The CMO-CIO relationship is far greater than the sum of its parts

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 - Shannon Werb, Chief Information Officer, vRad
Shannon Werb, Chief Information Officer, vRad

I’ve worked in radiology IT leadership for more than 20 years, but over the past year and a half, I’ve learned more about all three—radiology, IT and leadership—than in the previous 18 years combined.

While it sounds like hyperbole, it also happens to be true. No matter what you know or how experienced you already are, you can’t help but grow by orders of magnitude when you collaborate, closely and regularly, with your primary customer. For an imaging IT professional, that customer is the radiologist.

When I joined vRad as CIO in September 2013, I knew that the CMO, Ben Strong, MD, was going to be someone with whom I would interact on a daily basis. What I didn’t know was that Ben had thought deeply about a vision of how technology can transform radiology into a true patient-centric care process.

That kind of innovative thinking wouldn’t go far in an echo chamber. Buy-in had to be broad, with all hands on deck, to turn this big idea into metamorphic action, which is something easier said than done.

Breaking the mold

In all high-tech medical specialties, there’s a fairly constant internal tension between “the clinical side” and “the technology side.” It waxes and wanes, but it’s always there, and everyone learns to live with it.

From day one, I saw that vRad was an exception. It’s not that the two sides see eye-to-eye on every point that gets raised or every issue that arises. In fact my first six months were largely spent figuring out the source and nature of various frustrations on both sides. But it was clear that the two sides—along with every other team and every other department within vRad—were rallying behind Ben as he absorbed everyone’s ideas like a sponge and led all of us into uncharted territory.

That included Ben’s boss, Jim Burke, our president and CEO. Tellingly, it included our engineers, many of who would tell you how their input previously fell on deaf ears in settings in which they’ve worked.  

What’s different? Ben’s vision was, and is, much broader than just refining our clinical systems, important as that always is. It encompasses all the changes we need to make to drive clinical quality, improve operational proficiency and maximize financial efficiency. It involves building trust among and between teams. And it never loses focus on the people we’re really here for: the patients and doctors who rely on our superb subspecialty services to treat them.

I can explain the good things this visionary culture yields for our healthcare-provider clients by describing one of our top accomplishments of 2014, and one that we’re working hard to bring to fruition this year.  

Trauma treatment rethought

Working off of a list of high-priority to-dos that we call the CMO initiatives, last year vRad set out to innovate a fast-response trauma protocol. We knew it could mirror our established stroke protocol, but it would have to be advanced in workflow improvement. That’s because trauma teams sending our radiologists images to read are widely multidisciplinary, unlike stroke teams, and the images can be of any part of the body. In fact, whole-body scans are not uncommon in trauma imaging.

We built out our technology to allow us to unbundle all of the various kinds of trauma studies, enabling our radiologists to concurrently read and report the head study to the neurology specialist, the orthopedic study to the musculoskeletal specialist, and so on. Now, we can break each study off from the whole, have subspecialized radiologists read each one on an ASAP basis and then send an integrated report back to the client through the multidisciplinary team management (MDT) process. 

Internally, this project was a model of interdepartmental teamwork. It took cooperation, collaboration and ongoing communication among and between clinical leadership, technology people, marketing, sales and lots of others.

As CIO, I was tasked with keeping the technology troops, as well as cross-functional vRad teams, informed and aligned with the protocol goal. This entailed briefing them on the clinical aims, as well as frequently updating them on things like customer feedback and implementation issues. Along the way, I did a lot of listening too.

And the result? The new trauma protocol has been up and running for almost half a year. It’s serving 200+ trauma facilities with consistent and increasingly improving results. Our radiologists are getting their eyes on images in less than five minutes and sending integrated results back to clients, on average, in just 11 minutes.

We have seen the future, and it is pixels

What do we do for an encore? Tackle dozens of equally exciting CMO initiatives at once. One I’m especially jazzed about—largely because only vRad has the massive medical-image volume, the vast client-facility base and the accompanying big data to even attempt it—is our work with the technology referred to as deep learning.

Deep learning involves teaching a set of algorithms to recognize context as well as content in images. A familiar nonmedical example is facial-recognition software.

Right now vRad is partnering with a number of organizations to create deep-learning algorithms that can identify certain types of critical findings in radiology studies. We feel confident that we’ll be demonstrating this in the market this calendar year and improving it over time.

Our plan is to blend deep-learning technology with our imaging platform so that we can, for example, take in a trauma study looking for a hemorrhage in a brain. We will put a study through a deep-learning algorithm and, in essence, ask it if it sees signs of a hemorrhage.

If it does, the case will automatically move higher up on a radiologist’s work list. This is by no means a replacement for clinical expertise. It is, rather, a tool to empower the radiologist in managing his or her queue.

Through this application of technology, we will take our leading work in stroke and trauma protocols and build on it exponentially. And right now, I don’t see how anyone but vRad is in position to do this kind of work.

Why? Because, in order to leverage deep learning for clinical use, you have to have access to tremendous amounts of aggregated image content. Over the past few years vRad has leveraged its billions of images to break a lot of ground with data analytics and imaging informatics. That will continue. But we firmly believe the future is in—you heard it here first—pixels.

Which brings me back to the close CMO-CIO collaboration at vRad that I am privileged to enjoy. There’s not a healthcare CIO in the world that would not relish the chance to collaborate with a visionary clinician on work this important with the potential to change the game. It continues to personally inspire me, and all of our people, and to bring out our best as we continue to transform radiology, so that radiology can help to transform healthcare.