Celebrating 10 Years of the HIMSS-SIIM Enterprise Imaging Community and Enterprise Imaging Informatics

Driving thought leadership through white papers, workgroups, and regular HSEIC communications, “enterprise imaging” has become common parlance in hospitals, healthcare news media, and industry partners. Fifteen HSEIC workgroups and taskforces have been commissioned in all, detailing the current state, best practice, and future opportunities for several important enterprise imaging administrative and clinical functions, such as governance, ideal orders-based and encounters-based workflow, image exchange, and image viewing through a series of influential white papers (Fig. 1). Including this paper, the HSEIC has produced 16 open-access white papers that have been downloaded over 100,000 times, shaping industry standards and influencing enterprise imaging implementations across the globe (Fig. 2) [2‐16]. The HIMSS Annual Conference and SIIM Annual Meeting have together hosted more than 150 educational sessions centered on enterprise imaging since 2016. HIMSS and SIIM have also presented over 100 enterprise imaging meetups, webinars, and podcasts.

HSEIC workgroups and taskforces are groups of volunteers of varying roles and experiences dedicated to collaboratively approaching complex problems that typically do not have one single, simple path forward. Constructive disagreements on multifaceted issues have surfaced, as hospitals employ different approaches to meet similar imaging needs. The richness of the discussions, disagreements, and questions led to more informed participants and insightful whitepapers. For example, the Foundation of Enterprise Imaging workgroup recognized several imperfect methods to segment multimedia content. While content could be broken into familiar clinical specialty silos (cardiology, obstetrics, radiology, surgery, others), the lines would have been too blurry, as a given image may be captured, interpreted, or consumed by many specialties. Categorizing content into DICOM and non-DICOM was considered. Eventually, the group decided to focus on clinical relevance more than data format and transfer mechanism, as it was unclear what standard formats would be most common years into the future for some clinical content. As a result, the Foundations workgroup did not deeply probe this DICOM/non-DICOM categorization. After several meetings discussing the nature of enterprise imaging content, the workgroup determined that categorizing content as diagnostic, procedural, evidentiary imaging, and/or image-based clinical reports would ultimately best illustrate the spectrum of enterprise imaging content. In the end, the discussion across imaging and non-imaging providers, industry partners, and IIPs to describe a nuanced, largely uncharted space led to a more refined classification and early enterprise imaging cultural growth.

HIMSS Analytics™ has helped hospital systems measure the maturity of their informatics strategy and implementation since launching the Electronic Medical Record Adoption Model (EMRAM) in 2005. In 2016, HIMSS Analytics™ collaborated with the European Society of Radiology (ESR) to launch the DIAM, although this first DIAM iteration incorporated radiology only. In partnership with the HSEIC and the European Society of Medical Imaging Informatics (EUSOMII), HIMSS expanded the DIAM in 2019 to encompass enterprise imaging. Today, the DIAM helps organizations objectively measure their maturity across many areas of enterprise imaging capabilities, including image management, governance, workflow, decision support, patient engagement, and analytics. As many organizations recognize the best practices described by the HIMSS adoption models as directional and aspirational, the DIAM has become an unbiased and informed source guiding the development of their enterprise imaging strategic plan.

Today, the HSEIC comprises over 1225 members, including providers, IIPs, nurses, data scientists, vendor partners, and other occupations. Regular newsletters, webinars, online roundtables, and in-person meetups provide networking opportunities for members, which connect members across provider and industry organizations to solve local challenges, share best practices, and develop new solutions. As the HSEIC has grown, it has developed partnerships with other specialty societies to help address challenges pertinent to each imaging specialty. Examples include the HSEIC’s work with the American Institute of Ultrasound in Medicine (AIUM) to advance point-of-care ultrasound workflows and the Digital Pathology Association (DPA) to advance pathology workflows. There are numerous points of entry into the HSEIC for interested imaging informaticists of all personas, expertise, and roles, including signups on the SIIM website, HIMSS website, and at HSEIC Annual Meeting Meetups [17, 18].

Driven by workgroup outputs, HSEIC members recognized that technology gaps led to clumsy clinical workflows. They sought to address these gaps by collaborating with Integrating the Healthcare Enterprise (IHE), a heavily vendor volunteer-led initiative jointly sponsored by HIMSS and the Radiological Society of North America (RSNA) with a mission towards standards-based interoperability [19]. Successfully developed interoperability profiles with HSEIC participation include encounter-based imaging workflow (EBIW), interactive multimedia reports (IMR), and integrated reporting applications (IRA) [20‐22]. While these profiles were built within the Radiology IHE Domain, they were purposefully written to be inclusive of other specialties and imaging workflows.