Diagnostic Reading #45: Five Must-Read Articles From the Past Week

Carestream LogoThis week’s Diagnostic Reading focuses on duplicate imaging on emergency patients, medjacking, the cost doctors are paying for technology, tomosynthesis implementation, and the importance of setting up a data security plan.

1. Study: Emergency Patients Get Duplicate X-ray, CT Exams – AuntMinne

Researchers from Emory University examined the cases of more than 3,600 patients who underwent both x-ray and CT studies on the same body part as part of their workup after admission to the emergency department (ED). The team found that many of these exams were unnecessary, with both x-ray and CT sometimes ordered simultaneously, or CT ordered before results from an initial x-ray study were received.

2. Medjacking: The Newest Healthcare Risk? – Healthcare IT News

A recent article in WorldNow proclaimed, “It may sound like a science fiction novel, but medical devices could someday be the target of hackers.” But the fact is that these devices are already being hacked, a trend that is alarming hospitals and other healthcare organizations. In fact, this kind of hacking is already widespread enough to have a new name: medjacking.

3. Docs are Paying More for Technology Than Ever Before – Healthcare IT News

According to a new MGMA report, medical practices across the U.S. are now spending a lot more on technology this year, up nearly 34 percent from four years ago. The annual report published by Medical Group Management Association shows that just from last year alone, physician-owned multi-specialty groups reported nearly a 12 percent increase in technology-related operating costs.

4. Imaging Department Reaps Benefits of Tomo After Careful Implementation – Radiology Business

The Baylor College of Medicine department of radiology recently implemented DBT at their breast imaging department. They wrote about the experience for the  Journal of the American College of Radiology, stressing the importance of taking things one step at a time. Ebuoma and colleagues wrote that the first step was getting staff fully prepared for the transition. From the person answering questions from behind the front desk to the radiologists interpreting the images, each staff member had to adapt to this new technology and how it would impact their day-to-day operations.

5. Data Security: The Importance of Planning, Training, and Having a Risk-Management Strategy – Healthcare Informatics

According to a recent report from the Breach Level Index, the healthcare industry had the highest number of data breaches in the first half of 2015 and also led the way in number of records breached by industry, with 84.4 million records. These findings represent a dramatic shift from the past few years when healthcare had relatively small numbers of records involved in data breaches, according to the report. The report findings are just one more reminder of the ongoing threats to healthcare information security and highlight the importance of building a strong information security program.

What Does Clinical Collaboration Really Mean?

Carestream Clinical Collaboration PlatformWe’ve been talking about clinical collaboration and Carestream’s Clinical Collaboration Platform quite often since before RSNA 2014.

For us, clinical collaboration was born out the use of our vendor-neutral archive (VNA). The VNA served as a housing mechanism for medical images across a variety of –ologies, not just limited to DICOM images. With the VNA, the images remain safe and accessible when necessary, however, to enable intelligent, user-based sharing, more than just storage is needed.

To go beyond the VNA and expand the capabilities that truly lay within its technology, there remained a need to bring in other systems that could result in an enterprise-wide tool to unite departments. With our own Clinical Collaboration Platform, we break down the capabilities in four areas: capture, manage, archive, and collaborate.

Capture. The goal is to provide a unified, patient-centered clinical record that pulls together images and data from departmental systems across the enterprise, and even beyond it. The solution needs to be flexible enough to be where the data acquisition happens: bed-side, by specific modalities, even from mobile devices in a wound care/urgent care environment.

Manage. From a web-based portal the user can now manage clinical imaging data whether it’s at the point of care or as part of the administrative process. Having the right clinical context to each image or clinical data ensures that information can be properly stored, viewed, and share these clinical images and accompanying data. This capability involves advanced metadata tagging, quality control to ensure consistency, and leveraging latest industry standards to ensure interoperability.

Archive. This stage involves the storage and access of clinically meaningful data throughout the enterprise, with access across each patient’s clinical history. This consolidated repository for clinical data helps to support effect collaboration via intelligent lifecycle management, optimized storage and access anytime, anywhere, standards-based and vendor-neutral, and risk-free migration from legacy archives.

Collaborate. This is the ultimate stage that supports dynamic collaboration between providers, patients, payers, administrators and IT managers, with tools and views tailored to each user’s needs. The main goal is to put patients at the center of efficient, effective healthcare. This involves EMR/EHR integration, zero-footprint interface for administrators, user-specific functionality, patient engagement, and payer reporting.

With the evolution of the VNA going beyond the simplicity of storage and access, it is clear that these new capabilities will bring out the value of allowing clinicians to collaborate with each other and take part in valuable communication with their patients. This has been the direction healthcare has been heading in for sometime, and the time is now to embrace these advancements.

You can visit our website for more information about Carestream’s Clinical Collaboration Platform.

Cristine Kao, Healthcare IT, CarestreamCristine Kao is the global marketing director for Carestream’s Healthcare Information Solutions (HCIS) business.


Diagnostic Reading #44: Five Must-Read Articles From the Past Week

Carestream LogoIt’s time for a new edition of Diagnostic Imaging. This week we’re looking at medical imaging and pregnant women, digital tomosynthesis and CT lung nodules, how business intelligence affects security, doctors using EHRs, and imaging informatics and archiving in Scotland.

Diagnostic Imaging May Be Safe for Pregnant Women – Diagnostic Imaging

According to a review article published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS),  some radiologic imaging can be safe for pregnant women who have sustained traumatic injuries. Researchers from the Thomas Jefferson University in Philadelphia, PA, and the Garden State OB/GYN Associates in Voorhees, NJ reviewed the diagnostic dilemma that confronts emergency room physicians when pregnant women present with traumatic injuries that require diagnostic imaging.

Digital Tomo Falls Short of CT Lung Nodules – AuntMinnie

A new study published September 8 in the Journal of Digital Imaging indicates that tomo may have a tough time finding a role in the chest that’s not already well-served by the other two modalities. Researchers from the Mayo Clinic in Rochester, MN, compared digital tomosynthesis with chest x-ray in a population of 82 individuals, while also comparing both technologies to CT as the gold standard. They found that tomo was much better than standard radiography in several areas, such as for detecting nodules larger than 4 mm — considered the threshold for clinical significance.

Security Needs Business Intelligence – Healthcare IT News

A truly risk-based security framework needs more than mere protective measures. It requires awareness. This article features quotes from Ron Mehring, senior director and chief information security officer, Texas Health Resources, who oversees security architecture and operations at the sprawling 25-hospital system/ Mehring explains how large health systems need to escalate up from “baseline security requirements” to something much more robust.

More Than 80 Percent of Docs Use EHRs – Healthcare IT News

More than eight in 10 doctors across the country, or 83 percent, have adopted electronic healthcare record systems, according to a new report from the Office of the National Coordinator for Health IT. Counting only certified EHR adoption, however, that rate goes down to 74 percent. Also, 51 percent of doctors are using only basic EHR functionalities, according to ONC.

Imaging Informatics: Archiving Scotland – Radiology Today

Alan Fleming, program manager for National Health Services (NHS) Scotland, says the process of setting up Scotland’s archive required extensive input from both clinical and business stakeholders. One of the most important tasks was selecting a supplier for PACS, data center storage, and hosting [Disclosure: Carestream was selected to provide the PACS and national image archive]. NHS Scotland also had to specify the services that would be provided by the archive, and the final implementation plan required approval from senior government officials.

Video: The Value of Imaging Sharing in Clinical Collaboration

With Carestream’s Clinical Collaboration Platform, you will see how more images can be shared across the enterprise from more modalities.

The ability to share more image formats across more devices is integral to making collaboration throughout the enterprise a reality.

In the animated video below, learn how image sharing on the Clinical Collaboration Platform is able to give clinicians real time, on-demand access to imaging results, as well as how it can empower patients to share their images between facilities, physicians, and specialists.

You can visit our Clinical Collaboration Platform page to learn more.

Diagnostic Reading #43: Five Must-Read Articles From the Past Week

Carestream LogoWe are back this week with a new issue of Diagnostic Reading. This week’s topics focus on structured radiology reporting, sonographer health, EMR data security, EHR usability standards, and radiologist performance tied to Physician Compare metrics.

1. Structured Reporting Improves Quality of MRI Reports – AuntMinnie

At Brigham and Women’s Hospital, a structured reporting template yielded a significant improvement in the quality of MRI reports for the crucial task of staging rectal cancer. A team led by Dr. V. Anik Sahni found that the percentage of reports deemed to be satisfactory or optimal nearly doubled after the voluntary adoption of structured reports, reaching more than 70%. Furthermore, more than 40% of reports were judged to be optimal after structured reporting was implemented, whereas none were prior to adoption.

2. Making a Difference as a Sonographer: Pain in the Neck – AuntMinnie

Doug Wuebben, registered echocardiographer and also a consultant, international presenter, and author of e-books in the areas of ergonomics, exercise and pain, and injury correction for sonographers, goes through a number of exercises and stretches sonographers can do in order to prevent injuries.

3. Even with Encryption, EMR Data at Risk – Healthcare IT News

A recent security report by Microsoft finds that, even when cloaked in encryption technology, “an alarming amount of sensitive information can be recovered” from electronic medical record databases. For the report, “Inference Attacks on Property-Preserving Encrypted Databases,” which included 200 hospitals, researchers from Microsoft, University of Illinois and Portland State University examined four types of cyberattacks targeted at EMRs.

4. Study: Large Number of EHRs Do Not Meet Usability Standards – Healthcare Informatics

A significant percentage of electronic health record (EHR) vendors failed to meet federally mandated user-centered design requirements and did not conform to usability testing standards for their EHRs, according to a new report. The report, from the National Center for Human Factors in Healthcare at the Washington, D.C.-based MedStar Health, found that this lack of adherence to usability testing standards by EHR vendors could result in poor usability of EHRs.

5. Are Physicians Compare Metrics Missing the Mark on Radiologist Performance – Radiology Business

According to a recent study published by the  Journal of the American College of Radiology , the CMS Physicians Compare Initiative should include more imaging-specific metrics so it can accurately reflect a radiologist’s overall performance. Andrew B. Rosenkrantz, MD, of the department of radiology at the New York University Langone Medical Center, and colleagues studied how radiologists scored in six different Physicians Compare metrics compared to nonradiologists. In two of the metrics, radiologists significantly outperformed the nonradiologists. Radiologists scored 60.5 percent in PQRS participation, while nonradiologists scored 39.4 percent. And in receipt of PQRS Maintenance of Certification incentives, radiologists scored a 4.7 percent while nonradiologists scored 0.3 percent.

Diagnostic Reading #42: Five Must-Read Articles From the Past Week

Carestream LogoAnother week means another edition of Diagnostic Reading, This week’s topics focus on mammography screening volume, cyber attacks on healthcare organizations, CT use in children’s hospitals, accountable care organizations (ACOs), and patient-radiologist communication.

Higher Screening Mammo Volume Equals Better Outcomes – AuntMinnie

According to a study published in the Journal of Medical Screening, women who undergo mammography screening at breast centers with high volumes tend to have better outcomes, which is encouraging news for a modality often criticized for its tendency to overdiagnose.

4 in 5 Health Orgs Hit by Cyber Crooks – Healthcare IT News

According to KPMG’s 2015 Healthcare Cybersecurity Survey, more than 80 percent of healthcare chief information officers, chief technology officers and other security leaders say their organizations have been victimized by at least one cyber attack in the past two years. Barely more than half – 53 percent of providers, 66 percent of payers – say they feel adequately prepared for a cyber attack.

Children’s Hospitals Utilizing Less CT in Favor of Other Modalities – Health Imaging

According to a new study published in Pediatrics, CT utilization in children’s hospitals is declining, possibly due to potential side effects related to pediatric exposure to ionizing radiation. According to the authors, more and more research has revealed the possibility that exposing children to ionizing radiation may increase their risk of cancer, leading to efforts to minimize such exposure.

Premier’s Damore: With the Right Help, ACOs Are Moving in the Right Direction – Healthcare Informatics

Shortly after the federal Centers for Medicare & Medicaid Services (CMS) announced the latest results coming out of the two main accountable care organization (ACO) programs operating under the aegis of the Medicare program, the Medicare Shared Savings Program for accountable care (MSSP) and the Pioneer ACO Program, leaders at the Charlotte-based Premier, inc. were able to trumpet positive results coming out of Premier’s population health initiative.

Patients Don’t Want to Talk to Radiologists – Diagnostic Imaging

According to a new study published in the Journal of the American College of Radiology, answering some fundamental questions might be wise before the field of radiology “embarks on such a sea change” of more direct communication with patients Based on a total of 617 survey responses from patients, they found that the majority—63%—preferred receiving their imaging results from a referring provider, not a radiologist.

Four Reasons Multimedia is the Future of Radiology Reporting

Vue Reporting - Multimedia-enhanced Radiology ReportingWe have been touting the power of multimedia-enhanced radiology reporting for some time. We have shown the history of reporting in our industry, as well as showcased the important business cases multimedia reporting provides to departments via referrals from physicians.

In brief—multimedia-enhanced radiology reporting is the future. Still don’t believe us? Consider these four key points that highlight the benefits of these new-age reports:

1) Improved context related to patient history. This new format for radiology reports provides physicians and radiologists with more history related to the patient. With this history, radiologists gain a greater understanding of the patient’s health, as well as insight into patterns that may help with diagnosis.

2) The display of data is cleaner and easier to access. Images, lesion measurements, graphs, charts—they all exist to provide easier access to necessary information. Hyperlinks also exist within multimedia reports, so physicians can access an image splice via a hyperlinked description within the text of the report. In a recent study conducted by the National Institute of Health (NIH), oncologists and radiologists agreed that quantitative interactive reporting would be superior to traditional text-only qualitative reporting for assessing tumor burden in cancer trials at its institution. Based on this study, NIH said that it aims to improve its reporting in concert with its new PACS capabilities that include semiautomated lesion segmentation, interactive reporting, and metadata management of lesions.

3) Promotes better communication between patients and physicians. With a format that is easier to read and understand, physicians have a resource that is much easier to explain to patients. By showing them their medical images, as well as associated measurements, physicians have better visuals and information to use to talk with their patients about their diagnoses.

4) The possibility of more referrals from physicians. A study conducted by Emory University School of Medicine found that 80% of physicians would preferentially refer patients to a facility with multimedia reporting. The study also found that 79% of physicians are more likely to recommend that their peers refer patients to a facility with multimedia reporting. This shows that not only is multimedia reporting better for the patient, but also for the radiologist’s department or clinic, as they are more likely to receive more patient referrals when using multimedia reporting.

Multimedia radiology reporting is the next logical stage in the evolution of the radiology report. As communication between physicians and patients becomes more commonplace and expected, doctors will need the appropriate tools to explain diagnoses to patients in a way that is easy to comprehend. The capabilities offered via multimedia enhanced radiology reporting can effectively serve as these tools and provide physicians with the valuable information they need.

Cristine Kao, Healthcare IT, CarestreamCristine Kao is the global marketing director for Carestream’s Healthcare Information Solutions (HCIS) business.



Diagnostic Reading #41: Five Must-Read Articles From the Past Week

Carestream LogoAnother week has passed us by, which means it is time for another edition of Diagnostic Reading. This week’s articles focus on MedPAC data on imaging growth, radiology reports, radiology value, community hospitals replacing EHRs, and mHealth tools.

Radiology Takes Aim at MedPAC data on Imaging Growth – AuntMinnie.com

Advocates for radiology are criticizing new data from the Medicare Payment Advisory Commission (MedPAC) that show growth in medical imaging from 2000 to 2012. In fact, the data indicate that imaging utilization has been declining since 2009. Imaging advocates say MedPAC’s annual data book released in July paints an inaccurate picture of the specialty and its contribution to healthcare costs, which distracts from the real questions about healthcare waste.

Rad Reports Should Not Include ‘Cannot Exclude’ – Radiology Business

According to a recent commentary in the  Journal of the American College of Radiology, radiologists need to stop writing “cannot exclude” in their reports as the phrase is overused and adds no additional value to patient care. “Radiologists should list only pertinent differential diagnostic considerations and advise on the need for further imaging needed to confirm a diagnosis,” wrote Jenny K. Hoang, MBBS, of the department of radiology at Duke University Medical Center. “Radiologists’ skills are most valuable when they are used to make diagnoses, not exclude them.”

How to Offer Value When Nobody Seems to Want It – Radiology Business

David M. Naeger, MD, writes, “For years, radiologists on the vanguard have been telling us that we should consider relaying radiology results directly to patients.  We already do this in women’s imaging in the form of mammography patient letters, but there is much more room to continue this practice.

“The reasons to consider communicating directly with patients are many: We are the imaging experts, and, in many ways, no one is better suited to explain the findings and interpretation of an imaging examination. By directly engaging patients, we also have the potential to increase their participation in their care and help our referring colleagues in the challenging and time-intensive process of relaying test results.”

Community Hospitals Replacing EHRs – Healthcare IT News

As they grapple with meaningful use and grumble about usability, nearly 20 percent of community hospitals polled for a recent report are “actively looking to replace” their electronic health record vendors. Smaller hospitals are being tasked with more physician documentation for MU, and the extra time required, disrupted workflows and and frustrating EHR functionality means many providers’ patience is wearing thin, according to Community Hospital EHR 2015, by research group peer60, which polled 277 providers.

Research: mHealth Tools Have Not Been Fully Studied – Healthcare Informatics

While smartphone apps and wearable sensors have the potential to help people make healthier lifestyle choices, evidence of these mHealth tools being effective for or reducing risk factors for heart disease and stroke is limited, according to new research. These findings are according to a scientific statement from the American Heart Association, published in the association’s journal Circulation. The new statement reviewed the small body of published, peer-reviewed studies about the effectiveness of mobile health technologies for managing weight, increasing physical activity, quitting smoking and controlling high blood pressure, high cholesterol and diabetes.

Video: Advancements in Cardiology PACS

CARESTREAM Vue Cardio is a web-based PACS that consolidates review of echocardiography, cardiac cath, ECG, nuclear cardiology and hemodynamic results with easy comparison of priors for better patient care.

In the demo video below, you will see how this cardiology PACS acts as a single solution that streamlines enterprise access and reporting of cardiovascular data for faster diagnosis, reporting, storage, and distribution of clinical data.