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No more CD-ROM: The next logical radiology step

Despite a successful transition from film-based to digital imaging in radiology, both radiology reports and its images have not had any major improvement in more than two decades, but CDs.

Currently, radiology images still are been delivered to patients in old-fashion CD-ROMs, converting them in a major headache for patients and doctors when opening, which it is also against current trends of designing PCs and laptops that does not come anymore with CD-DVD readers. (starting by Macs)

For many doctors, a printed radiology report is considered a stand alone business model, while for others is a personal card for radiologist’s reputation. Nevertheless,  CDs still are blocking this final message of what finally does radiologist want to express over images.

Leaving the radiology department

A printed version of a final report lose its value when doctors need to revisit the case again or when need to compare it against a series of previous studies. The CD again it is a complicated drive to be loaded among many studies in same splitted window. Also it is true that today many physicians did not even look again the radiology report, but most importantly rely on concepts extracted directly from images stored in the CD instead.

CDs represent a minimalistic view of radiologists, but even same radiologists and others doctors involved in the imaging community complain on daily basis about the difficulties of these CDs to be created, readed, or loaded. In summary, the major guilty that reports are printed “black and white” and images are static is the CD.

In summary, CDs represents a huge gap for an easy readability, and sharing workflows for empowering patients. It is a common complain hear about the hassle when doctors needed to open a CDs during consults, compared with the short time designated to exam every patient.

The Cloud

How to get rid of CDs? The cloud, but not any cloud.

The concept of transporting medical images over Internet is difficult due to HIPAA and security issues, that creates a barrier for  radiology departments to prefer to block any access directly to their PACS over the web.

Its it undeniable that having a portal for each hospital despite benefits over CDs, surpasses the cost of delivering studies in non-DICOM OR DICOM CDs. Moreover, each department that consider use a cloud itself need to comply safeguards for imaging and healthcare information privacy rules, which is a downside for radiology clouding, compared with the experience of who has already have sensed the power and value of sharing images via apps or in the cloud.

PCHRs (Personally Controlled Health Record) in the rise

The following is a basic strategy 6 points for answering how to share images across cloud computing compared with transporting them in CDs.

  1. Integrate PCHR: Integrate a neutral third party of a cloud archive with DICOM viewer. This creates a information flow to be readily shared between computer systems that may not communicate directly with RISPACS; And also solves the problem for those who don’t like to grant outsider access to their PACS.
  2. Eliminates lost, duplicated CDs: Temporal cloud systems is a trending way to help greatly reduce waste, costs and duplications specially for those cases called “one time” visit images, which are mostly normal.
  3. Find a digital business model against CD cost: Forwarding cost of a PCHR (Personally Controlled Health Record)  into a system that can act as a smart cloud for uploading and downloading medical images, and includes two-way communication between physicians and patients.
  4. Change radiology report format: No more “black and white” reports. Create a printed radiology report is one thing, but creating a report over images is another one that involves symbols, graphs, links for sharing info with multiple facilities; thus finally reveal this hidden value of radiologist expertise, than saying “Unremarkable”. A new way need to be found to replace printed format with long narratives, and more itemized formats that opens a controlled language as a touch base for conveying Machine Learning capabilities over semantics, and also integrating RADLEX with PQRI (Physician Quality Report Initiative).
  5. Transfer ownership for patients as end-user access: Instead of giving disks, allow patients to share links and granted them controls to forward links to another provider, then Radiology Department’s responsibility in transporting the information ends. HIPAA and PHI are now responsibility shared between PCHR (Personally Controlled Health Record) and finally the “patient“, both will be responsible in making sure the data securely managed their way to the intended recipient and forwarded to the final recipient (doctor).
  6. Innovating traction models: Create bundle services for sending hospital-managed communications (instead of relying massive marketing emails) inside same Cloud-PCHR to provide clearly better value proposition for healthcare organizations.

DISCLAIMER: I am CEO of MEDPIKE, and FOLDERSALUD.COM  a new comming product for replacing CDs available soon in LATAM.

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