This content is part of the Conference Coverage: RSNA 2017 conference coverage and analysis

Cloud medical imaging is coming to radiology and healthcare in general

Remote patient monitoring, cloud medical imaging, and gamification in healthcare are strategies recommended by health IT innovation expert Rasu Shrestha, M.D.

Rasu Shrestha, M.D., chief innovation officer at University of Pittsburgh Medical Center, met with SearchHealthIT at RSNA 2016 to discuss innovative technologies in medical imaging and health IT. Shrestha is also executive vice president of UPMC Enterprises, the health system's venture capital arm. In the second part of a two-part Q&A, Shrestha, who was trained as a radiologist, talks about the advantages of cloud medical imaging, as well as UPMC's experience with a remote patient monitoring system vendor that UPMC invested in. He also touches on other subjects, including gamification in healthcare. In part one, Shrestha addressed medical imaging innovations and mobility in imaging.

When will large health systems move their medical imaging systems to the cloud?

Rasu Shrestha, chief innovation officer, University of Pittsburgh Medical CenterRasu Shrestha

Rasu Shrestha: Traditionally imaging, and radiology in particular, has been very departmental. We've seen that transformation in the last 20 years, where we've moved away from it being a departmental solution to being an enterprise solution. It's not just about the radiology department and RIS (radiology information systems) and PACS (picture archiving and communication system) and 3D and voice recognition, those are all systems we've had within the department. But now, [with cloud medical imaging systems], it becomes a service offering, an enabler of better care throughout the enterprise. How do we better integrate with the EMR (electronic medical record), how do we make sure that we're able to integrate with the health information exchange, with patient portals, with patient engagement initiatives where the power of cloud computing comes into play?

It's not just about having these on-prem solutions that we're going live with after months of integration and interface. With cloud-based technologies, we're really able to scale these solutions. With the stroke of a button, you're able to have elasticity and scalability. You're able to deploy highly complex algorithms that otherwise would have needed very expensive investments in on-prem servers and devices. Now through the cloud, you can access them from fairly not-so-powerful tablet devices or computers, or your phone for that matter. So making technology and innovation infinitely scalable and accessible anywhere anytime is one of the big powerful forces we can leverage when it comes to cloud.

Shifting gears from cloud medical imaging, what's the coolest technology you've chosen for UPMC in both your roles as chief innovation officer at UPMC, and executive vice president of UPMC Enterprises?

As we talk about the future of healthcare, if our hospital beds are full, we have failed.
Rasu Shrestha, M.D.University of Pittsburgh Medical Center

Shrestha: We really believe in care transformation at UPMC. Through UPMC Enterprises, what we've been doing is really looking at the entire landscape of pain points that exist in the delivery of healthcare. As a payer and provider organization that is tightly integrated, we're familiar with a lot of these pain points.

One thing that's really interesting in particular is a technology in which we've not only put our money where our mouth is, but also our resources, data, clinical insights, and payer-provider insights as we're pushing value-based care forward. The technology is intelligent remote patient monitoring. As we talk about the future of healthcare, if our hospital beds are full, we have failed. This company, Vivify Health, has this technology that allows us to discharge patients at UPMC with smart devices and sensors and it's absolutely remarkable.

These are patients who are risk-stratified when they come in with some kind of chronic illness. When we discharge them, we want to make sure they don't come back to us. We don't want them back. We're discharging them with these smart technologies that are monitoring them. We know they're falling off the rails before they know they're falling off the rails, because we're monitoring them. We're able to intervene through care coordinators. We're able to talk to them and help them and coach them toward healthy behavior and make sure they get back to that green circle of wellness so they don't come back to our hospital. It's really cool and I think that's where the future of healthcare is going.

At RSNA 2015, you challenged people to do gamification of radiology. How has that played out?

Shrestha: You know, gamification is important and we're starting to understand what that means to healthcare at large. Specifically, one of the things we're working on at UPMC as we look at transforming what radiology really means and the value we provide, how do we quantify and incentivize value? Value is not really easy to measure. Volume is. How many studies did you read? What was your report turnaround time? Check. Check. With value, it's really about quality, it's about outcomes, it's about satisfaction, it's about care coordination. So quantifying the value, in many ways gamifying it such that it becomes fun, makes it easier for us to do the right things and you're being incentive toward those value-based metrics. Those are the types of things we're really looking into at UPMC.

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