They've got I.T. Goin' On
During the many frustrating “down moments” in the radiologist’s average day – while on hold waiting to convey an important finding or waiting to access prior studies for comparison — there is time to dream about the future. Radiologists imagine a time when, at the click of a button, they can read the background of a case, access relevant exams through a digital storage system, look at prior reports or test results, review additional patient information, dictate findings through a voice recognition system, and complete a diagnostic report available for immediate review by the referring clinician. Educators dream of a time when teaching files of interesting cases are accessible to residents from any location, while administrators envision making managerial decisions using customized, data-driven analyses. Researchers imagine a future where, at the click of a button, they can instantaneously retrieve cases that are relevant to their research.
Such dreams are predicated on information technology — digital image storage, web-enabled databases, customized software, web design, and enormous technical expertise. To make these dreams come true requires a myriad of fully integrated systems, interfaces, and applications, as well as the technical expertise to develop such tools and ensure their seamless integration with the disparate systems in use at NYU. Imagine the power of a radiology department with all of these tools right at its fingertips. In this world, information is truly power. This is the vision of NYU Radiology Information Technology (RadIT) — a vision that Joseph Sanger, M.D., Director of RadIT, and Nanda Kirpekar, Manager of RadIT, not only share, but with their nine-person staff, are swiftly on their way to making a reality.
WHAT THEY DO: THE NUTS AND BOLTS OF RADIT
There are many challenges to running RadIT, as the group must quickly adapt to the ever-changing needs of the radiologists and administrators within the NYU community. At the same time, Dr. Sanger and his team must remain responsive to the larger challenges and trends that are shaping the delivery of efficient, high-quality service in the cutting-edge imaging field. As Director of RadIT, therefore, Dr. Sanger plays an instrumental role in the department’s strategic direction, core operations, and highly fluid model of systems and technology. He provides managerial oversight of all RadIT functions, including the group’s creative and innovative work on “special projects,” which involves the speedy design and implementation of proprietary applications that enhance departmental productivity and efficiency. In addition, Dr. Sanger acts as the face and voice of RadIT outside of the department, facilitating the coordination of activities between RadIT and the rest of the medical center with their affiliated I.T. departments. Dr. Sanger also directs a small group of programmers for the NYU Medical Center I.T. (MCIT) group, creating web-enabled database software applications for the institution at large.
As manager of RadIT, Mr. Kirpekar fulfills a different but complementary role. He spends a significant amount of time on data management and interface design and maintenance. Mr. Kirpekar is the source that the department leaders contact when they need information to make managerial decisions involving workflow, quality assessment, or strategic direction. Mr. Kirpekar also leads RadIT’s oversight of interfaces, ensuring that the main departmental information system, IDXrad, can successfully interface with dozens of external systems. Such interfaces need to be designed, coded, implemented, and then continually updated as clinical needs change. The level of specialization and customization offered by RadIT is a significant factor moving the NYU Radiology Department to the forefront of cutting-edge technology and the highest quality of patient care.
CLINICAL SERVICE
As a clinical department, Radiology’s primary I.T. needs involve the constant flow of clinical images and reports, since, in the simplest terms, the practice of radiology entails generating images and producing diagnostic reports as accurately and as quickly as possible. A host of commercial and proprietary systems and tools are necessary to allow the departmental support staff and radiologists to accomplish this goal. RadIT is responsible for managing all of these functions, which range from server administration and hardware support to interface management and custom application development.
If you look at any cutting-edge radiology department throughout the world, you will find that certain I.T. systems have become integral to the field of radiology, and NYU is no exception. There are three primary clinical systems that keep the Department of Radiology running: the Radiology Information System (RIS), the Picture Archiving and Communications System (PACS) and the Speech Recognition System. The staff of RadIT works tirelessly to maintain and administer all three.
The NYU Department of Radiology uses the IDXrad system as their RIS, and, as Dr. Sanger explains, the RIS acts as the central nervous system of the department, since it touches everything done in radiology along the path of patient to image to diagnostic report. The RIS is involved in scheduling exams, tracking patient information, storing reports generated by the speech recognition systems, and feeding these reports downstream to other systems such as the Hospital Information System (HIS) and the Electronic Data Repository (EDR).
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The I.T. Group Seated, left to right: Joseph Sanger, M.D., Ricki Stern, Michelle Oddman, Nanda Kirpekar. Standing, left to right: Abdul Waheed, Matt Lisowski, Robert Moy, David Yee, John Khosrofian, Andre Stevens, Quyen Ngo.