informatics in medical imaging

biomedical informatics (BMI)

the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, motivated by efforts to improve human health

platform

refers to a specific informatics device or process

sub specialties of BMI

- translational bioinformatics

- clinical research informatics

- clinical informatics

- consumer health informatics

- public health informatics

clinical informatics

subspecialty of BMI that uses data and information to deliver healthcare services

what is clinical informatics used for?

- generating, managing, and integrating anatomical images

- clinical documentation

- computerized provider order entry

- clinical decision support systems

HIS (hospital information system)

manages scheduling, billing, and reports

RIS (radiology information system)

manages radiologic-specific workflow like order enters, scheduling, and reporting

EMR (electronic medical record)

electronic version of a patient's medical chart, often accessible through patient portals

MIMPS (medical image management and processing system)

inputs, distributes, reads, stores, and transmits digital images

integration

MIMPS integrated with HIS, RIS, and EMR is vital for patient centered care

DICOM (digital imaging and communication in medicine)

universal standard for communications biomedical image files

DICOM contains two classes

object class and service class

object class

information about patient and study

service class

describes what to do (store, print, query)

SCU (service class user) and SCP (service class provider)

describe equipment roles

HIPAA (health insurance portability and accountability act of 1996)

defines standards for data exchange between healthcare systems

IHE (integrating the healthcare enterprise)

promotes the combined use of DICOM and HL7 standards

hardware

CPU, memory, input/output devices, bus (tangible components)

software

programs and applications executed by the hardware

bandwidth

network capacity for transferring large image files, measured in bits per second (bps)

LAN (local area network)

connects systems within one facility

WAN (wide area network)

connects systems across long distances

file size of a pixel formula

pixel x bit depth/8

advantages of using MIMPS in a radiology department

- more efficient workflow: less film handling, radiologists can interpret faster

- faster medical care: instant image access, remote consultation

- cost savings: no film, processor chemicals, or lost film issues

- improved communication: integration with HIS/RIS/EMR improves continuity of care

short-term storage for digital images

- for recent/current studies

- fast access

- commonly uses RAIDS systems

- holds about 3-4 weeks of studies

long-term storage for digital images

- for archived studies

- must be retained for 5-7 years

- requires redundant storage

- archive types: hard disk, DVD, tape, Cloud storage

compression

reduces file size for storage efficiency

two types of compression

lossless and lossy

lossless compression

retains all original image data

loss compression

reduces file size by discarding some data- can reduce image quality

workflow of medical imaging from order to report distribution

1 patient visits provider with symptoms

2 provider enters data and orders imaging in EMR using CPOE

3 exam scheduled via HIS/RIS

4 modality receives work list from RIS

5 technologist acquires images and checks quality

6 images sent to MIMPS for storage and distribution

7 radiologist retrieves and interprets images

8 radiologist dictates report (linked to study in MIMPS/EMR)

9 report reviewed by referring physician

10 patient accesses report via patient portal

CPOE (computerized provider order entry)

- allows providers to electronically order imaging exams

- reduces transcription errors and improves efficiency

CDSS (clinical decision support system)

- guides appropriate imaging order selection

- promotes adherence to clinical guidelines and prevents unnecessary exams

legal

HIPPA compliance, data retention, access control

cybersecurity

passwords, encryption, and network projection

operational

training, software updates, workstation ergonomics

downtime concerns

server failures, power outages, or weather events

voice recognition

for efficient report creation

personal practices

always log out, never store patient data on portable

formula

matrix or pixel size x the bit depth / 8