Gradual cloud transition boosts teaching capabilities

As part of a premier academic medical center, BIDMC Radiology is committed to maintaining its leadership in science and technology, which includes evolving its technological capabilities to educate the next generation of radiologists. The department is known for its hands-on learning approach, where residents, fellows, medical students and visiting scholars learn directly from experienced radiologists, gaining the opportunity to form independent opinions and receive immediate feedback. To enhance students’ exposure to a diverse range of pathologies beyond their regular rotations, it is essential to provide access to unusual cases from BIDMC Radiology’s digital teaching archives collected over 30 years.

Managing an increasing volume of medical images has become more challenging, with modern diagnostic cases often comprising hundreds of computed tomography (CT) and magnetic resonance imaging (MRI) images. This surge demands significant storage capacity and a robust infrastructure capable of efficiently handling, sharing and anonymizing these images. The need for radiologists and residents to access and review cases remotely, especially from home during off-hours, has also become critical to support flexible working conditions and continuous learning and collaboration among radiologists and students.

To meet current and future demands, BIDMC collaborated with Optum to develop Change Healthcare Stratus Imaging Discover (Stratus Imaging Discover), a cutting-edge, cloud-native teaching solution. Dr. Seth Berkowitz, interventional radiologist and medical director of radiology informatics at BIDMC, was instrumental in the development effort, helping to define the system’s requirements to be an integrated solution that enhances education, peer learning and collaboration within radiology.

As a long-term user of Change Healthcare Radiology Solutions (CHRS), including on-premises picture archiving and communication system (PACS) and teaching tools, BIDMC recognized the benefits of transitioning to a cloud-native platform. Berkowitz noted, “Every organization is at a different stage in their cloud journey, which is undeniably the future of global organizational operations. As we evolve, our focus is on enhancing interactions across our hospital network. Cloud technology is essential in this shift, especially for peer learning and teaching programs that cross facility boundaries.”

The Optum team effectively partnered with BIDMC to enable a complex yet smooth development and implementation of the new system. The transition required only a small adapter on the PACS workstations. Enterprise authentication integration facilitated end-user adoption, promoting widespread system use.

“An integrated solution with seamless teaching case creation is ideal for radiologists who are lifelong learners and struggle to maintain their intellectual curiosity in the era of increasing reading volumes and clinical demands,” said Dr. Berkowitz. The platform also allows for virtual tumor boards and peer learning discussions, which can happen anytime and anywhere.

“Anonymizing images is crucial but often challenging,” said Dr. Berkowitz. “Many radiologists don’t understand the process and just want to quickly save and submit their files. For example, cropping images in PowerPoint is risky because the original data can still be accessed by uncropping. It’s important to note the significant risks of accidentally disclosing protected health information. A one-click solution to anonymize patient names, birthdays and other dates ‘burned-in’ to the images is highly valued and very useful.”

Stratus Imaging Discover is built from the ground up to take full advantage of the cloud environment. The design eliminated the need for a virtual private network (VPN) for remote access, and its elastic storage easily handles large files, supporting both digital imaging and communications in medicine (DICOM) and non-DICOM data. Dr. Berkowitz noted significant efficiency improvements following the transition from their previous on-premises teaching solution to Stratus Imaging Discover, which better accommodates complex imaging studies. “We’re no longer restricted to whatever our local storage is, so that our teaching library can grow as the complexity of our studies grows.”

This cloud-native teaching solution has been pivotal in enhancing education, peer learning and collaboration within radiology. By eliminating the need for a VPN for remote access and offering elastic storage to handle large and complex imaging studies, BIDMC has started to realize the immediate benefits of a cloud-native solution. This transition improves efficiency and supports flexible working conditions. It also lays a strong foundation for future growth, ensuring scalability as the center’s needs evolve.