Comp6 Unit7 Lecture Slides

Health Management Information
Systems
Medical Imaging Systems
This material Comp6_Unit7 was developed by Duke University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.
Learning Objectives
1. Examine the purposes, processes, and
management issues
2. Understand the economic and technological
factors associated with digital displays
3. Describe the major challenges
4. Describe the future directions
2
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Health Management Information Systems
Biomedical Imaging
The science and the branch of medicine
concerned with the development and use of
imaging devices and techniques to obtain
internal anatomic images and to provide
biochemical and physiological analysis of
tissues and organs.
3
Medical Imaging
Any visual display of structural or functional
patterns of organs or tissues for diagnostic
evaluation. It includes measuring physiologic
and metabolic responses to physical and
chemical stimuli, as well as ultramicroscopy.
4
Medical Imaging Informatics
Relatively new multidisciplinary field
Intersects with the biological sciences, health
services, information sciences, medical
physics, and engineering
Touches every aspect of the imaging chain
5
Why Use Imaging Systems
Detection and diagnosis
Assessment and planning
Guidance of procedures
Communication
Education and training
Research
6
Imaging Systems and Health care
Processes
Acquiring/managing images
Image creation and acquisition, image distribution and
management, image storage and retrieval
Interpreting images
Image processing, analysis and understanding, image
visualization and data navigation; image interpretation
Communicating the interpretations
Image reporting and communications
7
PACS Configuration
Image courtesy of Keystone Medical Technologies
http://www.keystonemedicalus.com/Multi-Modality-PACS/pacs-configurations

8
Format Standards
Digital Imaging and Communications in
Medicine (DICOM)
Standard for the electronic exchange of
medical images
Data associated with the images
Health Level Seven (HL7)
Message standard
9
Management Issues
Storage concerns
Film versus digital
Image modalities differ
Contrast and spatial resolution requirements
Number of images or the size of the data sets
Raw or processed data
Use of data compression
10
Management Issues
Image integration
Viewing stations
On-line image databases
Image-management systems
Networks
11
Management Issues
Technological and human engineering
factors
Radiologist
View and interpret
Referring clinicians
Review and consultation
Economic factors
12
Major Challenges
Image integration
Hospital Information System (HIS)
Contains all the clinical, administrative, financial,
and demographic information

13
Major Challenges
Medical imaging system
Radiology Information Systems (RIS)
Standalone
Components of HIS

14
Integration Example
PACS integration
Hospital information system
Radiology information system
Benefits to integration
Economic
Rapid access enhances the quality of patient
care
15
Major Challenges
Reporting methods
Dictation/transcription
Speech recognition
Structured
Tools for entering data
Defined data elements
May use predefined list or vocabulary

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Future Directions
Advances in medical imaging technology
Increase in imaging studies
Increase in imaging data
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Future Directions
Development of standards
DICOM medical image exchange standard
Supplement 145
Potential for DICOM requirement by 2013
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Future Directions
ARRA
HITECH Programs
Meaningful use of interoperable health information
technology and qualified EHRs
Expansion of meaningful use
Expectation that stage 2 meaningful use will
include images in the certified EHR
technology
19
Summary
Definitions
Purposes, processes, and management issues
Factors related to storage concerns and image
integration
Future directions
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References
References
AHIMA e-HIM Work Group on Speech Recognition in the EHR. (2003). Speech recognition in the electronic health
record. Retrieved from
http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_022107.hcsp?dDocName=bok1_022107
American Health Information Management Association. (2012). Pocket glossary for health information
management and technology (3
rd
ed.). Chicago, IL: Author.
Arenson, R. L., Andriole, K. P., Avrin, D. E., & Gould, R. G. (2000). Computers in imaging and health care: Now
and in the future. Journal of Digital Imaging,13(4),145-156. Abstract retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/11110253
Bhachu, D. (2005, September 1). The medical digital imaging revolution. Retrieved from
http://www.hospitalmanagement.net/features/feature681/
Branstetter, B. F. (Ed.), Practical imaging informatics: Foundations and applications for PACS professionals (pp.
429-442). New York, NY: Springer Science + Business Media.
Centers for Medicare and Medicaid Services. (2011, November 7). EHR incentive programs overview. Retrieved
from https://www.cms.gov/ehrincentiveprograms/#BOOKMARK1
College of American Pathologists. (2010, September 16). Medical imaging standard extension for pathology will
help advance health information interoperability. Retrieved from http://tinyurl.com/2elpbvh
Goedert, J. (2010, October 14). Advanced imaging app approved. Retrieved from
http://www.healthdatamanagement.com/news/health-care-technology-news-imaging-nasa-mammogram-analytics-
41165-1.html
Greenes, R. A. & Brinkley, J. F., (2006). Imaging systems in radiology. In Shortliffe. E. H., & Cimino, J. J. (Eds.),
Biomedical informatics: Computer applications in health care and biomedicine (3
rd
ed) (pp. 626-659). New York,
NY: Springer Science + Business Media.

21
References
References
Health Level Seven International. (n.d.). About HL7. Retrieved from http://www.hl7.org/about/index.cfm?ref=nav
Krupinski, E. A. (2010). Viewing images. In Branstetter, B. F. (Ed.), Practical imaging informatics: Foundations and
applications for PACS professionals (pp. 99-108). New York, NY: Springer Science + Business Media.
National Electrical Manufacturers Association. (n.d.). DICOM. Retrieved from
http://medical.nema.org/dicom/geninfo/Brochure.pdf
National Library of Medicine. (2004, August 24). Biomedical imaging. Retrieved from
http://www.nlm.nih.gov/tsd/acquisitions/cdm/subjects15.html
National Library of Medicine. (2012). Diagnostic imaging. Retrieved from
http://www.nlm.nih.gov/cgi/mesh/2012/MB_cgi?mode=&index=3786&field=all&HM=&II=&PA=&form=&input=
Ralston, M. D., & Coleman, R. M., (2010). Introduction to PACS. In Branstetter, B. F. (Ed.), Practical imaging
informatics: Foundations and applications for PACS professionals (pp. 33-48). New York, NY: Springer Science +
Business Media.
Society for Imaging Informatics in Medicine. (2012). Imaging informatics. Retrieved from
http://www.siimweb.org/index.cfm?id=324
van Bemmel, J.H., & M.A. Musen, eds. (1999). Handbook of Medical Informatics. Vol. 3.3. Rotterdam,
Netherlands: Erasmus University and Stanford University

Images
Slide 8: PACS Configurations: Facility-wide solution [image on the Internet]. (n.d.). Retrieved from
http://www.keystonemedicalus.com/Multi-Modality-PACS/av-advanced-visualization-3d-4d

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