In this episode of Imaging Informatics Unplugged, we explore Interactive Multimedia Reporting (IMR) and why traditional text-based radiology reports are no longer enough for image-driven clinical care.I’m joined by Seth Berkowitz, interventional radiologist, clinical informaticist, and Medical Director of Radiology Informatics at Beth Israel Deaconess Medical Center. Seth led the HIMSS–SIIM whitepaper work defining the technical challenges of vendor-neutral, interoperable multimedia reporting and is deeply involved in RSNA and IHE reporting standards.We discuss:• What Interactive Multimedia Reporting actually is (and what it isn’t)• Why most IMR implementations remain vendor-specific• The role of IHE profiles, FHIR, and DICOM in enabling interoperability• Real-world barriers to adoption, including workflow and reporting time• How AI and structured reporting could finally make IMR scalable• Why reports should behave more like modern digital tools, not static textThis conversation is for radiologists, imaging informatics professionals, CIIPs, vendors, and health IT leaders who care about clarity, interoperability, and the future of imaging communication.Referenced Papers:• Multispecialty Enterprise Imaging Workgroup Consensus on Interactive Multimedia Reporting Current State and Road to the Future: https://link.springer.com/article/10.1007/s10278-021-00450-5 • Interactive Multimedia Reporting Technical Considerations: https://link.springer.com/article/10.1007/s10278-022-00658-z 🔗 Learn more about our work and upcoming courses:https://www.nagelsconsulting.com🔗 Follow Nagels Consulting on LinkedIn:https://www.linkedin.com/company/nagels-consulting👍 If you found this episode useful, please like, subscribe, and share.💬 Let us know what imaging informatics topic you’d like us to tackle next.

Choosing a PACS can shape the next 10 years of your imaging department. Yet many leaders still rely on gut feel, vendor hype, or checklists that do not reflect real clinical operations. In this episode of Imaging Informatics Unplugged, I sit down with Dr. Alex Towbin, Professor of Radiology and the Neil D. Johnson Chair of Radiology Informatics at Cincinnati Children’s Hospital, to break down the complete PACS selection process behind his team’s widely referenced study. The PACS Selection Blueprint: What Every Imaging Leader Gets Wrong | with Dr. Alex TowbinWe cover every stage of the journey. The politics, the data, the shortcomings of vendor demos, and the real-world constraints that most hospitals underestimate. Dr. Towbin explains how his team evaluated 10 PACS vendors, how they neutralized bias within the committee, why radiologists often remain attached to their first PACS, and what PACS 3.0 will require as AI-driven workflows mature.If you are a PACS admin, enterprise imaging strategist, IT architect, radiology leader, or anyone preparing for an upcoming procurement, this episode will give you a clear and practical blueprint to follow.📝 Read the full published paperhttps://link.springer.com/article/10.1007/s10278-025-01672-7⸻In This Episode• How Cincinnati Children’s designed a transparent and data-focused PACS selection process• Why radiologists become “imprinted” on their first PACS and how that shapes department culture• The hidden cost of switching PACS and why minor improvements may not justify a complete replacement• How real anonymized data exposed significant weaknesses in vendor demos• What to expect in the shift toward PACS 3.0 with AI-enabled and automated workflows• Why database access, technologist workflows, and support models often matter more than shiny features• How to scale your procurement approach based on the impact of the system• What imaging leaders should rethink heading into their next PACS evaluation cycleChapters0:00 When your PACS feels tired – episode setup2:09 Meet Dr. Alex Towbin and the PACS selection study2:39 Why Cincinnati Children’s re-evaluated their PACS3:41 How radiologists get “imprinted” on their first PACS5:32 Alex’s journey across three generations of PACS6:14 Principles for a fair and transparent PACS selection8:53 Equal voice for radiologists, technologists, and IT11:24 Balancing data, emotion, and gut feel in decisions14:03 Sticking with the incumbent and the real cost of switching17:42 Asking vendors to load real anonymized pediatric data24:22 Lessons learned and how they would run the next RFP25:42 Support models, database access, and working with vendors30:50 Final advice⸻🎓 Advance your Imaging Informatics Skills• Courses: https://learn.nagelsconsulting.com• Consulting and Solutions: https://nagelsconsulting.com• Spotify: • LinkedIn: https://www.linkedin.com/company/nagels-consulting⸻🎧 Listen on Spotifyhttps://open.spotify.com/show/4DAxDXd0kpvRh6NwvSJiVF📺 Watch on YouTubehttps://www.youtube.com/@NagelsConsulting

In this conversation, Rishi Nayyar discusses his journey from banking to healthcare innovation, focusing on patient access to medical images and the role of AI in enhancing patient understanding and automating workflows. He emphasizes the importance of empowering patients with control over their data while also addressing the challenges of image exchange and the need for efficient non-clinical workflows. The discussion highlights the significance of building trust in AI solutions and the ongoing efforts to improve patient engagement and data management in healthcare.Takeaways:-Rishi Nayyar transitioned from banking to healthcare to address patient access to medical images.-The initial inspiration came from a personal experience with outdated technology in medical imaging.-Patient empowerment is crucial for reducing reliance on CDs for medical images.-Both patient-to-provider and provider-to-provider access are essential for effective image exchange.-Patients engage more with their health data during significant health issues.-AI can enhance patient understanding of medical reports through layman translations.-Automating non-clinical workflows can significantly improve efficiency in healthcare.-Data retention policies vary widely among healthcare organizations.-Trust in AI solutions is built through transparency and reliability.-Healthcare systems must adapt to new technologies while maintaining patient care quality.⸻🎓 Advance your Imaging Informatics Skills• Courses: https://learn.nagelsconsulting.com• Consulting & Solutions: https://nagelsconsulting.com• LinkedIn: https://www.linkedin.com/company/nagels-consulting⸻📺 Watch on YouTubehttps://www.youtube.com/@NagelsConsulting⸻

In this episode of Imaging Informatics Unplugged, Jasonwelcomes back Don Dennison, CIIP, FSIIM, and Mohannad Hussain for a deep dive into the evolution of the Imaging Informatics Career Development Matrix — nowreborn as a fully web-based platform at IIPCareers.com.

The discussion continues from our last conversation(https://www.youtube.com/watch?v=7KIMlAsngBA&t=751s), where the team explored how imaging professionals can define, assess, and grow their skills inthis rapidly evolving field.

In this episode:

• Don demos the new web interface that replaces the originalExcel matrix.
• Mohannad explains how the tool’s database-driven backendenables real-time updates and community feedback.
• Learn how to use role-based skill mapping, AI-poweredcareer planning, and prompt templates for job descriptions and quizzes.
• See how institutions can apply this tool to standardizejob roles, guide professional development, and identify training needs acrossimaging domains.

 

Whether you’re a PACS admin, analyst, or imaging leader —this conversation will show you how to take control of your growth in imaginginformatics and empower your teams to do the same.

 ⸻

 🔗 Featured Resource

 🧠 Explore the tool: https://iipcareers.com

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 👏 Special Acknowledgment

 A huge thank you to Ghadeer Albattarni for her contributionsin helping develop the IIPCareers.com platform. Your expertise and collaboration helped bring this resource to life!

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🎓 Advance your Imaging Informatics Skills

• Courses: https://learn.nagelsconsulting.com
• Consulting & Solutions: https://nagelsconsulting.com

• LinkedIn:https://www.linkedin.com/company/nagels-consulting

⸻

📺 Watch on YouTube

https://www.youtube.com/@NagelsConsulting

⸻

 📌 Stay Connected

🌐 Website: https://www.nagelsconsulting.com

🎓 Courses: https://learn.nagelsconsulting.com

🔗 LinkedIn:https://www.linkedin.com/company/nagels-consulting

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What happens when large language models (LLMs) move from casual conversations into clinical practice?

In this episode of Imaging Informatics Unplugged, Dr. Woojin Kim joins Jason Nagels to explore the hype, reality, and future of AI in radiology.

Dr. Kim is the Chief Strategy Officer and CMIO at HOPPR, Chief Medical Officer at the ACR Data Science Institute, and a musculoskeletal radiologist at the Palo Alto VA Medical Center. He’s also a proven entrepreneur, co-founding Montage Healthcare Solutions and Equium Intelligence, both acquired by major players in imaging AI.

We cover:

• How Dr. Kim consumes 4–6 hours of AI research daily using tools like Notebook LM and Recall 
• The underestimated risk of silent degradation in clinical AI models and why continuous monitoring matters 
• The difference between prompt engineering vs. context engineering for PACS and RIS integration 
• Opportunities and pitfalls of structured reporting with LLMs 
• Critical discussions on bias, fairness, and synthetic data in radiology AI 
• Where Dr. Kim sees the field heading: multimodal models, agentic AI, and the evolving role of the radiologist 

If you’ve ever wondered how much we can really trust AI in clinical imaging, this episode offers an unfiltered look at the challenges and opportunities shaping the next decade.

🔔 Don’t forget to like, subscribe, and hit the bell to stay updated on future episodes exploring the intersection of imaging, informatics, and AI.

👉 Learn more at:

🌐 https://www.nagelsconsulting.com

📘 https://learn.nagelsconsulting.com

🎙️ Featuring Toni Skokovic | Imaging Informatics Unplugged | Ep. 2Why is healthcare interoperability still so difficult—even with mature standards like HL7, DICOM, and FHIR? In this episode of Imaging Informatics Unplugged, Jason sits down with Toni Skokovic, a 25-year health tech veteran and founder of YourRevenuePlan, to explore what’s really blocking progress.Whether you’re a provider, vendor, PACS admin, or health IT strategist, this conversation goes deep on what’s broken—and what we can finally do about it.🔍 What we cover in this episode: • Why “integration” ≠ interoperability • The real cost of automation without alignment • How agentic AI fits into healthcare workflows (and where it doesn’t) • Why adoption still fails after go-live • Practical steps for providers to tackle real workflow bottlenecks • How vendors can sell solutions instead of specs • The importance of measuring outcomes, not just implementing features📅 UPCOMING TRAINING:Join us for EIB_110: Enterprise Imaging for Business Professionals, a 1-day course split across two half-day live sessions on September 17th and 18th.Ideal for imaging IT teams, clinical ops leaders, and vendor staff.📘 Register here → https://learn.nagelsconsulting.com/course/eib-110-september—🔔 Don’t forget to like, subscribe, and hit the bell to stay updated on future episodes exploring the intersection of imaging, informatics, and AI.👉 Learn more at:🌐 https://www.nagelsconsulting.com📘 https://learn.nagelsconsulting.com🔗 https://www.linkedin.com/company/nagels-consulting#HealthcareInteroperability #ImagingInformatics #HealthIT #EnterpriseImaging #FHIR #DICOM #HL7 #AgenticAI #PACS #MedicalImaging #DigitalHealth

In this episode of Imaging Informatics Unplugged, Dr. Mana Moassefi (incoming Radiology resident at Mayo Clinic) shares insights from a groundbreaking multi-institutional study that evaluated the use of large language models (LLMs) to annotate radiology reports — without any model training.

Mana and her collaborators from institutions including Mayo Clinic, UCSF, Moffitt Cancer Center, Harvard Medical School, UC Irvine, and Emory used prompt engineering to guide commercial LLMs in extracting diagnostic labels from 3,000 radiology reports. The study found:

🧠 LLMs outperformed traditional NLP due to better contextual understanding

🛠️ Prompt engineering was critical, often outperforming chat-based approaches

📊 Structured reporting improved accuracy, but radiologist variability still introduced challenges

😵‍💫 Hallucinations occurred, especially when LLMs were uncertain — leading to verbose, off-topic answers

📈 Consistency matters: AI may not be perfect, but it’s reliably imperfect — a surprising edge over human variability

We also explore future use cases, from structured patient-facing summaries to multi-agent AI workflows that could quantify uncertainty and improve communication across clinical systems.

🔔 Don’t forget to like, subscribe, and hit the bell to stay updated on future episodes exploring the intersection of imaging, informatics, and AI.

👉 Learn more at:

🌐 https://www.nagelsconsulting.com

📘 https://learn.nagelsconsulting.com

🔗 https://www.linkedin.com/company/nagels-consulting

In this episode of Imaging Informatics Unplugged, we sit down with Dr. Jay Crawford—educator, innovator, and one of the foundational voices in imaging informatics. With over 30 years of experience, Jay has helped shape the field from the early days of PACS and digital imaging to global training initiatives in places like Malawi.We explore why technical skills alone are no longer enough, how to build transferable knowledge beyond button-clicking, and the soft skills today’s professionals need to truly thrive. Jay also shares hard-won lessons from training imaging professionals across dramatically different healthcare environments and the importance of adapting to local realities.This episode is packed with insight for PACS admins, imaging analysts, healthcare IT professionals, educators, and anyone looking to level up in this space.🌐 Website: https://www.nagelsconsulting.com🎓 Courses: https://learn.nagelsconsulting.com🔗 LinkedIn: /nagels-consulting

In this episode of Imaging Informatics Unplugged, we explore one of the standout tools from SIIM 2025 — the Imaging Informatics Career Development Matrix, presented by Don Dennison during this year’s Dwyer Lecture.

The matrix serves as a practical guide for:

• Defining key roles and career paths in imaging informatics

• Supporting individual growth and team development

• Identifying gaps and planning workforce capabilities

• Leveraging AI for training, interviews, and performance alignment

• Advancing a collaborative, open-access framework for the field

Don Dennison is joined by Brad Genereaux and Mohannad Hussain, offering insights into the development process, real-world applications, and the vision for community stewardship moving forward.

🔗 Explore the Imaging Informatics Career Matrix

https://siim.org/resource/imaging-informatics-career-matrixdefine-compare-and-advance-your-imaging-informatics-knowledge/

🎓 Advance your imaging informatics skills

• Courses: https://learn.nagelsconsulting.com

• Consulting & solutions: https://nagelsconsulting.com

• Spotify: https://open.spotify.com/show/4DAxDXd0kpvRh6NwvSJiVF?si=8d0b1c6a56994b78

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🔔 Subscribe to stay current on the people, platforms, and principles shaping the future of imaging informatics.

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#ImagingInformatics #SIIM2025 #RadiologyIT #CIIP #CareerMatrix #HealthcareIT #PACS #NagelsConsulting #DwyerLecture #MedicalImaging #AIinHealthcare #HealthcareCareers

In this episode of Imaging Informatics Unplugged, Jason sits down with Robert MacDougall to unpack one of the most talked-about — and often misunderstood — concepts in healthcare: the digital twin.

🎯 What exactly is a digital twin in the context of radiology?

💡 How can it be used to optimize imaging operations, increase access, improve patient satisfaction, and boost revenue?

📊 Why are semantic interoperability and a unified data layer critical for success?

Robert shares insights into building a digital twin of the radiology department — modelling scanner usage, staffing, scheduling, quality, and operational efficiency using DICOM, HL7, and proprietary semantic layers.

We also discuss:

• The real-world barriers to digital twin adoption in radiology

• How AI and agentic automation are starting to reshape radiology ops

• The evolution from dashboards to dynamic, intervention-driven systems

• Governance and trust in AI-powered recommendations

• Why the future of radiology needs smarter, interoperable infrastructure

📌 Whether you’re a PACS admin, imaging department lead, healthcare CIO, or just digital health curious — this episode is full of practical insights on the future of imaging operations.