Strategic Radiology’s CIO Jim Whitfill, MD, was recently installed as chair of the board of directors for the Society for Imaging Informatics in Medicine (SIIM). Whitfill, a clinically trained internal medicine physician, entered radiology by way of an informatics fellowship undertaken in the late 1990s, after which he took a position as CIO with a large radiology practice in the Southwest.

As both the first physician non-radiologist chair of SIIM and the first fellowship-trained physician informaticist to serve as chair, Whitfill sees his term as a logical extension of SIIM’s evolution from a radiology-based society to an organization with a broader base across the image-producing specialties and the health care enterprise.

In addition to serving as SR CIO, Whitfill is chief medical officer for an ACO based in Phoenix, AZ, clinical assistant professor in the departments of internal medicine and biomedical informatics at the University of Arizona College of Medicine, and principal of Lumetis. He agreed to discuss some hot topics in informatics as well as his goal as SIIM chair for the next two years.

Q: How will your experience in the broader healthcare and private practice settings inform your leadership of SIIM this year?

Whitfill: One of the things that is helpful about being a little bit of an outsider, is that there is lots of room at SIIM for people like me because the diversity of our membership.  SIIM is a super-specialty in a world where we see more and more super-subspecialization. We have physician members, we have the imaging informatics professionals (the folks who run the PACS), and we have researchers and vendor partners. We are a disparate group—including in the clinical category where we now have radiologists, cardiologists, and pathologists. Being a leader of that type of organization requires reaching across boundaries and different constituencies to help those different groups be heard, and also being able to craft strategic directions and leadership that move the whole organization forward. This is something I have a lot of experience doing, and it will be helpful as we navigate the challenges of the next couple of years.

Q. Radiology is a data-driven specialty and SIIM’s purview touches nearly every aspect—operations, reimbursement, clinical quality, and research. Are there any areas that will receive more attention than others this year?

Whitfill: If you think about data within radiology and health care as a whole, it is going to explode as an area of interest. Increasingly, people understand that the analytics of how we do our work is a critical part of how we deal with the challenges of increasing demand for health care but with fewer resources. We already have seen an explosion in the use of analytics within imaging—we measure everything from workflow to optimizing safety and quality and those functions have been very much highlighted within SIIM.

For example, there is a workflow standard called SWIM that was developed within SIIM and  is now incorporated into Radlex and IHE.  SWIM identifies and defines the workflow points of an imaging procedure—when is the exam scheduled, when does the patient arrive at the imaging center, when do they get their registration information in, when does the patient get taken back to their room, when do they get put onto the equipment,  etc —. Using SWIM, SIIM has defined a standard nomenclature for these points of care so that organizations can have an apples-to-apples comparison for questions such as wait times for patients, because in the past, everyone had different definitions for what that is.

We see ourselves as helping to create standards for measuring ourselves. We create communities where people can compare this information, and we bring a lot of education around actual tools for people to be able to be able to use analytics. We have done hands-on learning labs with R, which is an open-source statistical analysis tool that can be used within an analytics workflow. You can walk in not knowing how to use the tool and walk out two-hours later with a working knowledge.

Q. How do you see SIIM addressing these hot topics in imaging informatics—machine learning, CDS, and blockchain?

Whitfill: Those are three of the biggest newsmakers, and they all are having a big influence on our practice, but there also is a lot of hype, particularly around block chain and artificial intelligence. Artificial intelligence is where we are putting most of our efforts, simply because we have the tools to help advance the field. We have a strong history in the research space and have set up platforms that allow researchers to test and validate AI algorithms. We see ourselves as helping organizations and researchers to advance the field as a whole. We have the Journal of Digital Imaging, a longstanding imaging informatics peer reviewed journal, where articles can be published, but we also recognize that in the advancing space of AI, there are other publishing venues that are open for access and more immediately used by the larger AI community as a whole. We are navigating the path between traditional academic publishing and what we are seeing in the field of AI which is open-source repository publishing. I think you will see us continue to focus on AI.

I think we will see a lot of effort on the HIMSS side in the broader health care technology space to look at blockchain. Again, there is a  lot of hype around it, but I think blockchain has some very novel and innovative approaches to decentralizing information. There are a lot of patient-centric models of information management that are being tested in blockchain, but on the imaging informatics side, blockchain hasn’t had quite the same control over the zeitgeist as AI.

Clinical decision support continues to be a looming tool that is going to dramatically impact the workflow of imaging ordering across the enterprise, and it is something that the ACR has spent a lot of time on. We have not brought as many resources on the SIIM side, simply because the ACR is doing a great job of managing that topic.

Q. If you could accomplish just one thing during your leadership term, what would that be?

Whitfill: I think of my leadership term as being one of the times that we really improve the internal governance and core operations of SIIM. We’ve had incredible growth over the last several years, not in small part due to things like artificial intelligence and enterprise imaging. We see that continuing.

We also have great partnerships with our counterparts in Europe and Asia and see that continuing. We have a new executive director who is doing a phenomenal job.

We want to make sure—and I see this as my core focus over the next two years—that our core governance structures are ready to deal with us growing into the next phase of SIIM.  It’s not very exciting to say, “Hey, I’m going to get really charged up about governance,” but I think it is an investment in making sure that our committee structure, that our involvement across our different constituencies is rich, that we continue to build our bench depth, and that we have a long line of volunteer leaders ready to lead in the efforts that are so critical to SIIM.

Q: Do you envision any places where your work with SIIM and SR could potentially intersect?

Whitfill: I was talking to Matt Long (Radiology Associates of North Texas) at the most recent SIIM meeting, and I’ve talked with Ron Cornett (Radiology Ltd) about this as well. Strategic Radiology has incredible technical and informatics resources available with a number of its practices, it represents the vanguard of what is going on in radiology IT across the country in the private practice space.

SIIM is not just an academic organization, it is an organization that spans multiple different disciplines. In fact, the way that I got my personal start with SIIM was giving lectures on how imaging informatics works within the private practice imaging space. There is a huge interest in understanding the similarities and differences across those different venues. There are absolutely opportunities not only for knowledge transfer,  also for promoting common standards so that vendors create interoperable tools along the lines of something that we can expect to plug and work together no matter what type of environment within which it is used

I would say that there is a huge open door at SIIM to Strategic Radiology for collaboration, and we are excited that there are so many Strategic Radiology organizations that are already members of SIIM.