2023-06-5.md

2023-06-5

Agenda

• SIIM

  • Hackathon https://siim.org/page/hacking_healthcare
    • Starts on Wednesday
    • Ideas: https://docs.google.com/spreadsheets/d/19tWRF7e_zwDvFsXIneAuLHAcImYTxjGi0cIkZDcXFOY/edit#gid=509659304
  • Panel discussion on Generative AI / ChatGPT
  • Who is attending in person?
    • Chris Hafey
    • Simon Rascovsky
    • Brad Genereaux
    • Khaled Younis

• Radiology Report structuring with GPT-4

  • https://github.com/kbressem/gpt4-structured-reporting
  • https://pubs.rsna.org/doi/10.1148/radiol.230725

• NCI's De-Id workshop

  • https://wiki.nci.nih.gov/display/MIDI/2023+Medical+Image+De-Identification+Workshop

• Cloud Native https://siim.org/page/SIIM23_3015

  • What does it mean?

    • HITECH recommends that the location of data must be known - how does this work in a cloud setting?
    • Customers have difficulty explaining what it is
    • Spectrum
      • One extreme - not cloud native (lift and shift)
      • Another extreme - all managed services
      • Reality - somewhere in between
        • https://www.primevideotech.com/video-streaming/scaling-up-the-prime-video-audio-video-monitoring-service-and-reducing-costs-by-90
    • Depends on who is asking - a developer? a radiologists? an HIT employee?
    • Geographic distribution of resources - for increased availability
    • Customers mainly want reliability and scalability from cloud / cloud native
    • Availablity, using micro services
    • One thing that IS NOT cloud native in medical imaging
      • DICOM DIMSE / Port 104 - must use web protocols (HTTP)
    • Can a customer buy a service, import DICOM and everything is managed by vendor going forward
    • https://docs.aws.amazon.com/whitepapers/latest/aws-overview/six-advantages-of-cloud-computing.html
    • Lots of confusion from customers about what this is
    • Resources - cloud vendor frameworks
      • https://learn.microsoft.com/en-us/azure/cloud-adoption-framework/strategy/business-outcomes/
      • https://aws.amazon.com/cloud-adoption-framework/
    • "An advantage might be if two health systems are cloud based, then merging might be easier."
    • "having per-customer deployments is probably a sign of poor cloud integration as well"

  • Why is it important?

  • How can I tell if a solution is cloud native?

    • SLA for data access
    • Multi-cloud solutions
    • Where the infrastructure is installed and managed - vendor account, your account or hybrid?
    • AWS Well Architecture Review
    • Are software updates automated or scheduled?
    • How frequently is the software updated?
    • Does the solution use commercial enterprise databases (SQL Server, Oracle) or cloud vendor provided databases?
    • Does the solution use more than one database?
    • Does the solution use object storage (AWS S3) or file/block storage?
    • Does the solution leverage and expose cloud vendor provided identity and access control (AWS IAM)?