The Promise of TRIP™: Improving Quality Through Better Data
By Chris Meenan, CIIP
Among the things I am most excited about at this year’s SIIM Annual Meeting in Orlando is being able to participate in ongoing discussion and collaboration surrounding the SIIM initiative known informally as TRIP™ (Transforming the Radiological Interpretation Process). For those not familiar with the history of TRIP™, Bradley J. Erickson, MD, PhD, provided an excellent blog post last fall. More information is also available on the main SIIM Web site.
At a high level, the goal of the TRIP™ initiative is to focus attention on and enhance clinical quality, workflow, and process improvement efforts through access to better data. We hear a lot about “big data” these days, but not so much about better data. What does better data mean for the imaging community? For many of us who struggle with day-to-day requests for operational data for our departments, the challenge is to get comprehensive information from our systems to answer the clinical or operational question at hand. Often the data needed for measurement of key workflow metrics must be obtained from disparate information systems. The challenge is made more difficult by the fact that the same data point may have different identifiers or naming conventions in different systems (e.g., “Exam Complete” in one system may be called “Taken” or “Ended” in other systems). Moreover, access to operational data may be limited or hidden behind “canned reports” or may be entirely unavailable. These and other technical issues were identified by SIIM members as the biggest obstacles to creating useful quality and business analytical frameworks that can be used across institutional and industry platforms to effect real change and improvement.
SIIM’s approach to the TRIP™ initiative was to start with the most basic and obvious problem: tackle the workflow issue directly by researching and creating a standard language (or lexicon) to describe workflow steps in radiology. Existing lexicons, like RadLex, serve to describe physician-based aspects of workflow quite well, but the multidisciplinary expertise of SIIM was able to expand this focus. The TRIP™ Committee, including physicians, IT specialists, and industry participants, created a catalog of workflow steps and suggested standard metrics to calculate several performance measures based on that lexicon. At the same time, the technical committee members proposed (and implemented) a basic method to consume TRIP™ data through Web services. SIIM then created a sample dataset of more than 17,000 test patient records with key workflow steps populated with data based on the TRIP™ Lexicon, hosted by a cloud services provider for global access.
Those who were present at the 2011 TRIP™ Demonstration will remember the air of excitement in the crowd in the exhibits area. Two vendors (GE and AGFA) each used their own business intelligence tools to pull data from SIIM’s test data set and displayed the same results for the appreciative imaging informatics experts in attendance. This demonstration clearly proved the potential of the project and set the stage for new activities at this year’s Annual Meeting.
Now is the perfect time to get involved in the SIIM TRIP™ initiative! One of the greatest strengths of SIIM—and in many ways what makes us unique as a society—is the diversity of our membership and the various strengths on which we can build. We need the participation of clinical, technical, and quality experts to take our early successes from the last year and develop TRIP™ to reach its full potential. If we are successful, we will be the first area in medicine to be able to analyze workflow across previous institutional and technical barriers and provide the kinds of data that regulatory agencies, business analysts, and planners will demand as a routine part of IT operations in the future. Stop by the SIIM TRIP™ demonstration area in the technical exhibits to talk personally with a member of the committee or stop by the TRIP™ Group Session on Saturday, June 9 at 11 am. I look forward to seeing everyone in Orlando!