the push for imaging informatics professionals to attain their certification. SIIM, in conjunction with the American Registry of Radiologic Technologists, had established an independent certification body called the American Board of Imaging Informatics, or ABII, in 2007. While the surge of candidates has hit somewhat of a plateau, leveling off this year at 270 people, the panelists agreed that certification represented a big change from the past. Its future progress looks promising, they said.

“It hasn’t hit momentum yet,” said Bowers, of Health Care Information Consultants, LLC. “But I think it’s getting there, possibly in another 2 or 3 years.”

The 150-question test focuses on 10 major areas of knowledge identified by imaging informatics professionals as being critical to competence. Image management and information technology represents about one-third of the examination, with the remainder of questions covering operations, communications, systems management, clinical engineering, medical informatics, procurement, project management, and training and education.

Defining Unifying

During the talk, SIIM panelists named a range of concerns, encompassing such topics as the sharing of images across institutions, patient identification and privacy issues, effective mining of information, image overload from CT scanners, and pay for performance, to name a few.

But possibly the most crucial issue examined during the 4-day meeting was the concept of integration. Langlotz bemoaned the act of logging into three entirely different systems, and Siegel talked about integrating the core electronic medical record with a facility’s RIS/PACS solution.

Recognizing that integral essentially means “being one,” Erickson cautioned that wanting a more “unified” environment did not necessarily equate to utilizing a single system that handled all processes. Rather, he posed a question: “How do we get all these pieces to work together in a harmonious fashion?”

Vendor Solutions

Perhaps serving as a response to Erickson’s question, interoperability was a favorite descriptor of many vendors, including Washington, DC-based Compressus, which announced an agreement with Seattle Radiologists, APC, to implement a single, enterprise-wide solution that would integrate digital imaging and data management systems. A spectrum of MEDxConnect System’s components will be installed at eight sites to seamlessly integrate disparate information systems. Users will have the freedom to select best of breed PACS, HIS/RIS, EMS, and CIS tools, regardless of vendor. Carestream Health Inc, Rochester, NY, redeployed advanced 3D capabilities integrated with its KODAK CARESTREAM PACS platform into a new turnkey 3D solution for health care facilities currently without PACS as well as for existing PACS users with limited or no 3D capabilities. The CARESTREAM Virtual 3D solution, which allows for comparative viewing of MR and CT studies, is available as a stand-alone workstation or as a workgroup configuration that lets multiple users access the server-based software from existing workstations.

GE Healthcare IT announced a pair of new partnerships that combines its technology with those of other companies. In collaboration with Orthocrat Ltd, GE will integrate its Centricity PACS-IW (for hospitals and imaging centers) and Centricity PACS Office-IW (for physician’s offices) with Orthocrat Trauma-Cad software, providing for single-click, Web-based access to digital orthopedic templating tools. The powerhouse will also team up with advanced speech understanding solutions provider M*Modal, incorporating the company’s Any-Modal Conversational Documentation Services technology into GE’s Centricity RIS-IC Reporting module. Users will have a way to dictate without any change in workflow. “Ultimately, the ability to share highly accurate, structured, encoded clinical documents improves the efficiency of health care providers, and better information drives improved patient care,” said Michael Finke, CEO of M*Modal.

Among the topics panelists spoke on were patient privacy issues and interoperability.

Philips Healthcare reported an integration in the works with AMIRSYS and its STATdx Diagnostic Support System, a reference technology that offers users enterprise-wide access to on-demand reference tools at the point of care. MedQuist Inc further contributed to the interoperability trend, with the release of enhanced integration capability between its SpeechQ for Radiology and various medical imaging PACS, such as Philips iSite. According to MedQuist, the SpeechQ-PACS integration will have the ability to achieve better bidirectional messaging and communication, as well as streamlined log-in and log-out for radiologists.

Representing another integration in the speech recognition arena, MedQuist has also teamed up with StructuRad LLC to provide new add-on capability for macro-reporting. Specifically, the SpeechQ macro-reporting product will utilize content macros derived from StructuRad’s proprietary knowledge base radiology lexicon. The exhibit hall also showcased heightened enhancements offered by other speech recognition companies, such as Nuance Communications Inc. The latest version of its Dictaphone PowerScribe for Radiology speech-enabled reporting solution, PowerScribe 5.0, is said to reduce the word error rate by 35%. It natively supports multivendor RIS environments, which streamlines workflow for sites with disparate systems and inconsistent operational processes.

The majority of exhibitors at this year’s gathering also said that an essential driving factor behind their products’ development was meeting the demands of radiologists and IT users for maximizing workflow with minimal disruptions. User friendliness was a priority addressed by many product managers and company executives, many of whom cited the increasing amount of images that radiologists can read through tailored solutions. This may lead to an increased revenue stream and therefore more business, they said.

Interoperability was also a favorite topic for many vendors in the exhibit hall.

The advantages of a single log-on were emphasized in Agfa Health-Care’s IMPAX Clinical Applications US release, which permit users to perform complex image processing without the need for a specialized workstation. The software provides Registration-Fusion, X-Ray Angio Analysis, and OrthoGon in a package that offers tight integration in Agfa’s PACS. Addressing the time and financial constraints of radiologists, Siemens demonstrated its complete syngo Suite, a Web-enabled RIS and PACS with intelligent postprocessing and CAD applications in addition to embedded speech recognition or dictation and voice functions. Touted as a tailored solution specifically designed with the radiologists’ needs in mind, the technology is able to pull relevant information, optimize tasks, and deliver a role-based, context-sensitive, and knowledge-driven reading environment. For example, syngo Imaging XS is a scalable PACS solution that supports both centralized or decentralized system architecture, while syngo Workflow features order entry and registration, supply tracking, event and patient tracking, coding, paperless communication, messaging, interactive documents, online order requisition, reaction tracking, technique capture, peer review, speech recognition, digital dictation, PACS integration, and bidirectional communication.

With the increasing load of patient data comes a need for its organized management, as well as a demand for security. At the Mammography Reporting System booth, executives demonstrated the MRS Scheduling Matrix and Resource Tracker, which schedules staff, patients, equipment, and rooms, and MRS Secured Access, which places patient results on the Internet in a fully HIPAA-compliant system. Emageon’s Enterprise Content Manager integrates with departmental diagnostic applications and manages patient information over its life cycle, performing integrations and data backups for content management across multiple sites. For stand-alone operations, Candelis Inc debuted the iMed-Stor 300, a dedicated DICOM-compliant archive appliance designed to provide secure management of digital medical images and studies. RamSoft introduced major updates to its adaptable Gateway Router, which routes DICOM studies safely without requiring a VPN. InSiteOne promoted an InDex Recovery Bundle, which aims to provide security through the storage of off-site data.

The Future

While panelists admitted there is still a long way to go to achieve true interoperability, seamless workflow, and secure access to patient information, all agreed that these are exciting times for the growing informatics profession.

“The discipline of imaging informatics is still near the beginning of its journey,” Langlotz wrote in his final column as SIIM chair.

Next year’s SIIM meeting will take place on June 4-7 in Charlotte, NC.

Elaine Sanchez is associate editor for Axis Imaging News. For more information, contact .