Imaging informatics focus transitions from having technology to using it wisely

Soon, having the latest informatics technology, such as electronic health records, will no longer differentiate one hospital from another. What will help distinguish facilities is how that technology is used, how well the data is leveraged to improve processes and patient care, according to John P. Glaser, Ph.D., vice president and chief information officer of Partners Healthcare Systems.

Glaser opened up the 2007 Society for Imaging Informatics in Medicine meeting in Providence, RI, with a talk titled "The Evolution of the Role of Imaging Informatics in the Health Care Delivery System," which focused on the transition that healthcare IT finds itself facing.

Several forces are shaping the IT industry and community, he said. One is that the days of large investment in EHRs, with the organizational energy needed to put them in place, are essentially over.

A 2006 poll revealed that two-thirds of hospitals have fully or partially implemented EHRs. In the outpatient setting, growth in IT is seen in larger groups, 50 physicians or more, and it's increasing rapidly, according to Glaser.

The questions now are: "What does a hospital do once the hardware and software are installed?" And, "Where is the value, both economic and in terms of patient quality?"

It's dangerous to think that imaging informatics will bring about a sudden transformation that allows one to think the job is done, Glaser said.

"Transformation goes on all the time. We have to continually work at it," he said. "We are never at the pinnacle of IT existence."

Healthcare informatics is entering an era, "life after EHR" in which the focus will be on:

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• continually improving processes;

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• leveraging data; and

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• extending the reach of these systems outside facility walls to patients and to clinical affiliates

Glaser gave an example of finding value by leveraging information. An analysis of data in his organization found no evidence of follow-up for 36% of women with abnormal mammograms or Pap smears. Being able to access this information and then acting on it can make a difference in patient care.

Another force shaping IT involves the nature of interconnectivity or interoperability across the country. The current model of broad regional health information organizations will not thrive, Glaser said. It will be replaced by organizations with very specific and targeted business goals.

These include many players who will use healthcare IT to reduce costs: providers, employers, pharmacy benefits managers, and even state governments, as they integrate care across community health centers.

"There will be a well-engineered national health information network, which will be the collective result of lots of independent actions on the part of organizations trying to advance their causes," Glaser said. "Will the world be better off? Sure. Will it be an orderly system? No. Not at all."

A third force shaping informatics involves the nature of IT architecture, which will become more service-oriented and will more extensively support clinical decision making.

Architecture will also be affected by the mobility of information consumption through cell phones and PDAs, which will open up new horizons for IT. One example Glaser pointed to is the use by younger people of cell phone cameras to take pictures of skin lesions and send them to dermatologists, thus avoiding the long wait of an office visit.

The last force shaping IT is the growing sophistication of management and leadership, who are much more willing to invest in technology but are asking tougher questions requiring proof of value and cost efficiency.

In the early days, the technology was there to do things such as computing and networking, Katherine Andriole, Ph.D., assistant medical director of imaging IT at Brigham and Women's Hospital, told Diagnostic Imaging. The key now is to work more intelligently, to integrate all these systems and solve problems for the future of healthcare.

"The notion that images are not just radiological, that they are healthcare-enterprise-wide is understood by those in radiology. The feeling is that we know how to deal with images and these technologies, so why not help the healthcare enterprise? This is our focus for now," she said.