For RadXX Trailblazer, Imaging Informatics Passion Comes from Strategy

The RadXX awards are less than five years old, but they have become a focal point of the Radiological Society of North America annual meeting in that short time, drawing attention to and recognizing the significant contributions that women have made to the field of medical imaging informatics.

This year, Cheryl Petersilge, M.D., founder and chief executive officer of the consulting firm Vidagos received the RadXX Trailblazer award for her pioneering and innovative work in the field. Not only was Petersilge on the front lines of implementing enterprise imaging during her tenure at the Cleveland Clinic, but she now leads efforts to help both healthcare organizations and vendor develop and implementing imaging informatics strategies.

She spoke with Diagnostic Imaging about her journey into imaging informatics and how her efforts have changed the field not only for women, but also overall.

Diagnostic Imaging: Explain what initially led you to be interested in the field of imaging informatics.

Petersilge: I really become interested in informatics toward the mid-portion of my career, and I saw it as something that was becoming more and more important in healthcare. It was something I really wanted to learn about, and I actually started my informatics experience in clinical informatics. I was a physician champion for computerized physician order entry in my local hospital, and, then, I was the Regional Medical Director for the East Side for the implementation of electronic documentation in the regional hospitals at the Cleveland Clinic. As those efforts were underway, enterprise imaging was being established at the Cleveland Clinic. It was prompted by the changeover in our PACS system, and it was a really great fit for a radiologist to become a medical director.

I started working with the team that was implementing that initiative and became the first medical director. It gave me the opportunity to really shape the direction and establish the strategy for how we were going to go implementing that throughout the Cleveland Clinic. It was a great fit for me because my passion really lies in strategy developments. I really liked having the opportunity to establish something new. The great thing was it wasn’t just establishing something new at the Cleveland Clinic, it was helping establish something new for all of healthcare since we were really one of the first enterprise imaging programs. We became one of the most comprehensive enterprise imaging programs during my tenure there.

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Diagnostic Imaging: You received this year’s RadXX Trailblazer award largely due to your experience and innovative efforts. What are some of the main accomplishments you can point to that led to your earning this accolade?

Petersilge: I think of two different things. One is helping to lead the enterprise imaging program at the Cleveland Clinic and uncovering some of the challenges that actually continue today. For example, how do we label photographs as they go into the electronic medical record? And, what are the challenges around that? When we were having discussion with our clinicians about what we were doing, we realized there was a disconnect. We kept calling things orders, and they kept saying they didn’t give orders – to us, orders meant how you label things in the electronic medical record. So, we had to uncover those challenges.

Some of that work set the stage for establishing the encounters-based workflow which is now an HIS standard. I’m not going to claim that we drove that, but I think we helped uncover the problem and played a role in defining the problem statement. Also, with surgical imaging, we were exploring how do you implement surgical imaging programs into your enterprise imaging program? What all needs to go into the consideration of that program? Those programs are still in their infancy in most organizations.

Other than that, one of the avenues of work that I’ve done is in photo documentation – incorporating medical photographs into the enterprise imaging program. I alluded to some of the challenges we had at the Cleveland Clinic. Through that, we were able to establish the photo documentation workgroup for the HIMSS and SIIM enterprise imaging community that is working to bring together multiple disciplines that are engaged in photo documentation. This is an area that radiologists don’t play in, so we’re getting a lot of other fields together to try and coordinate what has been very specific work into a unified process.

Diagnostic Imaging: How did that get you to founding Vidagos, and what role does the company play in medical imaging informatics?

Petersilge: As I mentioned, strategy is really what I enjoy – it’s what makes me happiest. As the Cleveland Clinic program matured and the roadmap was established, we did a lot of strategy and defining work. I would say it’s now turning over to more of an operational and implementation type job. I established a new radiology group for the Cleveland Clinic and a place where I used to work in private practice, but after a few years, that was when my interest in imaging informatics started. I was looking for other opportunities to engage my passion for learning and developing strategy.

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As I was ending the process for enterprise imaging at the Cleveland Clinic, I knew that informatics was really something that I truly enjoyed. I had fulfilled my course at the Cleveland Clinic and was looking for new opportunities. Couple that with the fact that I got my MBA several years ago and the fact that I was always an entrepreneur at heart. So, I decided that it was time to go out and establish my own business. Frankly, I even looked into leaving healthcare to engage that passion, but after exploring a lot of things, I realized that informatics and healthcare was really where I belong – where I had the most to contribute.

I decided to start Vidagos consulting firm. There, my goal was the help organizations develop their enterprise imaging strategy and really bring them my experience because there are a lot of people out there that have built a program when no roadmap exists for how to do it. I knew that I could really help healthcare organizations. One of my goals was also to work with the vendors to help them understand what the healthcare organizations need, to be a voice for enterprise imaging to the government and to talk to and educate the government. I’ve really been able to fulfill all of those obligations. I work with many different healthcare organizations, educating them on what enterprise imaging and helping them assess their current state. For many organizations, that’s a daunting task. They don’t even know where to begin, so I walk them through what they want their enterprise imaging program to look like and what their guidelines should be. I develop their roadmap with them. Similarly, I’m doing the same thing for vendors, helping them understand what organizations need and how the field is evolving.

But, I’m not one to let moss grow, and I have expanded beyond enterprise imaging and am becoming more involved with general healthcare information exchange, data governance, standardization, and data commercialization. That’s primarily through my vendor relationships right now, but I also know that it will feed what I bring to healthcare organizations.

Diagnostic Imaging: With that as a backdrop, how do you feel your work has changed the field of imaging informatics – what would you point to as being the impact you have made?

Petersilge: Driving photo documentation and the consolidation or coordination of medical photography across the entire organization, as well as the recognition of the importance of metadata. One initiative I am deeply involved with – but I’m not leading – is selecting standards for body parts so we can unify al medical imaging through body part identification. So, whether it is a photograph of a wound, MRI of the wound, or the pathology of the wound, all of that would be unified by the body part. You could look at the full concept of that patient’s disease process. I think raising awareness of that has been one of the ways I’ve changed the field of imaging informatics.

One of my goals for this year, sort of one of my two messages, is to really stress the importance of the electronic health record and the difference between the electronic health record and the electronic medical record. I think many organizations are focused on their electronic medical record, and, certainly, there’s a lot of work to do there. But, we need to understand that there is so much information in the electronic health record and that includes patient generated data, even expanding the social determinants of health. That’s one of the new messages that I’m out there really trying to drive education for.

Diagnostic Imaging: How do you feel what you’ve been able to accomplish has potentially impacted the field of imaging informatics for women who are interested in the specialty?

Petersilge: One of the most important things is for early-career people to see people that look like them be successful. Two of my mentors in imaging informatics have been women. For women to see women be successful, it is a huge influence on the field, so I think more and more women feel comfortable in the field. Also, to have people that they talk to about how they’ve dealt with some of the challenges might be unique to whatever part of the population you belong to. So, for RadXX, that would definitely be women.

For women to see these close relationships among women, to see women helping women is very important because women don’t always help women.I think to set the example of women supporting and developing other women is very, very important.

Diagnostic Imaging: What is your hope for imaging informatics as it moves into the future as a specialty?

Petersilge: I really want to see imaging informatics become an enterprise priority. It needs to move beyond radiology, but radiology definitely needs to be a leader and a mentor. Radiology plays a critical role in imaging informatics. But, as we try to coordinate healthcare, we have to coordinate imaging. It has to be a cooperation among all of the different imaging specialties. I really want to get healthcare informaticists to understand that there is a wealth of information held in all of these images.

We also have to get the message out about the role imaging informatics can and will play in population health. In fact, one presentation at RSNA this past week talked about information that’s hidden in images that can be used to understand the health of your population. I think we’ve only begun to scratch the surface on that.

One of my hopes for the coming year is to start to reveal the role that imaging informatics should be playing.

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