While “contagious” isn’t usually a positive term in healthcare, this is an exception. When Dr. James Whitfill, incoming chair for SIIM, spoke about some of the work he’s done, as well as some of the work SIIM is doing, his excitement and enthusiasm was contagious.

HCB News: What inspired you to get involved in healthcare?
James Whitfill: I think there were probably a couple of inspirations. As a child, my father was an internal medicine physician like myself. So I had a very strong role model. He was in practice by himself, which is almost a bygone era of medicine, but I saw the relationship he had with his patients. As I got older, what I began to really enjoy about healthcare is that it’s a melding of science and art. While we’d like to think that there’s a lot of science in what we do – and there is some – there’s a tremendous amount of art involved when you’re working with patients. Particularly when you’re working with people who are sick and afraid, and oftentimes suffering tremendous pain.

The ability to pull together my love of data and science and all those parts, but also being able to sit with people when they’re going through some of the biggest events in their life, has always been a big inspiration for me in healthcare.

When I went on to college, one of the difficult things is that you have to start investing in that career many years before you realize what that career entails. I thought there was a chance I’d go on to medical school, so I started taking the requisite classes, but I also thought deeply about studying English literature. I really enjoyed the intellectual exercise of that. The work involved of bringing new ideas to old ideas. At that point, I had to make a decision. I felt like in healthcare, there were more opportunities to do many different things going forward.

HCB News: How did you get involved with SIIM?
JW: I’ve had a very unconventional or dynamic career path. I went to University of Pennsylvania for med school and stayed there for internal medicine. While I was doing my residency, I was doing some research with a geriatrician on a collection of patients living in area nursing homes. He was trying to see if there was a relation between nutritional intake and clinical outcomes. He was storing all the info in a shoebox. I was looking for a mentor and I think he was looking for someone to organize his research, and he told me I could start by organizing the data. I was familiar with Microsoft Excel, but I thought this needed more. I talked to some of my colleagues from college that had gone off to management consulting and investment banking, and seemed to know a lot more about the world. They said, “Oh, you need a database to track all that.” I literally went to the university store, bought Microsoft access, and taught myself, and created a system for organizing all the data. I found that I loved it. It was super exciting to have the ability to bring a tangible analytic tool to see who was going to get sick, and test these hypotheses. At the time, in our hospital, all the charts were on paper. I think we had a computer terminal for looking up labs and radiology, it really wasn’t much. But nonetheless, I decided to do a fellowship in informatics and I was the first MD at Penn to do that in the department of internal medicine.

So I was excited about that, and then my wife and I decided to move to Arizona. The reason that’s germane is that if you were doing informatics in the late 90s, the only place you could end up at that time, to my knowledge, was in academia. So we came to Phoenix, where there was no medical school at the time, and I ended up doing some consulting work with some colleagues. A large radiology practice in town found out about my skills and they wanted some help being able to extract data out of their combined RIS-billing solutions and run reports. I worked with them more and more, and they were looking to put in a RIS, PACS, and an IT network, and make the jump to digital imaging. Eventually I became their IT Director and then the CIO. After a number of years, one of the physicians told me about SIIM (at the time, they were called SCAR). I went to the Orlando meeting around 2005 and it was this magical moment. The culture was amazingly open and instantly I felt a connection to so many likeminded people.

HCB News: When you talked about your start with informatics and predictive healthcare, it brought to mind Google’s efforts around tracking and predicting the spread of illness using search term data. Are applications like that interesting to you?
JW: In 2012, I decided to try to branch off into new interests. I started a small company called Lumetis to get into some more analytics work and to do some consulting with that. While I did that, I was also recruited to chair the IT committee for a clinically integrated network now called Innovation Care Partners. It was a group coming together to contract for value-based care payment systems. It’s been very exciting because we have a lot of data from our systems that we can use to look at who might get sick and how we can prevent people from getting sick. For me, it’s been a golden era, where the technology, and the financial incentives are finally aligned.

HCB News: How did you get to where you are today in the society?
JW: The connections I made were so valuable, but I also wanted to give back to the group. I remember back in 2007, I had done work starting a GE PACS user group. I remember going up to Brad Erickson, who’s a giant in informatics. I told him I was at a private practice group in Arizona and we’re doing a lot of imaging informatics, but that it’s a little different from what he’s doing in the big integrated healthcare divisions. I added that I’d love a chance to talk about that sometime. I didn’t expect much to happen, but a few months later I got a call from someone in the SIIM program who asked me if I could put together three lectures or a track on what imaging informatics is doing in the imaging centers or private practice. It was a sign that the society is so flat that you could walk up to the most senior person and they’d listen to you. I was coming in as an internist and CIO, and brought a different perspective that people wanted to hear, so I got a chance to speak more. Later, I was asked to join the board. I kept showing up, I kept wanting to contribute.

HCB News: What initiatives are you planning to focus on during your time as SIIM Chair?
JW: There are two technological phenomena that are driving our industry right now. They would be machine learning and enterprise imaging.

For many years, maybe from 2009 to 2016, imaging informatics was relatively quiet, after the 2000s, we saw two things. The great recession and the American Recovery and Reinvestment Act really brought a singular focus on implementing EHR in the U.S. That really meant that almost all of the Healthcare IT focus was on EHR, and I think imaging informatics was kind of dormant. We’ve seen it come roaring back. It’s critical that SIIM stays at the forefront of AI and enterprise imaging. We need to continue to exchange ideas and implement them.

HCB News: One of your recent blogs touted the big increase in interest surrounding enterprise imaging. Where is healthcare at in regard to EI? Is it generally just the “interest” stage, or is there exploration, adoption?
JW: I think we’re still in the early phase. You have organizations like Cleveland Clinic or Duke who are clearly early adopters. But for many of us, imaging informatics in our space, locally, is still very much radiology and maybe cardiology. So there’s a big delta between where some of the leading organizations are and the rest of the market. Though we think it’s a great opportunity for SIIM to provide a very practical education for people, so that they’re ready for when they start adopting these new methodologies.

HCB News: What work needs to be done in EI to advance it? Is it work by vendors, by healthcare organizations, insurers? Physicians?
JW: Probably the biggest thing is for the space as a whole to decide if there are going to be tiny fragments of informatics within multiple specialties, or can we create an inclusive community where each image-producing specialty is welcome. If we can do that, I think enterprise imaging will grow.

HCB News: What are the top challenges for SIIM members today?
JW: Many of our members have to bridge two different spaces. They may have started in radiology and subsequently entered the enterprise IT space. And the people of their former department see them as part of the larger formal enterprise, and the people in the enterprise might not see them as true IT professionals.

HCB News: Can you tell us about the Diagnostic Imaging Adoption Model (DIAM)?
JW: Several years ago, HIMSS and SIIM began working together on the space of enterprise imaging, and they created the HIMSS/SIIM enterprise community. Out of that organization, about a year and a half ago, we started working on an imaging informatics adoption model. Unbeknownst to us, the European Society of Radiology and HIMSS Europe had started working on a similar model. So we had two adoption models across the globe. Over the past year, we’ve been able to merge that into a single maturity model. There will be a radiology imaging flavor and imaging informatics flavor. It will define, for the first time, different levels of maturity, about what it means for an organization to adopt enterprise imaging.

HCB News: What are you looking forward to at the upcoming show this year?
JW: I think one of the biggest pieces of news is our new executive director, Cheryl Kreider Carey. The reason that’s so important is because Anna Marie Mason led the society successfully for two decades. Cheryl is bringing a new era for SIIM. I think you will mark this as the beginning of SIIM’s next phase of its continuing evolution. I think the meeting will be symbolic and be the start of SIIM’s metamorphosis to be a more inclusionary multi-disciplinary society.