Health Informatics
Health Care is changing!
Modern healthcare is responding to the technical revolution by embracing engineering, IT, biomedical and other sciences to create equipment, gadgets and software, never imagined before. In 2007, Scotland became the first country to achieve a countrywide PACS system. Scan a patient in northern areas like Aberdeen or even John o'Groats (end of the land) and 10 minutes later, you can see the scan in tertiary care centres of Glasgow or Edinburgh.
Here are a brief history and future forecast of radiology and why health informatics is the way forward. (Image courtesy: iq systems)
1. Picture Archiving and Communication Sytem
PACS has been the very foundation of the change which will result in a near-complete revolution of the Radiology and Imaging practices so far, and in years to come. We now have the ability to store, recall and organise DICOM images and the link with Radiology Information system (RIS), Hospital Information system (HIS), Electronic Health Records (EHR), enabled by HL-7 capability. These apparently simple words and ideas have really transformed the healthcare with quantum leaps in diagnosis, treatments and how these are executed. (Image Courtesy: Infinite PACS)
2. Image Processing
PACS had a phenomenal impact on radiology practices. It became the hub of all sorts of imaging modalities into one screen. Enabled by software for post-processing, volume reconstructions, 3D rendering and filtering/merging of images opened new dimensions like never before. (Image courtesy: Paxcera Health).
3. Centralisation of radiology reporting.
With establishment of PACS with multiple image upload points and radiologist workstations - reporting for remote locations became possible. It facilitates the workflow where expert opinion became available to multiple centres at the same time. It became the foundation of heath exchanges as in NHS England. Unfortunately it could not work well as different trusts had non-compatible software further complicated by red tapes. However, it was greatly executed in UAE where the capital city of AbuDhabi hospitals were connected in a health spine called 'Malafi'. All patient under a unified national number could be traced back to any previous admissions in any hospital across the state. Image, labs, and clinical/nursing notes were shared across the country,
Artificial Intelligence in radiology
With technological advances and the quantum leap in the capacity of the hospital systems, workflow rose exponentially. A classic example would be the number of CT scans. In the USA alone, the total number of CT Scans in 1995 was around 2.7 million which rose to almost 16.2 million in 2007. With modern CT scanners and capacity to perform submillimeter slices, total number of slices/data per scan also increased. Handling of such a large number of patients, data, workflow management and reporting services, artificial intelligence slowly made way into numerous centres. From automated breast US developed by GE to AI-enabled reporting by Fuji PACS or radiology workflow management by Infinite 'Smart Assign', AI has made steady ways into radiology and hospital workflow. Needless to say that its effectiveness and response has been varied. Most of these AI-based workflows claim the sensitivity of the specialisation, urgency and need for accuracy. However, there are significant existing challenges and errors resulting from the complex nature of multiple modalities, varied protocols, referring physicians, insurance providers, legal frameworks and prohibitive costs for smaller centers.
