Governance must be built into hospital medical image exchange from the start.

That was what Monief Eid, a senior consultant for enterprise imaging and e-health for Saudi Arabia's Ministry of Health, stressed in the HIMSS24 APAC session, "Enterprise Imaging and Image Exchange Challenges Across the Globe." He noted governance, along with interoperability and infrastructure, as a major challenge in health information exchange.

"You deal with multiple departments, multiple stakeholders, multiple workflows, multiple demands, different ways of work."

Having the right governance framework, Eid emphasised, helps an organisation tackle compliance, change management, policies, processes, and the type of skills required to meet data exchange requirements.

When sharing medical images, having interoperability standards is also crucial. He demonstrated this point by comparing two ECG cards in a cardiology report. "[One] card fully supports DICOM and produces structure interoperable data with zero footprint. I can also view it as raw data and annotate and do measurements. Versus the other one, I ended up with ugly data – just PDF. I cannot do analysis [with it], nor extract [data] from it." 

He also emphasised that providing a specific use case is crucial in getting patient consent for data exchange. "I need to give you my data and you need to give me my data… This is the exchange principle of pull and push."

Eid demonstrated another case. In one CT-based clinical study, he said, a doctor may have to go through 500 slides with a total of 3,000 images. "[The doctor] will need around 200 images to annotate and look into to make his final report… that's a lot of data." 

"[It may take] one to two years to build up data of images [from that study]."

A "solid infrastructure," he said, is required to exchange that kind of data.

"To have a successful enterprise imaging sharing, you have to consider the adoption [by] clinical practitioners – cardiologists, dermatologists, radiologists, dentists, and patients through a clear governance. [This will] ensure interoperable healthcare data will be shared," Eid said in conclusion.