Integrated Imaging Informatics Track (I3T)

Clinical informatics is an emerging and fast-evolving field recognized as a Board-certified subspecialty. Imaging informatics, a subfield of clinical informatics, encompasses the management of information during all steps of the imaging chain – from ordering to communication of findings to the physician and/or patient. Electronic health records (EHRs), picture archiving and communication systems (PACS), radiology information systems (RIS), hospital information systems (HIS), and many other information technology (IT) tools are part of our day-to-day lives, which increases the need for qualified professionals with technology expertise as well as medical experience, communication skills, and leadership skills.

The idea of the radiologist’s role to solely sit in a dark room and interpret images is obsolete. Radiologists are likely the most tech-savvy of medical specialists and now are expected to take the lead in the management of information systems. Imaging informatics provides radiologists with innovative tools to add value and prevent the commoditization of our specialty. Imaging informatics education is critical for all current radiology trainees, regardless of their career plan; indeed, imaging informatics topics are included on the ABR’s Core Exam guide. For those interested in leadership roles, there are many new opportunities at the intersection of medicine and IT, not only on a departmental level – Director of Imaging Informatics, Vice Chair of Imaging Information Systems, etc. – but also on the enterprise C-suite level - Chief Medical Information Officer (CMIO), Chief Health Information Officer (CHIO), Chief Innovation Officer (CIO), etc.

I³T residents learn skills needed to improve the quality and efficiency of imaging services while supporting clinical, educational, and research efforts through the use of information technology. I³T trainees act as liaisons between our Diagnostic Radiology and Interventional Radiology residency programs and the Division of Imaging Informatics. I³T trainee projects are designed to improve the residency training experience using innovative information technology solutions while acquiring hands-on experience in the field of imaging informatics.

Through a combination of early exposure to the National Imaging Informatics Course (NIIC); recommended readings and modules; small group discussions and activities; lectures; and organized leadership, operational, and research opportunities, the I³T program aims to

1. Introduce trainees to the different aspects of imaging informatics as a career;
2. Develop in trainees the skills necessary to be a successful leader in imaging informatics in either academic or private practice radiology;
3. Provide an avenue for trainees to undertake information technology projects, building on both theory and practice by taking part in leadership/operational meetings and hands-on projects;
4. Foster leadership and scholarship through mentored hands-on change management projects involving information technology; and
5. Advance the field of imaging informatics and radiology as a whole.

The program's ultimate goal is to produce well-rounded radiologists who can be leaders in academic and/or private practice.

I³T residents are encouraged to work on projects for presentation at the Society of Imaging Informatics in Medicine (SIIM) annual meeting. These might turn into papers and mentors will advise on how to design operational/quality improvement projects that can result in scholarly publication.

• Digital Imaging and Communications in Medicine (DICOM) standard and other protocols for radiology data management
• Enterprise scheduling
• Evidence-based patient care
• HIS, RIS, PACS, HL7, DICOM, IHE (and how they all communicate)
• How to communicate with vendors
• Information and management of imaging departments
• Machine learning, predictive analysis basics
• Ontologies and standard nomenclatures
• Project management, technology interpretation, managing change, customer service, and innovation
• Security and privacy issues and approaches
• Structured reporting

I³T residents in their R2 or R3 year will propose their capstone projects to the faculty mentors for approval. Potential projects include but are not limited to an innovative quality improvement project using information technology, learning a new programming language for a specific task involving the residency program and/or the Division of Imaging Informatics, or preparing for and passing the CIIP exam.

If a quality improvement project is chosen, the same project can be used to fulfill the ACGME quality improvement requirement all residents are expected to complete prior to graduation.

Each trainee's primary responsibility is their clinical training in diagnostic radiology. Each trainee is expected to demonstrate clinical competency each year with the diagnostic radiology curriculum adhering to the guidelines established by the ABR and the ACGME.

During research/academic electives, residents are expected to continue to fulfill their call responsibilities and to participate in required clinical conferences. If a resident encounters clinical difficulty, his or her participation in the I³T is reevaluated by the program directors on a case-by-case basis. In such circumstances, the resident may be removed from the I³T program.

Successful completion of the I³T program will require attendance of the small group discussions, completion of the NIIC course in the firsttwo2 years of residency, and submission of a capstone project as detailed above. Trainees will also be required to present at least one deliverable (national meeting abstract, national meeting oral presentation, or manuscript submission). All activities will undergo peer and I³T Committee review.

Annual review of each trainee by the I³T Committee will provide trainees with valuable feedback to ensure appropriate progression through the program.

Application for the Integrated Imaging Informatics Track is open to first-year radiology residents. Up to two residents are selected per year. Residents will receive more information about the application process early in the first year of radiology residency.