Ashwini Zenooz, a radiologist and Salesforce SVP
Most of us can agree that CD-ROMs are a thing of the past.
Unless you’re in the health-care sector.
Salesforce’s chief medical officer Ashwini Zenooz is a radiologist with an ancient computer at home that she keeps around because it still has a disk drive. In her specialty, it’s still very common for medical imaging to be stored on CDs.
It’s big challenge to share medical imaging, like X-rays and MRI results, between hospitals that rely on different vendors for the systems that store these images. Patients also struggle to access their own information, which is particularly problematic for those who are sick and require regular imaging. Sometimes, they’re forced to shuffle physical CDs with images on them between doctors’ offices.
It’s a big and expensive problem for the radiology field, as doctors often re-order imaging because they can’t get existing images, exposing patients to unnecessary radiation along the way and creating delays, especially in emergencies. A 2006 study estimated that more than $20 billion a year was being spent on duplicate testing — and the number is probably far higher today.
So Zenooz and other radiologists inside tech companies are teaming up to promote electronic sharing of medical imaging. The group is called “Ditch the Disk” and its members and advisors include Microsoft Healthcare Chief Architect Josh Mandel and Michael Muelly, a radiologist who recently left Google Cloud.
“We talk a lot about interoperability when it comes to clinical data from electronic health records,” said Muelly by phone. “But we often forget about imaging.”
For Zenooz, the mission hits close to home. When her mother got sick, Zenooz went with her to appointments and carried around the CDs and a laptop to show her doctors the imaging. That’s a common occurrence for patients with serious health conditions. “I saw firsthand how it impacts someone with a chronic illness,” she said.
That prompted her to apply for a fellowship at the federal government, where she worked on health data interoperability, with a goal to making it easier for hospitals and clinics to share patient information. When she joined Salesforce in the fall of 2018, Zenooz threw herself into the Ditch the Disc task force. The group now meets every month or quarter, depending on schedules, to talk about their plans to finally rid the health-care industry of CD-ROMs.
“The goal is to make it as easy as sharing a text message on a phone,” she said.
In line with other interoperability efforts
Most of the largest technology companies have hired radiologists and cardiologists because there’s big potential to sell machine learning tools into these specialties. Vast volumes of data are available for doctors to analyze, which could some day speed diagnoses. The tech companies are finding, however, that their rate of progress is stymied by the lack of interoperability. Medical information is still trapped in legacy IT systems, making it hard to access for research and other purposes.
Ditch the Disc is prompting the industry to support a new application programming interface, or API, that will make it easier for patients to authorize a hospital or doctor’s office to transfer their imaging. That’s in line with efforts underway to free up other types of medical information, including much-anticipated legislation from the Department of Health and Human services to ease information sharing.
With that mission in mind, the membership behind Ditch the Disk has now grown much larger than just big tech. The largest professional radiology societies, including ACR and RSNA, are involved, says Zenooz, along with a few of the vendors that work with hospitals to help them store and share medical imaging, such as Ambra Health. Some academic hospitals are also tuning in to the calls, like Penn Medicine and Stanford.
Morris Panner, CEO of Ambra Health, said he decided join the cause after one of his company’s largest hospital customers said they needed access to imaging studies from rival vendors. “For two seconds, I thought to myself about whether that was threatening as they might like one of my competitors better. But then I thought, who cares?”
“What we should be winning on is the tech, and not because a vendor made it hard for someone to access their info outside of their own proprietary system,” he continued.
Panner said he had to explain to his board that he felt it was the right thing to do, but the company has rallied behind this initiative.