Digital imaging fellowship charts course to subspecialty of the future

Digital radiology departments need radiologists who are more than just clinically proficient. Today's radiologists must also be informatically competent, since they will be expected to understand such arcana as PACS technology and administration, usability and acceptance testing, workflow analysis, digital image acquisition, compression, and quality control.

These topics, however, are not thoroughly addressed during residency training.

Seeing a need, the Mayo Clinic in Rochester, MN, has formed an Electronic Imaging and Technology (EIT) fellowship focusing on practical, technical, and administrative aspects of PACS, electronic imaging, and teleradiology.

"In the world of PACS and the ongoing transition to enterprise-wide filmless radiology, there are increasingly complicated practice issues regarding the selection, deployment, and utilization of technology," said Dr. Brian J. Bartholmai, a Mayo radiologist and first EIT fellowship recipient.

For radiologists to have an informed leadership role in today's digital department, someone must be able to bridge the gap between the typical practicing radiologist and the technical IT support staff, he said.

"This fellowship is truly at the cutting edge of radiology," Bartholmai said.

Part of his job as the first fellow is to help formalize the program. He discusses fellowship goals and curriculum specifics in a paper that he will present at upcoming meetings of the Society for Computer Applications in Radiology and the Association of University Radiologists. It will also appear soon in the Journal of Digital Imaging.

"An electronic imaging and technology specialist has a critical leadership role in steering a modern radiology department and communicating with vendors for equipment selection," Bartholmai said.

The training also has obvious benefits for clinical practice, since on-the-job use of advanced tools for diagnosis and computer-aided detection is becoming commonplace.

The EIT program differs from existing informatics fellowships that typically concentrate on a few aspects of information science or the technical factors involved in modern imaging. The EIT fellowship is broader in scope. It includes other practical skills:

?group leadership
?rational/systematic technology evaluation
?PACS administration
?education regarding medicolegal issues (such as HIPAA) that pertain to modern radiology

"The EIT fellowship provides the time to study PACS technology in depth, beyond mere image acquisition, networking, storage, and display," Bartholmai said.

The program also emphasizes workflow analysis, usability testing, enterprise distribution, RIS/HIS/PACS integration (Integrating the Healthcare Enterprise), teambuilding and leadership skills, quality assurance, and basic research in the field of digital imaging.