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RSNA Day One: Already an Unexpected (and Moving) Story

November 29, 2010
by Mark Hagland
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When it comes to making a difference in people’s lives around the world, diagnostic imaging and imaging informatics can make all the difference—just ask a pregnant villager from Uganda

Amid the annual swirl of the RSNA Conference, sponsored by the Oak Brook, Ill.-based Radiological Society of North America, it can sometimes be easy to momentarily forget what the conference is ultimately about (and what healthcare itself is inevitably about, of course), and that is improving patient care across numerous dimensions. After all, with nearly 60,000 radiologists, radiological professionals, IT professionals and others descending annually on the multiple-building complex that is McCormick Place in downtown Chicago, and with hundreds of scientific sessions and two full exhibit floors filled with medical and information technologies, there is so much to take in that some of the fundamentals can get lost, at least momentarily.

Yet the fundamentals of what all that technology can do for actual people were brought home to me on Sunday when I met with Kristen DeStigter, M.D. Not only does Dr. DeStigter have an interesting and very important day job—she is vice chair of radiology at Fletcher Allen Health Care and of the University of Vermont Medical Group, both based in Burlington, Vt.; she is also doing something in her “off hours” (if most doctors can ever be said to really have “off hours,” that is) that demonstrates the truth of the oft-repeated saying that one person really can change the world (or at least make a significant difference in the world).

During the day, DeStigter is deeply involved not only in her own direct radiological practice, but is also the radiology residency director at Fletcher Allen/the University of Vermont. And in that capacity, she is finding significant success in using the RIS-PACS-EMR technology integration platform from the Sarasota, Fla.-based PeerVue. Among many other things, PeerVue’s multiple capabilities make it easier to thoughtfully supervise the preliminary reads of the radiology residents under her tutelage, and to make sure there is a closed loop around the process whenever, for example, a resident’s initial read needs modification by an attending, particularly when, as commonly happens, the emergency department physician involved, and sometimes the patient, need to be informed of any changes to study interpretation that have taken place, and the closing of that loop around notification and communication must then occur.

That element in itself, along with others, is of interest and importance; for one thing, I believe that integration and interoperability will increasingly be key markers of progress in the imaging informatics sphere. But what really blew me away on Sunday was learning about what Dr. DeStigter is doing on her own time, with an organization she co-founded with fellow radiologist Brian Garra, M.D., who is associate director of imaging and applied mathematics at the Food and Drug Administration. Following public health work they had both done previously in Africa, Drs. DeStigter and Garra saw a tremendous potential in applying mobile ultrasound technology to help people in remote villages in East Africa (and elsewhere; they plan soon to expand their initial project), and ended up creating Imaging the World, which for the past several months has been providing life-saving diagnostic imaging capabilities in the remote Kamuli District in Uganda, located about a five-hour drive from that country’s capital, Kampala.

Not surprisingly, there’s a long (and quite interesting) back-story to all this, but the end result is that, through the efforts of these two doctors, pregnant women in a very remote part of East Africa are now getting ultrasound procedures—performed by trained nurses in Ugandan villages, and then interpreted by radiologists from the U.S., Uganda, and elsewhere, who are volunteering their services to the initiative—and in many cases, saving lives. Recently, one village resident had already been in labor for three full days. Because her family was familiar with the Imaging the World project, which takes advantage of compression technology to provide 3D volume imaging whose indications are conveyed via cell-phone technology to an online database for remote interpretation, doctors in the U.S. were able to quickly determine that the woman not only was having twins, but that one was stuck in a breach position, a situation that the nurse midwife in the woman’s village was able to correct manually, thus saving the life of the woman and her babies. It doesn’t get any more hands-on (literally, in this case) than that.

What’s more, says Dr. DeStigter, not only is PeerVue helping to support this initiative; such vendors as Philips, McKesson, and GE Healthcare, fierce competitors in the commercial imaging informatics market back home, are also partners in the Imaging the World effort, and are working together on behalf of villagers in East Africa who otherwise would have no access to the kinds of diagnostic imaging services that we in the developed world take for granted, and that save lives every day.

There is much more information on the Imaging the World website (, but suffice it to say that I was impressed enough by this healthcare leader and by her initiative that I felt it was important to describe it here. And as impressive as the gains being made in imaging informatics are at Fletcher Allen Health Care/the University of Vermont, it’s simply not possible to hear the story of Kristen DeStigter and Imaging the World and not be both impressed and moved by it; and it’s impossible not to be brought back to fundamentals hearing the story. After all, beyond the hype and the headlines at RSNA (and some of the hype is deserved, though inevitably, a lot of it is overblown every year), one comes back to the core of what diagnostic imaging—and imaging informatics—was meant to do in the first place, and that is to save lives and improve health. And if Imaging the World takes off—and, given the vision and determination of Dr. DeStigter, there’s no reason it shouldn’t—ultimately, countless human beings in remote, impoverished corners of the world could have what we take for granted, and what healthcare policy leaders from around the world are trying to create for as many people as possible—the chance at a better life. Could there be any more satisfying story to come out of RSNA?

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