
Episode #11
Enterprise Imaging Interoperability: DICOM, FHIR, PACS and VNA Data Sharing | Michael Rosenberg
Michael Rosenberg has spent the last decade obsessed with a problem most of healthcare IT would rather not think about: how do you get a medical image from one institution to another, safely and without a human babysitting every step? An industrial and systems engineer by training, Michael cofounded Medicom Technologies in 2015 out of North Carolina State University, and as CEO he and his team built the company around what they call Enterprise Imaging Interoperability. Their software now runs across every VA medical center in the country along with some of the nation's leading IDNs and academic medical centers. In this conversation, Jason sits down with Michael to dig into why some of the most well-intentioned efforts in image sharing, the ACR's Ditch the Disc campaign among them, never fully solved the problem, and what it will actually take to get there.They start by grading the ACR's Ditch the Disc initiative: strong on messaging, short on the policy and mandates needed to change workflow. From there, Michael explains why three-point patient matching (name, date of birth, and one other identifier) is still common in DICOM image exchange, and why he considers it unsafe. He walks through Medicom's FHIR-based approach for pulling additional demographics from the EHR before a match is made, and why the study instance UID deserves treatment as a universal identifier across systems.Jason and Michael also dig into what a national scale rollout looks like, drawing on Medicom's work across the VA network, and how that compares to centralized models already in place in Canada and parts of Europe. From there they cover patient-driven image sharing, including a surprisingly high adoption rate for patient upload tools, the privacy risks buried in supposedly de-identified imaging data, and what happens when interoperability moves beyond radiology into pathology, cardiology, and oncology, where the workflows barely resemble each other. They close with a look at where imaging regulation is headed, including proposed ONC certification requirements that could finally make interoperability mandatory rather than optional.If PACS, DICOM, HL7, VNA, or enterprise imaging AI are part of your world, this one's worth the full listen.Jason also has a quick update from nagelsconsulting.com: the Imaging Informatics Primer course is a great starting point if you're new to the field, the CIIP Foundations material is built for anyone prepping for certification, and the hands-on DICOM Learning Lab gives you live, practical reps with the standard itself.Learn more at nagelsconsulting.com#ImagingInformatics #PACS #DICOM #HealthcareIT #RadiologyIT #EnterpriseImaging #VNA #HL7 #RadiologyAI #MedicalImaging #Interoperability #PatientMatching #FHIR #HealthIT #DitchTheDisk5. Chapter List (Timestamps)Note: chapter times are offset by 1:23 to account for the intro script

