How to Become an Imaging Informatics Professional

Transcription

1 Slide 1 RT to CIIP: How to Prepare Students for the Journey Susan Gregorie MM, CIIP, RT (R)(M)(MR)(CT)(QM) ARRT Slide 2 Session Description Radiography students may choose to become Certified Imaging Informatics Professionals (CIIP), also known as PACS Administrators, upon graduating from our programs. This seminar describes the profession of certified imaging informatics and the organizations that have an effect on that profession. Content knowledge sections of the ABII registry are outlined. There are specific areas in the Radiography program curricula that could be emphasized to help prepare radiography students who may choose this career path. This presentation is geared towards educators who are interested in supporting their students development for additional career opportunities and to discuss areas that educators can emphasis that will help Radiography students who wish to move toward a career as a CIIP. Much of the information referencing the individual organizations discussed comes directly from that organizations website. Slide 3 Session Learning Objectives Educators will: Be able to identify the role/tasks of a PACS administrator ( Imaging Informatics Professional) Have knowledge of the ABII organization, general content of the ABII registry, and knowledge of the SIIM organization and how they support the profession of CIIP. Have knowledge of specific areas in the radiography curriculum where emphasis can be placed to help students better prepare for a career as a CIIP.

2 Slide 4 Imaging informatics touches every aspect of the imaging chain from image creation and acquisition, to image distribution and management, to image storage and retrieval, to image processing, analysis and understanding, to image visualization and data navigation; to image interpretation, reporting, and communications. Imaging informatics professionals and scientists specializing in this evolving field are pioneers involved at the intersection of information science, imaging technology and healthcare and require clinical acumen as well as expert understanding of technology. K. P. Andriole, Chapter in: Advances in Medical Physics. Editors A.B. Wolbarst, R. Zamenholf, "Overview of Medical Imaging Informatics", Medical Physics Publishing, Madison, WI, 2006, pp K. P. Andriole. Business Briefings: Future Directions in Imaging "Introduction to Radiologic Informatics" 2006, pp 1-4 Slide 5 What is a PACS administrator? The healthcare professional who orchestrates a complex set of functions to achieve successful imaging informatics is often called a "picture archiving and communications system" or "PACS" administrator. These individuals have a foot in two worlds: clinical healthcare and information technology. For this reason, the most successful PACS administrators communicate clearly with highly technical network personnel, while understanding the diagnostic process of the radiologist. Their role often expands to system architect, workflow engineer and business analyst. SIIM 2013 Slide 6 Introduce the SIIM organization and speak about how they support the profession

3 Slide 7 Society for Imaging Informatics in Medicine Slide 8 Supporting healthcare through innovation, creativity, and discovery The Society for Imaging Informatics in Medicine (SIIM) aspires to be the leading healthcare professional organization representing interests and goals of those who work with and whose work is affected by the rapidly changing world of information and imaging technologies. SIIM seeks to spearhead research, education, and discovery of innovative solutions and new technologies to improve the delivery of medical imaging services and the quality and safety of patient care. Slide 9 A Vibrant and Open Community In 2006, the Society for Computer Applications in Radiology (SCAR) announced a name change to the Society for Imaging Informatics in Medicine (SIIM) This name describes the diversity of the Society's members, reflects the expansion of our research and educational activities, and embraces the dynamic changes in the healthcare environment. Imaging informatics components include image processing, image transmission and display, imaging information management, and decision support systems. SIIM provides a collegial forum for physicians, administrators, health information professionals, technologists, scientists, and engineers (individuals who develop and use information systems for medical imaging.)

4 Slide 10 Identify Your Imaging Informatics Educational Needs Let SIIM help you hone in on your educational needs by reviewing the education session in each of the core knowledge domains, and then map out your meeting schedule. The SIIM annual meeting program has been developed as a multifaceted education experience centered on the core imaging informatics knowledge domains, as well as CIIP Career Development, allowing each Informaticist to tailor his/her schedule to meet specific content needs. Slide program has four Core Imaging Informatics Knowledge Domains Domain 1: Analytics Domain 2: Enterprise Imaging Domain 3: Productivity Domain 4: Quality Slide 12 Opportunities include: General Sessions Hot Topic Sessions Learning Labs Special Scientific & Collaborating Sessions Roundtable Discussions Innovation Theater Sessions Open Source Plug Fest Hackathon CIIP Study Groups

5 Slide 13 SIIM Webinars SIIM is pleased to announce a 2015 Webinar Series - Enterprise Imaging Improving Quality, Productivity and Analytics. The SIIM 2015 Webinar Series is supported through an unrestricted educational grant provided by GE Healthcare. SIIM webinars are archived after the main event and made available as video-on-demand for SIIM members only. Members with schedule conflicts on the webinar day, can sign up anyway, and then access the on-demand presentation at their convenience. In addition to participants submitting questions during the webinar live Q&A, the webinars also include Tweet Chats so that those who tweet can on twitter and contribute to the conversation with #imaging IT. Upcoming Webinars April - Image Enable your EMR with RESTful APIs -April 30, Speaker: Chris E. Hafey, CTO, StatRad May - Value Based Healthcare Meets Enterprise Imaging - May 21, Speaker: Kevin W. McEnery, MD, UT MD Anderson Cancer Center June - Big Data from a Small Shop: Practical Imaging Analytics in an Epic Environment - June 25, Speaker: David Channin, MD, CIIP, Guthrie Clinic On-demand Webinars Entrée into Enterprise Imaging: Challenges and Solutions - Speaker: Louis M. Lannum, The Cleveland Clinic Mobile Development of Consumer and Enterprise Apps in Healthcare - Speakers: George Shih, MD, MS, Charles Lau, MD, MBA, and Ahmed El-Sherief How Big Data and Big Analytics Will Change the Clinical Practice of Radiology - Speaker: Eliot L. Siegel, MD, FSIIM How can IT and the Enterprise Better Handle Digital Imaging? - Speaker: Paul J. Chang, MD, FSIIM IT Standards in Business Process Improvement - Speakers: Bradley J. Erickson, MD, PhD, FSIIM, J. Marc Overhage, MD, PhD Re-Imagining Medical Imaging IT in a Flattened World: Meaningful Innovation and Translation - Speaker: Paul J. Chang, MD, FSIIM Slide IIP Bootcamp The 2015 IIP Bootcamp has been updated based on the latest revisions to the ABII test content outline. The IIP Bootcamp features an increased emphasis on implementing system-wide PACS, adapting to different workflows, sharing data across systems, and VNAs. The Imaging Informatics Professional Bootcamp provides an overview of imaging informatics that can be used as a tool for helping you identify your personal knowledge gaps. Whether you are a new attendee at the SIIM Annual Meeting, preparing to sit for the American Board of Imaging Informatics (ABII) CIIP Certification examination, or seeking additional professional growth, the IIP Bootcamp can help you recognize these knowledge gaps. Slide 15 The 2013 Imaging Informatics Professional (IIP) Bootcamp Webinar has been designed as an introductory course of study and is based upon the ABII CIIP Exam test content outline. This 8.5 hour self-paced course focuses on imaging informatics core competencies and is a valuable resource for all healthcare professionals who want to learn the basics of imaging informatics and/or prepare for the ABII CIIP exam. Participants will earn 8.5 hours of IIP Credits. An application has been submitted to ASRT for Category A CE credits. Members $100; Nonmembers $200.

6 Slide 16 Introduce the ABII organization Slide 17 American Board of Imaging Informatics Review criteria and content of the ABII registry. Supply definition of some basic terms helpful in understanding tasks/roles. Identify the role of a PACS administrator ( Imaging Informatics Professional - IIP) and discuss task specific skills that are required. Detailed review of the 10 sections of the registry. Slide 18

7 Slide 19 American Board of Imaging Informatics, Inc. (ABII) The non-profit organization that sponsors the Imaging Informatics Professional Certification Program and awards the Certified Imaging Informatics Professional designation to qualified candidates. Founded by the Society for Imaging Informatics in Medicine (SIIM) and the American Registry of Radiologic Technologists (ARRT), ABII offers a national certification program that defines the standard for demonstrated knowledge and competence in medical imaging informatics. Slide 20 Seven-Point Qualification System Experience Education Current Certifications Exam Apply and schedule Requirements to Maintain Certification and Recertification Fee Annual Continuing Education Requirements (12 per year = 60 over 5 years) Slide 21 What type of learner responds more effectively to videos, books and diagrams? kinesthetic auditory visual tactile What technology utilizes computational algorithms to help radiologists identify clinically important findings by highlighting areas of interest in a medical image? computer-assisted detection computer physician assistant clinical review system clinical diagnosis system Which of the following refers to a standard developed for electronic data exchange in healthcare environments? OSI SNMP ADT HL7 The type of policy that describes an organization's plan for managing the technical and communication aspects of planned or unplanned periods of system unavailability is referred to as the: patch management policy upgrade policy usage policy downtime policy

8 Slide 22 Test Content Outline Implementation Date: March 2014 A. Procurement 5% B. Project Management 5% C. Operations 10% D. Communications 10% E. Training and Education 5% F. Image Management 20% G. Information Technology 15% H. Systems Management 10% I. Clinical Engineering 10% J. Medical Imaging Informatics 10% Slide 23 Digital Imaging and Communications in Medicine (DICOM) A standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple manufacturers into PACS. The different devices come with DICOM conformance statements which clearly state which DICOM classes they support. Slide 24 Health Level Seven (HL7) A non-profit organization involved in the development of international healthcare informatics interoperability standards. HL7 and its members provide a framework (and related standards) for the exchange, integration, sharing, and retrieval of electronic health information. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. HL7 promotes the use of such informatics standards within and among healthcare organizations to increase the effectiveness and efficiency of healthcare information delivery for the benefit of all

9 Slide 25 Systematized Nomenclature of Medicine (SNOMED) A systematic, computer-processable collection of medical terms, in human and veterinary medicine, to provide codes, terms, synonyms and definitions which cover anatomy, diseases, findings, procedures, microorganisms, substances, etc. It allows a consistent way to index, store, retrieve, and aggregate medical data across specialties and sites of care. Slide 26 A. Procurement (7) 1. Needs Assessment a. Organization strategic plan and policies b. Procurement goals c. Methods of needs analysis d. Replacement or enhancement 2. Vendor Selection a. Collection tools 1. Request for Information (RFI) 2. Request for Application (RFA) 3. Request for Proposal (RFP) b. Vendor response analysis tools c. Vendor demonstrations and evaluation 3. Vendor Contracts a. Contract development b. Standard components of contracts 1. licensing and user fee models (e.g., charge per click/folder; capital) 2. performance metrics/payment milestones 3. uptime guarantees 4. liability 5. obsolescence clauses 6. service level agreements c. Evaluation of a contract Slide 27 B. Project Management (6) 1. Goals, Scope, and Risks a. Identifying common risks 1. internal and external dependencies b. quantifying and controlling risks 2. Project Feasibility a. Needs assessment design b. Needs assessment implementation and review c. Financial viability [financial feasibility analysis (FEA)] 3. Project Management Assessment Tools a. Documentation of readiness, planning, initiating, executing, monitoring and closing processes (e.g., PERT charts, Gantt charts, milestones, time-and-task schedules) b. Budget, cost schedule, resource, quality and procurement plan 4. Project Completion Assessment a. Validation and performance 1. documentation 2. user acceptance testing

10 Slide 28 C. Operations (13) 1. Quality Improvement (QI) Procedures a. Philosophical basis of QI b. Process improvement strategies (PDSA, SixSigma, LEAN) c. Tools for problem identification and analysis (e.g., runchart, fishbone) d. Target areas for improvement 2. Policies and Procedures a. System management (e.g., downtime, incidents, back-up and recovery, privacy and security) b. User management (e.g., access, roles) 3. Compliance with Federal Regulations a. HIPAA b. MQSA for digital mammography c. HITECH Act e.g., 1. Meaningful Use CMS program that awards incentives for using EHRs to improve patient care 2. PQRI - Physician Quality Reporting Initiative Slide 29 D. Communications (13) 1. Roles and Relationships in Healthcare Settings a. Organizational chart b. Medical specialties (e.g., radiology, pediatrics, orthopaedics, neurology) c. Organizational theory d. Customer service methods 2. Medical Terminology a. Anatomy, physiology, and pathology b. Common imaging positions c. Imaging planes d. CPT, ICD codes e. Modality-specific terminology 3. System Availability Issues or Changes, Notifications to Business Units a. Downtime b. Upgrades c. Changes in workflow d. Methods (who, what, when, why, how) e. Plans and techniques based on user roles 4. Management Reporting and Strategic Planning a. Strategic plan b. Effect of technology and procedure change on strategic plan 5. Feedback Mechanisms a. Reporting tools b. Surveying methods Slide 30 E. Training and Education (6) 1. Needs Assessment a. Types of learners 1. learning styles 2. characteristics of adult learners b. Measurement methods (e.g., surveys, task analysis) c. Instructional objectives 2. Training Programs a. Instructional methods b. Instructional tools c. Educational resources d. Assessment of training

11 Slide 31 F. Image Management (26) 1. Environmental Design for Viewing and Interpreting Images a. Ergonomics b. Environmental factors c. Room layout physical considerations 2. The Human Computer Interface a. EMR/RIS/PACS/dictation integration b. Usability c. Key image selection and image annotation d. Input devices e. Display devices 3. Work Flow Processes that Ensure Data Integrity a. Post- processing workflow b. Compression c. Image workflow (e.g., hanging protocols, read-ready) d. Teaching files e. Clinical trials f. Acquisition and display terminology g. Reporting and results communication h. Data integrity QC checks (store-commit) i. Optimization of workflow 4. Import and Export Images a. Policies and procedures b. Workflow procedures (e.g., IHE PDI) c. Data integrity d. Recording and digitizing technology e. Standards of file exchange Slide 32 G. Information Technology (20) 1. Storage and Archiving Technologies and Architecture a. Architectures (NAS, SAN, DAS) b. Storage network protocols (SCSI, fibre channel, ATA/SATA) c. Archive strategies d. Methods for storage management (virtualization, replication, mirroring, security, compression, process automation, storage provisioning) e. Storage metrics 2. Network Architecture a. Network protocols (Ethernet: 801, Wireless , Bluetooth, OSI/ISO mode, TCP/IP) b. Transmission protocols(dicom, FTP, HTTP, CIFS, SSH, Ports) c. Load balancing and fault tolerance d. Network components and hardware (hubs, switches, routers, gateways, trunks, CAT-5/e, CAT 6, fiber) e. Network configuration (IP address, LAN, WAN, VLAN, DNS, ARP, NAT, firewall, SSL, ports) f. Network metrics/dashboard (e.g., capacity, bandwidth, redundancy, performance, cost) Slide 33 continued 3. Hardware and Software Components a. Hardware components 1. video card, CPU, memory, hard drive network interface card, motherboard (PCI, USB, SCSI, AGP), removable media hardware, (CD, DVD, MOD) b. Software components 1. operating systems, mobile devices, browser, DNS, group policy, remote management (e.g., Citrix, VMView) c. Server architecture 4. Retrieval of Information from Databases for Operations, Quality Assurance, and Planning Purposes a. Structured Query Language (SQL) b. Key performance indicators: utilization, performance, uptime, capacity, exceptions, un-dictated exams, lost studies c. Database design 1. relational versus hierarchical 2. basic principles (e.g. keys, normalization, table joining, performance) d. Dashboard concepts 5. IT Standards a. Methods to identify appropriate standards 6. Obsolescence Planning a. Technology lifecycle b. Moore s Law - the number of transistors on integrated circuits doubles approximately every two years

12 Slide 34 H. Systems Management (13) 1. Requirements for Optimal, Cost Effective System Capacity and Throughput a. Study size calculations b. Scalability considerations 1. database 2. storage 3. server 4. networking c. Impact of new technology (e.g., 256 slice CT, breast tomosynthesis) d. Licensing models: concurrent versus fixed seat 2. Disaster Recovery Plans and Business Continuity Strategies a. Policies and procedures 1. test 2. downtime 3. failover 4. HIPAA compliance b. Data and system recovery 1. offsite archiving 2. hardware and software solutions 3. Applications Service Provider (ASP) Slide 35 continued 3. System Problem Management a. Availability monitoring and problem detection 1. reporting procedures, automated monitoring (dashboard), alerts, SNMP b. Troubleshooting/problem diagnosis (remote access tools) c. Root cause analysis 1. bottlenecks, single points of failure, alternate pathways d. Status reports to management 4. Data Migration Procedures a. Strategies for migration b. Physical data transfer considerations c. DICOM standardization and data integrity d. Work-product migration (key images, annotations, presentation states) e. Cost and performance models f. User impact 5. Data Security and Individual Privacy a. Standards, policies and guidelines 1. HIPAA 2. ACR-SIIM Practice guideline for electronic medical information privacy and security b. Security strategies 1. physical, system, application c. Privacy Slide 36 I. Clinical Engineering (13) 1. Support for Imaging Modalities a. Radiography/Medical Imaging b. Breast Imaging 1. screening and diagnostic, tomosynthesis, breast ultrasound breast MRI, interventional c. Magnetic Resonance Imaging (MRI) d. Computed Tomography (CT) e. Radiation Therapy f. Interventional Radiology g. Ultrasound h. Nuclear Medicine 1. functional imaging, SPECT, PET/CT, PET/MR nuclear cardiology i. Cardiology 1. diagnostic and interventional, nuclear cardiology, echo cardiology 2. Information Management from Outside Medical Imaging a. Pathology b. Ophthalmology c. Dermatology d. Oncology e. Orthopedic templates f. Surgical planning g. Stereotactic imaging

13 Slide 37 continued 3. Modality Integration a. DICOM configuration 1. configuration parameters: (AE title, port, etc.) 2. modality work list 3. performed procedure step 4. storage commitment b. DICOM services c. DICOM objects d. DICOM validation e. DICOM transfer syntax f. DICOM tools g. Other types of integration 4. Image Display Quality Control a. DICOM Grayscale Standard Display Function (GSDF) part 14 b. AAPM task group Clinical Awareness a. Electrical hazards b. Ionizing radiation c. Magnetic fields d. Infection/biohazards e. Sterile field procedures (e.g., operating room) handling, storing, printing, and transmitting information. file format definition, network communications protocol Slide 38 J. Medical Imaging Informatics (13) 1. Medical Imaging Workflow Solutions a. Implementation b. Evaluation/process improvement 2. Systems Integration a. HIS/EMR b. RIS c. PACS d. dictation systems e. post-processing software or systems f. radiation dose management g. decision support 1. order entry 2. exam protocols 3. interpretation, case comparisons h. critical results communication i. peer review j. clinical analytics 3. Medical Imaging Standards a. DICOM b. HL7 c. MQSA d. ACR e. AAPM, SIIM f. ICD, CPT, SNOMED 4. Apply Appropriate IHE Guidelines a. Integration profiles b. RSNA connectathon results 5. Integrate Image Architecture into Organization s Long-Range Plan a. Enterprise archiving b. Master patient index c. RHIOs (regional healthcare information organizations) d. Enterprise imaging specialties (cardiology, pathology) Slide 39 Be sure to visit ABII frequently asked questions: At ABII, we've done our best to create a website that anticipates and satisfies our customers' needs. With that goal in mind, we've compiled a list of frequently asked questions. If you do not find an answer to your question here, contact us at info@abii.org.

14 Slide 40 Medical Informatics: A Formal Subspecialty Whose Time Has Come unique new subspecialty physicians already boarded in virtually any specialty could sit for the clinical informatics examination. physicians to grandfather into the specialty via a practice pathway based on experience, or to qualify by earning a master s degree program in the field (those practicing as medical informaticists have until 2018 to grandfather in through experience and exam-taking) Healthcare Informatics serves as the leading source of information for forward-thinking professionals involved in the planning, development, and implementation of important technological trends that define tomorrow s healthcare. Pioneering concepts are presented and exchanged as important strategic and information technology issues facing organizations such as hospitals, medical groups, and integrated health systems are addressed. Members of the Healthcare Informatics community share a focus on healthcare IT leadership, vision, and strategy driving change forward by shaping innovations that point the way to the future of healthcare. Slide 41 HIMSS (Health Information and Management Systems Society) is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize outcomes using information technology. HIMSS is a global enterprise producing Health IT thought leadership, education, events, market research and media services around the world. HIMSS encompasses more than 52,000 individuals, over 600 corporations and 250 not-for-profit partner organizations, that share this cause. HIMSS serves the global health IT community offices in the United States, Europe, and Asia. HIMSS Vision Better health through information technology. HIMSS Mission Globally, lead endeavors optimizing health engagements and care outcomes through information technology. Slide 42 Top 10 Ways to Prepare for the CIIP Exam (2010) By Michael Toland and Paul Nagy, PhD Note: SIIM has a plethora of resources for those studying to be CIIPs, including the Practical Imaging Informatics textbook mentioned above as well as e-learning and the coursework offered at the SIIM Annual Meeting and the Imaging Informatics Professionals Bootcamp. Visit the IIP Community page for more information.

15 Slide 43 A certification, from the American Board of Imaging Informatics (ABII), demonstrates that an individual has mastered the necessary technical, clinical, and business skill sets to invest in quality improvement, be at the forefront of the profession, and innovate within the field of imaging informatics. Slide 44 What can we, as educators of Medical Imaging Programs, do to support our students who may choose to advance into the CIIP profession?. Add complete Imaging Studies from all medical imaging modalities into our Advanced Radiology Imaging class so that students can begin to recognize other modalities and protocols. Strengthen teaching skills in your communications class. PACS administrators spend a lot of their time educating people who will be using the PACS system. Place emphasis on healthcare industry s business model, specifically HIS, RIS, PACS, and EMR Slide 45