DataDoc discussing complex workflows with physicians.

Introduction

If you’ve been in medical imaging for more than 20 years like us, you know that the transformation from film to digital, birth of PACS, evolution of enterprise imaging, and now the incorporation of Artificial Intelligence (AI) into today’s technology stack has been nothing short of an incredible journey.

Along the way, we got better at doing everything.  Film became digitized.  PACS was the mechanism to give access to images to all caregivers who needed it.  Archives became consolidated to save time, money, and space.  Enterprise Imaging integrated those images into the patient record.  And we moved many systems to the cloud.  By connecting departments, organizations, and patients through better interoperability, we started to achieve better healthcare operations for all.

In many ways, these efforts have been remarkably successful.  Images are more accessible than ever before.  Clinicians collaborate across locations.  Healthcare organizations share studies with outside facilities.  Patients increasingly expect digital access to their own medical information.

The industry has accomplished exactly what it set out to do.  Yet something interesting has happened along the way.

As healthcare became more connected, it also became significantly more complex.  That complexity, not greater connectivity, is quietly becoming one of the biggest operational challenges facing medical imaging today.

The Successes That Created New Challenges

Think about it.  Not that long ago, imaging departments were largely self-contained.  Radiology managed radiology. Cardiology managed cardiology, and images remained within departmental boundaries, and workflows were relatively predictable.

As healthcare organizations expanded beyond traditional departmental boundaries, several industry forces accelerated this evolution. COVID certainly changed how care was delivered, but it also amplified trends that were already well underway – remote reading, enterprise consolidation, telehealth, staffing challenges, and greater operational complexity.

Healthcare demands did not change during COVID, but staffing shortages and new operational procedures did.  Telehealth had its shining moment as organizations learned to provide care from virtually anywhere.  Healthcare organizations further consolidated and began operating across multiple locations, like outpatient centers, physician groups, and remote reading organizations. Imaging studies moved between dozens, and sometimes hundreds, of systems every day.

Prior to COVID, larger organizations began implementing enterprise imaging to aid in consolidating costs and upkeep while offering enhanced access.  Cloud platforms began to be more widely adopted, while cybersecurity concerns grew, AI applications were introduced, patient engagement platforms emerged (think self-service), analytics tools were common, workflow automation became the next buzzword, and disaster recovery initiatives needed to be implemented.

None of these investments are problems.  In fact, each one represents progress, and if viewed wholistically, were inevitable.  Collectively, however, they transformed imaging operations into one of the most complex environments within healthcare, and that complexity continues to increase every day.

Connectivity Was Never the Finish Line

As new systems emerged forcing many other imaging departments to embrace digital workflows, the focus became connectivity.

Connect the PACS.  Connect and standardize the archive (archive standardization reduced the need for future data migrations as the need to change systems – or strategies – emerged.  Embed the images into the full electronic health record.  Connect everything to the enterprise, including outside organizations, as well as patients.

Those efforts fundamentally changed healthcare since it broadened the impact images can have across care teams planning patient treatments.  But connecting systems was never the ultimate goal.  It was the necessary first step.

No matter what new technology, process, workflow, or regulation emerges, we must always remember that the end goal to everything we do is to always improve patient care.  Making information available where and when it is needed the most becomes critically important as reduced staffing and complex health cases demand information and speed to succeed.

Today, most healthcare organizations have achieved some level of connectivity.  Their new challenge is to make all their connected systems operate together, but with far more efficiently.  Because connected systems don’t automatically create coordinated operations.

Complexity Actually Looks Different Than First Expected

Operational complexity rarely announces itself with a single catastrophic failure.  Instead, it creeps up across your organization as it appears in hundreds of small moments.

A routing rule that doesn’t behave as expected.  Maybe no big deal as an isolated incident but factored across hundreds of cases, becomes an operational burden.  An AI result that isn’t incorporated into an existing workflow.  Again, maybe no big deal on a single case level, but amplified across hundreds of studies and a patient care issue could surface.

Outside imaging arriving without the context clinicians need.  This sets up unnecessary delays in patients not only receiving imaging they need, but also in receiving the results their caregiver needs to improve their care outcomes.

Studies requiring manual intervention before reaching the radiologist, once again sets up delays in patient care, but also places unnecessary and undue burdens on staff.
Multiple teams managing overlapping technologies with limited operational visibility.  You might call this situation chaos.  Without proper governance, operational oversight, and well documented processes, efficiency declines and costs increase.

None of these situations are unusual.  Most healthcare organizations successfully work through them every day.  The question isn’t whether these issues occur at all, it becomes how often they occur, and how much time, effort, and cost are spent managing them.

As organizations continue expanding imaging services across their enterprise, reimagining their reading services, and meeting committed service level agreements, the operational complexity grows alongside them.

But Now, The Conversation Must Begin to Change

Historically, conversations about imaging technology almost always focused on acquisition, storage, viewing, and interoperability.  In fact, most organizations today still think of their PACS as a complete system that improves patient care.

Unfortunately, it’s not.  PACS remains a departmental solution that replaces film and is typically departmentally focused.  Don’t get me wrong, those conversations and capabilities remain important but we need to start thinking differently. Healthcare leaders are beginning to ask different questions as they evaluate new technology and replace legacy systems.

  • Where are our most pressing operational bottlenecks occurring and what causes them?
  • Which workflows require the most manual intervention and what could those workflows look like if they were automated?
  • How can imaging operations become more adaptable as we seek to improve enterprise access and bring the patients into the picture?
  • How do we simplify increasingly complex environments without introducing additional complexity?
  • How do we prepare our organizations for technologies that hasn’t fully matured yet?

These questions represent a shift. The discussion is gradually moving beyond infrastructure alone toward understanding how imaging operations perform across the enterprise.

The Time is Now to Prepare for What’s Next

Healthcare always has and always will evolve in response to new challenges that surface – both internally as well as regulatory.  As we think back to where this industry has evolved from only a decade ago, each evolution that appeared solved an important problem.  But as one problem was solved, new opportunities, and new complexities, were equally introduced.

Today’s healthcare challenges are no different.  You see it every day as our leading industry organizations, like HIMSS, SIIM, RSNA, and many others, continue to try and educate and tackle the greater challenges facing us all.

The next chapter in healthcare imaging won’t be defined by simply connecting more systems.  It will be defined by helping healthcare organizations better understand, simplify, and coordinate increasingly complex imaging operations.

Exactly how that evolution unfolds remains to be seen.  But one thing seems increasingly clear.  The future of healthcare imaging isn’t about managing more technology.  It’s about making complex healthcare environments easier to operate.  And that conversation is only just beginning.

Organizations that thrive over the next decade won’t necessarily be those with the most technology. They’ll be the ones that best understand how to simplify, coordinate, and continuously improve increasingly complex imaging operations.

At InsiteOne, we believe preparing for that future starts today.

For more information on how InsiteOne can provide a tailored solution to meet your organization’s Imaging IT needs, including workflow orchestration and imaging intelligence solutions, contact us today at 866.467.4831 or visit us here.