How CIIPS Can Add Value to Radiology

Since certification became available seven years ago, certified imaging informatics professionals (CIIPs) have steadily gained ground in radiology as staff members who understand the intricacies of IT and radiology technologies, such as PACS. As of this year, there are 1,000 CIIPs who have earned certification through the American Board of Imaging Informatics and are working in departments and practices nationwide. And, according to industry experts, they're setting the standard for how other specialties can merge their technical and clinical needs in the most effective and productive ways.

But there are still questions about the role and the value of a CIIP. These inquiries will be the subject of a panel at this year's Society for Imaging Informatics in Medicine (SIIM) annual meeting. Diagnostic Imaging spoke with panel member Paul Nagy, PhD, CIIP, quality director at Johns Hopkins University radiology and radiological sciences department, to discuss the importance of the CIIP and how this professional can positively impact almost every part of a practice's daily activities.

What role does the CIIP play in a radiology practice or department?

In many ways, they're the chief technology officer of the radiology group. They are involved in all levels of decision making around IT systems used in radiology, such as the PACS or RIS. They often support the department administrator who has been trained but who doesn't have a technical background, and they advise these administrators about getting the right features from vendors when choosing various modalities. They can also look at the raw IT system and provide recommendations.

How can CIIPs be most effective? What is their role and value?

The primary role of the CIIP is to, basically, keep the lights on and make sure the PACS is running okay. They make sure that users are using IT tools to deliver the best care. The challenge can be the "Paradox of Excellence." The better you build your system and the fewer fires you have to put out, the less people will see you. It's only when there's trouble - like when the PACS is broken - that you're likely to see people. And, that's a lose-lose situation because, then, they only associate you with negative events, and they don't think you're doing your job.

The value of a trained CIIP is that they can be a value innovator. In addition to providing advice on new systems, they can analyze multiple sets of data from the PACS or RIS to improve operational efficiency, patient safety, and overall satisfaction of service. The key goal is for them to understand the group's work flow so they know how to attach differing information systems so they don't get stuck in the job description of PACS administrator.

This is what radiology needs the most today. PACS are stable, sure information systems, but departments are struggling because they need to reduce waste and improve their financial footing. They need people to help them access and analyze data. That's the role for the CIIP - to be the analyst and understand the context of clinical activity in order to improve efficiency.

I think CIIPs are well positioned to do this because they can bridge the technical and the clinical. To be an advanced analyzer, they have to become even more fluent with the database. They have to become experts and, in some ways, they must be in tune with practice management and what data is being requested. The more time they spent with administrators, the more they understand how leaders want to use the data, the better equipped they are to provide actionable information.

Their value, really, is in bridging and connecting the clinical and the technical. They can be part of operations and quality committees and be a partner of the medical director to improve relations within the hospital and with referring physicians.

What challenges will CIIPs face in trying to positively impact and integrate with radiology groups?

The challenge will come if the CIIP is too passive. They won't be seen as part of the solution. They'll be viewed as just a support person in data entry rather than an essential resource. CIIPs have to do extra work to sell themselves. They must express that they have the interest and the capacity to do more than maintain the systems. They can understand how to use them better. And, certification helps.

CIIPs are really in strong demand remand right now, and there aren't a ton of them. They are people who can help reduce waste and utilize various IT systems. CIIPs can help with the electronic medical record implementation and computerized physician order entry, as well as be a good logistical liaison and translator between physicians, nurses, and other members of the healthcare team.

What types of leadership strategies should CIIPs employ?

The first strategy CIIPs need to use is time management. They must track time. What percent of their time they spend supporting systems and what time they spend improving efficiency, automating systems, and otherwise adding value.

I recommend they build relationships with administrators and the radiologists in the reading rooms to find mentors who can help them understand the clinical operations. CIIPs should also make an effort to help with the external pressures radiology groups face, such as quality requirements from the Joint Commission or dealing with declining reimbursement. Radiology is facing some real changes, and the industry needs people who understand its unique environment to be part of all conversations.

What topics do you anticipate discussing during the SIIM CIIP panel?

There's been an explosion of new applications in RIS development, particularly in quality control, safety, and contrast reactions among others, so I expect we will discuss the methods in which CIIPs can help build cultures of quality that allow for measurement and open the door to improved quality performance. There will also be discussion of the role CIIPs can play in the whole movement toward cloud imaging and the replacement of old PACS systems. And, since there are Meaningful Use Phase 2 requirements for radiology, there will likely be some talk about why it's good for CIIPs to be involved with measuring outcomes in meaningful ways in order to improve operations.