By Steve Holloway, AuntMinnie.com contributing writer
March 12, 2015

As an early adopter of healthcare IT, radiology has tightly controlled selection and use of IT systems such as PACS and RIS. Yet with the rapid advance of IT systems spreading across the hospital, the control of radiology IT is increasingly being dictated by hospital IT departments and executive leadership.

Unsurprisingly, this is causing issues for radiologists, forcing retraining on new PACS and RIS software, or even increasing apathy and disinterest in the broad digitalization of healthcare among radiology professionals. While this trend is a clear cause for concern, new enterprise healthcare IT also has the opportunity to re-enable radiologist control of their IT systems through "modularization" of departmental IT applications. Below, we take a look at how this is predicted to happen, and why short-term enterprise IT pain should mean long-term gains for radiologists.

Adoption of enterprise IT systems has been spurred recently by major initiatives to digitize patient records with electronic medical records (EMRs) in a bid to increase efficiency, improve the quality of care, and, ultimately, save money. While conceptually EMR adoption seems relatively simple, the complexity of healthcare shifting from paper to digital is rife with challenges. The sheer number of stakeholders, specialties, disparate data silos, and networks within one hospital is staggering. Add the complexity of local, regional, and state legislation; ill-defined and patchy data standards; and healthcare spending cuts, and the challenge becomes far greater. Therefore, we should not be surprised that so many different approaches to enterprise IT have been adopted with a varied range of success.

EMEA outlook for IT software and services
IT system Health provider focus 2011-2016 Provider focus 2017-2020 5-year outlook (revenue growth)
Radiology IT (PACS, RIS) - ++ 6%-9%
Cardiology IT - + 10%-12%
Vendor-neutral archives ++ +++ 8%-12%
Electronic medical records +++ + 7%-9%
Source: IHS. Jan-15

Despite the initial pain of enterprise IT implementation, there will be some clear benefits for radiologists in the mid- and long-term outlook. Enterprise IT systems can form consistent platforms on which "modular" application software can be "plugged-in," especially if cloud architecture is being utilized. Radiology could be one such application, laid on top of the EMR, hospital information, and enterprise storage solution. This could then hand back control of radiology IT software to those who use it the most, rather than being dictated by the enterprise hospital IT network.

Radiologists could choose applications that best suit their clinical, research, or unique departmental need, while still conforming to the core interoperability of wider hospital IT system. Moreover, radiologists could also benefit from a far greater pool of "longitudinal" patient data, tracking the complete history of the patient through the care pathway. This will not only drive greater clinical collaboration between radiology and other clinical departments, but should also drive better diagnoses.

Of course, this is a broad and simplified view, overlooking some of the complex challenges that exist to get to the point of modular radiology IT applications. Vendor compatibility, both from enterprise IT and specialist "ology" IT solutions, must improve, ideally under harmonized universal standards. Use of cloud architecture is still immature, hindered by security concerns, lack of infrastructure, and an overreliance on upfront capital-intensive investment rather than more cost-effective operational service approaches. In addition, many other clinical specialties are only just going digital. Oncology, pathology, and a whole host of "unstructured" health data must also understand how they fit into the enterprise architecture of modern healthcare.

Despite these challenges, the resolve of many healthcare providers has already been displayed in adoption of EMR systems and in pushing aggressive healthcare IT targets. Our recent research on a variety of healthcare IT types has shown a shift in focus in spending from departmental to enterprise IT over the past three years, led by the U.S. shift to EMR as part of major healthcare overhaul. Vendors of radiology IT have quickly either had to provide enterprise architecture and compatibility, or partner with new networking IT specialists from outside of the healthcare space. In Europe, transition has been less abrupt but is certainly well underway, led by the Nordic regions and pockets of regional trailblazers across the continent.

Of course the widespread adoption of such systems is some way off and a myriad of challenges remain unsolved, but the benefits of such capabilities are surely worth some patience and short-term pain?

Undoubtedly this transition has and will cause challenges for radiologists, both in loss of control of radiology IT and in adapting to a new era of hospital IT. For many, in radiology and other clinical disciplines, this has led to discontentment and resistance, slowing and stalling enterprise IT integration. However, what should be clearly communicated across the radiologist community is the purpose and promise of enterprise IT.

Already, small scale trials of enterprise networked hospitals and administration have shown that efficient collection, storage, and analysis of patient data can help to define new clinical care pathways and departmental collaboration and, ultimately, improve clinical outcomes. More impressive again is the use of population analytics to accurately predict future demand for health services, helping healthcare providers to ensure adequate resources and better manage healthcare spending.

Stephen Holloway is an associate director of medical technology at IHS. IHS Medical Technology provides market research and consultancy services to the medical device industry. Coverage includes medical imaging equipment, clinical care devices, healthcare IT, consumer medical devices, medical displays, and wearable technologies.

Originally published in ECR Today on 7 March 2015.

Copyright © 2015 European Society of Radiology

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