The Missing Puzzle Pieces: Imaging Informatics & Informaticists

Ask anyone what common career choices are in healthcare, and they’ll list doctor, nurse, pharmacist, and researcher long before informatics pops in their heads. The word informatics remains foreign to most. Healthcare informatics  is defined as, “the integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information. “ Simply put, healthcare informatics allows critical data to be available anytime and anywhere. Medical imaging, which is often shared on CDs, adds another unique layer to the puzzle as it remains one of the most challenging data forms to share within and across facilities.

The Value of Informatics

The amount of healthcare data is constantly growing;  healthcare organizations created an estimated 2,134 exabytes of data in 2020  and the number has continued to grow rapidly since. The U.S. Bureau of Labor Statistics predicts that the health services field will grow by 32% between now and 2023 . Healthcare facilities must be prepared to increase informatics skill sets across their clinical and IT staff.

Improved Patient Care

The COVID-19 pandemic has ushered in a new era of understanding the importance of rapid access. Studies have strongly indicated a positive relationship between well-managed health data and patient care. The Official Website of The Office of the National Coordinator for Health Information Technology (ONC ) lists numerous benefits of healthcare information systems including improved aggregation, analysis, and communication of patient information, reduced medical error, and prevention of adverse events. 75% of physicians believe that information systems like an EHR (electronic health record) allow them to deliver better patient care.

While the sharing of electronic health data has come a long way, medical imaging remains left behind.  The American College of Radiology Informatics Commission established the Ditch the Disk Task Force in 2018.  They encouraged practices to transition from cumbersome CDs to digital, secure, and cloud-based file-sharing. The continued use of CDs and lack of universal practices directly correlates to discrepancies in patient history, unnecessary imaging, and delays in treatment.

Opportunities for Research and Development

Medical imaging is a critical part of any clinical trial workflow but remains the most elusive. Workflows often still involve requesting imaging from another facility and awaiting the CD. Even when a digital workflow is implemented, challenges frequently remain around data matching, integrating post-processing systems, and intaking imaging from other sites. The clinical trials of the future will need a team of skilled informaticists who are well versed in data collection, analysis, and anonymization to turn imaging data into a valuable asset.

Healthcare data, especially in clinical trials , has long been focused on primarily white populations leading to lower drug efficacy in non-white groups.  Improved imaging informatics also provides a unique route to improved healthcare equity.

Improvements in health equity and informatics came together at the University of Pennsylvania. Dr. Tessa Cook  and her team of radiologists worked to improve screening rates for patients at risk of Hepatocellular Carcinoma (HCC). Black patients with liver disease are more likely to develop HCC than white patients and benefit from additional screenings. Using health information systems, the team was able to identify high-risk patients and alert them in the patient portal to a pop-up ultrasound clinic that would allow them to have a screening exam performed on the same day as other appointments.

3 To Ways to Support the Informaticist of Today

As informatics emerges as a critical career choice in healthcare, facilities may wonder how they can build their team or support team members who have expressed interest in diving into informatics.

On-Going Education

A recent workforce survey by the Conference Board found that 58% of employees are more likely to leave an employer if they do not offer opportunities for professional development. Investing in the professional development of your employees gives your facility a competitive edge by allowing them to stay ahead on industry trends and technology. Facilities can not only improve technical knowledge across their staff but also build opportunities for leadership and mentoring across diverse communities.

Organizations like SIIM (the society for imaging informatics in medicine) provide comprehensive healthcare Imaging and IT training  on PACS ,DICOM , andHL7  standards. They offer face-to-facetraining , both on-and off-site, as well as e-learning through instructor and stand-alone training modules which members can work into their own schedules.

Mentoring & Recruiting

Informatics is a foreign and often intimidating field and is made even more complex by the confusion around technical standards, never-ending acronyms, and the emergence of new tooling. Physicians or nurses who wish to learn more often don’t know where to go next. Mentorship can act as a key tool to inspire the next informaticist of today. A recent study in CIN: Computers, Informatics, Nursing examined how nurses can be supported to pursue a career in informatics. The study noted that particularly for women of color, there seemed to be limited leadership and development opportunities available. The researchers noted that offering opportunities for developing leadership skills, mentorship programs, and continuing education will be critical for encouraging more interest in the field.

Technical Harmonization

As facilities work to build out informatics skills across their staff, there is no question that confusion will emerge around image and data sharing standards. Organizations will need to identify where there are holes in workflows around technical harmonization and barriers to convergence. The only way to make progress is to build multidisciplinary groups that can identify, develop, adopt, and implement relevant standards.  A critical piece of the puzzle will be examining imaging data that is not in the traditional DICOM format, like those pictures taken by oncology and dermatology, or imaging shared by pathology.

Imaging informatics remains an untapped goldmine of data that could lead to valuable health insights for future generations. It’s up to facilities and vendors alike to review technical standards, work together across networks, and encourage a new population of dedicated clinicians and IT staff to take on the challenge.