As we prepare for RSNA where personalized medicine will take center stage, let’s take a moment to look at the related concept of “personalized radiology.”
As a radiologist, personalized medicine is about obtaining patient information that helps me make an accurate diagnosis. In the past, radiologists have often had very little information to work with: name, birthdate and a two- or three-word description. For example, I might get an abdominal CT exam to read with the description “abdominal pain.”
Well, is it acute abdominal pain with fever, elevated liver enzymes and a history of gall stones? Or is it vague abdominal pain without fever or elevated WBC, and a history of colon cancer? These descriptions help me define whether I am primarily looking for an obstructing common bile duct stone or a liver metastasis. And that’s where an EHR comes in, because it delivers personalized, pertinent information to radiologists and clinicians so that we can achieve accurate diagnosis and treatment.
It’s also important to know a patient’s ethnic group, because some ethnic groups are prone to different types of diseases, particularly if they have recently lived or traveled outside the United States. Now that we serve a more diverse population, we need data mining tools so we can deliver community-specific care. I read for several different hospitals and the disease states I see in young Latinos are far different from those in elderly Asian patients.
My ultimate goal and the goal of my fellow radiologists is personalized radiology, which is reading each exam with the medical history, current clinical state and other characteristics of each individual patient in mind. I believe this goal is going to be more attainable as we gain greater access to patient information through links to EMR/EHR systems.
Are you getting the clinical information you need to read patient exams? What information do you find most valuable?
Dr. Roger Eng, M.D., Chairman of Radiology, Chinese Hospital, and President of Golden Gate Radiology Medical Group