From the Chair: The Imaging Informatics Profession - SIIM News Fall 2008

Bradley J. Erickson, MD, PhD
Chair

Imaging informatics is a nascent, multidisciplinary field lying at the junction of biomedical engineering, computer science, and biomedical informatics. It is the formal field in which PACS, RIS, CAD, 3D, and other systems of interest to medical imaging lie. For many, installation of these systems and ‘going filmless’ seems to be the end of a journey. I believe it is the start of a journey, and a vital informatics profession is essential to the success of these systems, which in turn is essential for the success of the imaging enterprise. While some might view “Imaging Informatics Professional” as a fancy term for a PACs administrator, we must actively demonstrate that it is much more. IIPs must demonstrate their value to clinical practice, research, and education.

Imaging Informatics in Clinical Practice

The past decade has seen dramatic advances in imaging devices, and they are now easily capable of overwhelming the radiologist expected to interpret the data they produce. Imaging informatics is at the nexus of this problem of information overload, with such initiatives as SIIM’s TRIP™ - Transforming the Radiologic Interpretation Process – initiative. Imaging informatics will also play a key role in the financial aspects of the imaging department as information regarding the appropriateness of examinations as well as the quality of the department’s product become major components of reimbursement. Some departments have recognized the strategic role informatics plays in their future by appointing vice chairs for IT and/or creating divisions of informatics.

The clinical practice is seeing increasing pressure to assure that examinations are done when appropriate and that they are done with the highest quality. Informatics tools are critical to achieving this and demonstrating it to external observers and third-party payers. It may seem that collecting this information is straightforward, and not worthy of scientific evaluation, but this is too simple a view. The subtleties of how data is collected, represented, extracted, and mined can produce substantially different pictures. Informatics is the science that focuses on doing these tasks correctly. If imaging informatics professionals do not have a role in defining these techniques, we will be measured according to other people’s rulers, and that may not be what is best for your institution.

SIIM has always been tightly connected to clinical practices, and must continue to stay involved. While PACS and RIS have become better understood, the demands of CAD, 3D, and other decision support systems are a great opportunity for SIIM to stay at the forefront of clinical practice involvement. Structured reporting, and other elements critical to effective communication of imaging tests, is also a great opportunity on which SIIM can take the lead.

Research

Advances in informatics research that support the clinical practice also requires an informatics home. Most hospitals have IT departments that provide operational support—they do resource planning and implementation in concert with clinical divisions. However, they are not able to promote leading-edge research in the field, or to recruit staff with an interest in this field. Imaging departments must be able to speak as peers with IT departments, with each understanding and respecting the knowledge base and roles the other must play.

SIIM has taken some steps to do basic training about research techniques for its membership, and to support early investigative efforts. These must continue. SIIM is also working to engage governmental agencies that fund research to ensure appropriate levels of support.

Education

Education in imaging informatics is sorely lacking. It is rarely present in most radiology residency or medical school programs. There is some content in medical physics programming, but much less than is sufficient for the practice of the future. Radiology technologist training programs have similar gaps. Few, if any, computer science departments have content on imaging informatics, let alone requirements.

The SIIM annual meeting has a strong history of quality educational content for imaging informatics. An increasing amount of content is becoming available on the SIIM website. Other materials like textbooks and blogs will also help to improve access to educational materials. The certification of a person as an imaging informatics professional is an important step in establishing the body of knowledge in a field.

I hope that the next time you use the term ‘IIP’ to refer to a person that you do not conjure a mental image of a PACS administrator with a new certificate on the wall. I hope you think of a person who is actively improving the practice, pushing the frontiers of the field, and training the next generation of IIPs.

Dr. Erickson is a Professor in the Department of Radiology at the Mayo Clinic, Rochester.