Chang Gung Memorial Hospital, Linkou in Taoyuan City, Taiwan has recently achieved a country first through a Stage 6 validation for the HIMSS Digital Imaging Adoption Model (DIAM).

It has also been validated for Stage 7 of the HIMSS Infrastructure Adoption Model (INFRAM).

The DIAM evaluates an organisation's capabilities in medical imaging. The INFRAM model, modernised in March, gauges an organisation's infrastructure maturity based on cybersecurity, adoption, sustainability, performance, and outcomes.

Refining digital imaging

CGMH Linkou underwent the HIMSS DIAM validation to evaluate and refine its use of digital imaging technologies. Its Information Management Department closely collaborated with the specialised medical teams, holding "numerous cross-disciplinary meetings to integrate clinical expertise with IT proficiency."

"Our specialised medical teams played a key role in ensuring that the application of digital imaging technology effectively supported clinical decision-making and patient care. They worked with the Information Management Department to further optimise the system based on practical experience, ensuring that the digital imaging system remained stable and that integration with clinical systems met the needs of our healthcare professionals, allowing seamless connectivity through the hospital's information systems," said Dr Li-Jen Wang, professor and chair of CGMH Linkou's Department of Medical Imaging and Intervention.

"This collaborative approach not only enhanced our digital imaging capabilities but also demonstrated the high level of integration between medical technology and clinical practice during the HIMSS DIAM certification process," she added.

Assessors noted CGMH Linkou's clear vision, strategy, roles, and responsibilities as key strengths in imaging governance. The hospital was also praised for the imaging quality management processes across its clinical services and the maintenance of both long-term and short-term image storage capacity. 

At the core of CGMH Linkou's digital imaging is the AVIEW LCS Plus system, provided by Coreline Soft. Implemented in September 2023, the AI-based software for low-dose CT chest image scanning screens for small lung nodules, helping detect lung cancer, COPD, and coronary artery calcification early. The AI software, which also integrates with the hospital's PACS and EMR systems, has helped reduce radiologist workload by up to 87%.

IT governance excellence

Within a year, CGMH Linkou was able to upgrade its INFRAM validation to the highest stage. Behind this is a "major collaborative effort" across the hospital's departments, working on technology upgrades, process improvements, and staff training.

Its major IT project is the transformation of the Medical Data Center. CGMH Linkou embarked on this key project in 2021 as demand increased for IT-enabled services, necessitating the adoption of AI, big data, and precision medicine. "We faced challenges with rapid system expansion, so we rethought our data centre’s management, data transmission, and cybersecurity," said Hui-Yuan Shih, head of CGMH Linkou's medical information management department.

During the INFRAM validation, HIMSS validators commended CGMH Linkou's advanced cybersecurity capability, rooted in a "robust, multi-layered security strategy." CGMH Linkou adopted a service-focused architecture and flexible network design following the HIMSS INFRAM framework. This involves implementing software-define networking, upgrading to a high-speed 10-gigabyte fibre network, as well as adopting TIA-942 standards for data centres. The hospital also implemented its in-house Team+ secure messaging platform as part of improvements in internal communications.

A highlight of the validation was the implementation of integrated information monitoring panels at the Security Operations Center (SOC), which enables real-time surveillance and rapid threat detection. The SOC is part of the hospital's integrated security measure – along with Managed Detection and Response and two-factor authentication – following a Zero-Trust cybersecurity approach. 

Since establishing an SDN, according to CGMH Linkou, the hospital can now set up new equipment 40% faster; it used to take about four hours, from device installation to online, and now it can be done within 2-3 hours through VM and SDN. Coupled with AI analysis, the SDN has also boosted monitoring efficiency by 30%. 

Upgrading to a high-speed wireless network also increased data transfer speeds by "more than five times," CGMH Linkou claims, compared to traditional lines. This enhanced remote data synchronisation and big data transfers, including large digital pathology files. 

"This journey was not just about upgrading technology but also about enhancing our management practices and organisational culture. It has helped us build a strong foundation for delivering high-quality care in a modern, technology-driven healthcare environment," stressed Kun-Ju Lin, professor and deputy chief of CGMH Linkou's information security committee.

Emphasis on AI, big data

Following both INFRAM and DIAM validations, CGMH Linkou said it plans to ramp up investments in two key areas: data analytics and medical imaging management. The hospital intends to build a big data analytics platform to expand AI applications and develop AI-assisted diagnostic solutions to improve diagnostic accuracy and efficiency. 

The hospital, eyeing Stage 7 DIAM, also plans to implement a comprehensive radiation dose tracking system and upgrade its digital imaging applications to drive patient engagement. 

Additionally, it looks to further raise the speed and improve the stability of data access and transmission; enhance the long-term storage capacity and scalability of imaging data; optimise risk control measures to bolster digital resilience amid escalating cybersecurity threats; and adopt FHIR standards to facilitate telemedicine interoperability. 

"These investments will support clinical decision-making, predictive modelling, and personalised care, helping us build a smarter, more connected data ecosystem. This will ultimately lead to more accurate and proactive healthcare services," said Prof Lin.

ON THE RECORD

"Reaching Stage 7 of the HIMSS INFRAM shows that our organisation has achieved a high level of digital maturity and infrastructure security. This recognition boosts our operational efficiency and helps us provide safer and higher-quality patient care. It means we have met global standards for healthcare IT infrastructure, including areas like wireless networks, mobile devices, cybersecurity, team collaboration, and data centres. With this strong digital foundation, we can effectively use AI and big data analytics to improve clinical workflows, further enhancing our digital transformation efforts. This achievement also helps us attract and retain top healthcare professionals, as they can work in a modern, efficient environment focused on innovation and quality improvement," said CGMH Linkou superintendent and professor Dr Chien-Tzung Chen in a statement to Healthcare IT News.

"We believe that the development of digital healthcare is a crucial cornerstone for enhancing future medical services. Through the HIMSS [DIAM] certification, we can evaluate and refine our hospital's use of digital imaging technologies, ensuring that our systems and processes align with the highest international standards. Our aim goes beyond improving internal efficiency; it’s about providing patients with accurate and timely diagnoses and treatments. We are confident that [this] international certification not only allows us to gauge the level of digitalisation within our institution but also supports our continuous efforts to improve healthcare quality and build a strong foundation for future investments in digital healthcare," shared CGMH Linkou professor Dr Ming-Shien Wen, who is also vice chair of the hospital's smart healthcare committee.