Enterprise Imaging: Insights from the Field

Defined as “a set of strategies, initiatives and workflows implemented across a healthcare enterprise,” enterprise imaging is used “to consistently and optimally capture, index, manage, store, distribute, view, exchange, and analyze all clinical imaging and multimedia content to enhance the electronic health record.”

In the rapidly changing world of imaging technologies and information management, continuing to develop the knowledge and skills of imaging informatics professionals globally can help improve the quality, safety and efficiency of healthcare.

To learn more, we asked specialists across the field to share stories about their profession to help build an understanding of enterprise imaging (EI). The value that they bring to health information and technology is astounding and look forward to their great work ahead.

Les Folio, DO, MPH, Lead CT Radiologist, National Institutes of Health Clinical Center; a HIMSS-SIIM Enterprise Imaging Community Member

How would you define EI for someone who doesn’t understand the industry?

Ideally EI includes images, videos, graphs or tables in all electronic health (and medical) record encounters. A referring clinician, as well as the patient, shall have access to all perinate images that are described in specialists’ textual reports. These are to be available along timelines of treatment, across all facilities, central around the patient. Further, interactive reports link from the text to the image where discussed. For example, any clinician will be able to view a melanoma lesion on patient from the first encounter trough to the last, with descriptions and management a click away.

What advice do you have for those interested in the field?

Get involved in the HIMSS-SIIM Enterprise Imaging Community. There are more opportunities than you think.

How did you get started in the EI industry?

I was invited when leaders realized we were creating multimedia interactive content reporting routinely many years ago.

What lessons have you learned along the way?

Be open. Participate. Push for standards that will lead to interoperability.

What inspires you as an advocate for EI?

I am inspired by opportunities offered through the HIMSS-SIIM community.

What lessons have you learned during the COVID-19 pandemic?

Many imaging-centric specialties finally realize that enterprise imaging telehealth is imperative during pandemics.

Kim Garriott, Chief Innovation Officer, Healthcare, NetApp; a HIMSS-SIIM Enterprise Imaging Community Member

How would you define EI for someone who doesn’t understand the industry?

Enterprise imaging is the management of all medical imaging. From acquisition to disposition, EI is comprised of traditional imaging such as radiology and cardiology and also all other forms of medical imaging including digital photos, point-of-care ultrasound, scope images, waveforms and others.

What advice do you have for those interested in the field?

To jump in! Other than the electronic medical record, there isn't a clinical health IT domain that touches more people, including patients, than enterprise imaging. Every clinical service area generates some form of medical imaging whether it is a digital photo from dermatology, a scope image produced during a knee surgery, or a point-of-care ultrasound image acquired during an outpatient visit to the endocrinologist. You get to interact with clinicians from all disciplines and work with pretty cool technology, too!

How did you get started in the EI industry?

My path to EI was through radiology. My health IT career started at Indiana University Health where I worked as a radiology informatics project manager. There I led the planning and implementation of the transition from film and paper-based operations to digital. It was fascinating work that I loved. A few years later, I was fortunate to work at the Cleveland Clinic where we built an EI program before most in the field of health IT knew what it was. We grew that program to one that is still recognized as one of the most robust in the world.

What lessons have you learned along the way?

The most valuable lessons I have learned are related to the human element. Empathy, active listening and proactive communication are keys to creating an environment of engaged technology consumers. Empathy enables you to see things from another's perspective—a patient, a patient's family, a caregiver, a colleague. This is an important in many aspects of life and it’s necessary if you are designing or implementing a new technology for others to use. Active listening.

One of the best tips that a colleague once gave me is to know when to let others speak first. Don't fall into the urge to fill uncomfortable silence during critical conversations. Let others speak before you, actively listen, then determine how you will react. Proactive communication is appreciated by everyone and helps you to control the narrative. In the absence of information, people will make up their own.

What inspires you as an advocate for EI?

Improving the delivery of care. Practices like using point-of-care ultrasound enables clinicians to more readily assess a patient condition, determine the best course of treatment and potentially avoid more costly procedures and unnecessary exposure to radiation.

What lessons have you learned during the COVID-19 pandemic?

That we are more resilient than we think we are.

Jason Nagels, CIIP, PMP, Manager, Informatics and Operations, HDIRS; the HIMSS-SIIM Enterprise Imaging Advisory Council Chair and Community Member

How would you define EI for someone who doesn’t understand the industry?

When people think of imaging captured within a healthcare enterprise, often radiology/diagnostic imaging is what first comes to mind; however radiology represents just one set of imaging within a healthcare enterprise. For example, within a healthcare enterprise, imaging is leveraged for clinical specialties such as wound care, dermatology, point-of-care ultrasound, digital pathology and many other specialties.

What advice do you have for those interested in the field?

There are many opportunities to learn more about EI. The HIMSS-SIIM Enterprise Imaging Community has published white papers that cover a wide range of topics related to EI, with more white papers in development. These are all free/open access that provides valuable information to help get you started in EI. Additionally, the HIMSS-SIIM community hosts webinars in which experts in the industry provide their experience on topics related to implementing and managing EI workflow.

I also would recommend if someone wants to learn more, volunteer and join a HIMSS-SIIM community working group! These working groups provide an opportunity to work alongside and learn from experts in the field.

How did you get started in the EI industry?

In my current role working with HDIRS, a regional health information exchange (HIE) in Canada, we provide organizations the ability to share and exchange diagnostic imaging (radiology) exams across the region. A few years ago, the desire to implement new clinical imaging specialties to the HIE was proposed. I began investigating more about EI and began volunteering for some of the HIMSS-SIIM community working groups. This lead to me volunteering and participating in the IHE Radiology Technical committee during the development of the Encounters Based Imaging Workflow profile.

What lessons have you learned along the way?

Each clinical specialty has its own unique workflow and EI is not a matter of shoehorning radiology workflow onto other clinical specialties. Over the past number of years, I’ve come to better understand the workflows for other clinical specialties such as gastroenterology, dermatology and digital pathology, to name a few.

What inspires you as an advocate for EI?

We are all patients and we expect our doctors to have all the relevant clinical information, including EI, in order to make the best treatment decisions. This can be a difficult task when imaging is stored across multiple silos within a healthcare enterprise. Advocating for improved interoperability for enterprise imaging has a direct impact on the care we receive as patients.

What lessons have you learned during the COVID-19 pandemic?

Despite the terrible impact COVID-19 has had on the world, it has been encouraging to see the creativity and flexibility of people continuing to find ways to connect and collaborate together.

COVID-19 has slowed things down and allowed people to find new hobbies and interests. Over the summer I learned a bit about gardening and grew some pretty impressive pumpkins. 

The views and opinions expressed in this content or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.