Interoperability in Radiography Data: The Impossible Dream

Abstract

Background: Technology in healthcare is changing at a very rapid pace. To ensure that technology is used efficiently to combat rising healthcare costs and new federal policies and laws, all technology must be able to communicate with each other. Therefore, interoperability must be obtained. Radiography is no exception considering all the different types of equipment manufactured routinely used today. Some barriers need to be overcome to achieve interoperability within radiography departments.
Purpose: To review the literature on the interoperability of healthcare data to determine the barriers that Radiography departments would have to overcome to improve interoperability of their healthcare data.
Methods: The methodology of this literature review follows the fundamental principles of a systematic search, conducted in separate stages, but is not a comprehensive systematic review, which was not reasonable due to resource constraints. The stages of the literature search included defining the search strategy, identifying the inclusion criteria, assessing the relevance and validity of the studies retrieved, and data extraction and synthesis.
Results: There were attempts to ensure interoperability, such as the use of the Nationwide Health Information Network (NwHIN), but roadblocks such as financial incentives for physicians and costs of implantation have hindered the adoption of the NwHIN. Other barriers that limit interoperability exist. These obstacles included inconsistency of the Digital Imaging and Communication in Medicine (DICOM) standard for medical imaging departments and a complete lack of norms for certain data points such as the exposure index between different vendors.
Discussion: Multiple viable options for the improvement of interoperability are prevalent in radiography departments. One such option is cloud computing, which uses multiple various types of hardware and software as resources to help interoperability of healthcare data. Agent-based technologies, which can be used to distribute management of different standards, can also be utilized to communicate between standards. The largest need to ensure interoperability is standards that are well defined and stringent with an infrastructure to map different terminologies across different standards.
Conclusion: Various technological advances can be used to improve interoperability such as agent-based technology and cloud computing. However, until a standardization of terms within the DICOM protocol and a standard across vendors, and all data points standardized, it will be impossible to obtain true interoperability.