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Healthcare IT

Medical imaging's capacity building shortfall

By Jianggan Li | 3 June 2010

The rate of health IT adoption is becoming phenomenal among care providers in the Asia pacific region. During this process, the lack of qualified professionals in related disciplines as well as the need for general awareness are also becoming more apparent.

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“Granted that nothing replaces actual hands-on ground experience, proper preparation in form of education and training can minimize the learning curve and prevents unnecessary ‘reinvention of the wheel’,” says Adam Chee, an expert in healthcare informatics with a passion for digital medical imaging.

Chee runs a social enterprise called binaryHealthCare that seeks to raise the standards of health informatics through training, continuing education, knowledge exchange and collaboration; he also serves as adjunct faculty at the School of Applied Sciences of Singapore’s Republic Polytechnic and as an Executive Committee member of The Association for Medical and Bio-Informatics, Singapore (AMBIS).

Chee believes proper training focusing on the technology, management (including change management and policy development), concepts and culture aspects of medical imaging informatics professional is the fundamental key to success; however he says this is seriously lacking in the region and efforts to bridge the gap are urgently needed.

“Medical imaging plays a vital role in modern healthcare and almost every clinical discipline uses it to a certain aspect,” he says. “The success stories of digital medical imaging in radiology have raised the expectations and hypes in other medical imaging disciplines while the horror stories raise confusion and add additional barriers to the already challenging change management journey.”

Chee highlights that it is important to raise the awareness that “medical imaging does not equate to just radiology”. “While the radiology discipline has given birth to the concept of PACS, the clinical characteristics of radiology do not applies to all medical imaging disciplines and having a bias approach in the implementation process can have adverse effect,” he explains. “The various medical imaging disciplines, which now must now converge at the digital front end, are very complex and diverse.

There is a pressure to implement a ‘unified’ imaging informatics solutions catering for different imaging disciplines, mainly radiology, cardiology and endoscopy at present.

The ‘immediate challenges,’ as highlighted by Chee, is “meeting the clinical, technical and operation requirements of each discipline and getting it accepted by the relevant key stakeholders, each with different needs and objectives.”

In the long run, the framework and foundational build would need to cater for growth of demand as well as the needs of other medical imaging disciplines which come onboard to the digital journey.

While advancements of technology has been playing an important role in medical imaging workflow enhancement, Chee points out selecting suitable technology is the real differentiator.

“Effective implementation is not about adopting the latest and greatest technological gadget available in the market,” he cautions. “It is rather about the ability to adopt the right technology as an enable for improvement.”

An example of this, as Chee elaborates, would be the introduction of wireless Digital Radiology. “Both wireless and DR technologies have been around for a long time but the innovative idea of combining both not only translates to the retention of benefits of DR (high image quality and fast processing speed) but extends the flexibility that Computed Radiology brings in aspects of workflow.”

Beyond radiology and cardiology, Chee sees pathology the next big adopter of medical imaging. “The ability to transfer image-rich pathology data between locations for diagnosis, education and research is highly desirable,” he says.

Nevertheless, the inherent characteristics of pathology images present great challenges in adoption. The typical size of a pathology image is about three to four gigabyte, making not only storage, but also the ability to transmit difficult.

Although a DICOM workgroup has already been working on digital pathology standard, such standard is far from ready for real life adoption.

“The challenge can be overwhelming,” Chee says. Highlighting the need to be able to tackle this challenge, he adds that it is imperative for hospital to build up is competence and training in the area of digital medical imaging, as well as health informatics in general.