Imaging & Teletech Innovations_Duleep Wikramanayake: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Tim Kelley:
Welcome to Imaging and Teletech Innovations, brought to you by TeleRay. I’m your host, Tim Kelley. Join us as we explore the latest trends and developments in teleradiology and imaging solutions, from expert insights to real-world case studies. We cover everything you need to know to stay ahead in the rapidly evolving field of radiology. So sit back, relax, and let’s dive in.
Tim Kelley:
Welcome, Duleep! And I’m not going to say your last name because I’ll screw it up, SimonMed. We’ve known each other for a while, and I’m going to go with your profile that you wrote yourself: an accomplished technology executive offering 25 years of experience in technology-based positions of utilizing the latest technology to provide innovative solutions that enhance overall, recognized as a subject matter expert for Healthcare IT systems, interviewed by several radiology magazines, well-versed in emerging technologies and industry trends to deliver immediate results. So, does that sound about right?
Duleep Wikramanayake:
Sounds about right.
Tim Kelley:
All right. So, well, tell me a little bit more about yourself, Duleep, I know that was a lot there, but there’s more to the story.
Duleep Wikramanayake:
Yeah. So I start; my name is Duleep Wikramanayake. I am the VP of Information Technology at SimonMed. I used to be the CIO, and I’ve been in radiology for the last 20-plus years, right, and in IT for about 36 years, right, so I’m an old dog. And I’ve been in technology where, the whole idea of being a technologist is to help the user community to achieve what they’re doing, to give them a toolset that when they come in, just like the good old phone, right, you pick up the phone, you have dial tone, you dial the phone, and somebody answers on the other side, or you get a busy signal. It’s easy. Technology, on the other hand, I always expected it to get easier and easier, and it’s getting more complex and more complex, and then, so there are, it’s getting harder for the user. And I think you have to be very cognizant of what we do today to make it easy for the user, right? So that’s where the innovation is, right? I think we all forget, as IT folks, who we serve, right? So to me, my biggest user is everybody, right, that is logging into a computer. They want to be able to log in to a computer and be able to do their work without ever going, oh, why is this thing running slow? Why is this not doing something, what I want? And so when it came to radiology, what I did was I actually sat back with the technologists, with the radiologists, because at one time I didn’t know my anatomy because I didn’t go into that part of the, I was more into the sports world and probably a little bit of math and physics. But when it came to anatomy, I really didn’t know anything about body parts. So it was a big shock to me, I had to really learn what it was, and so I decided, if I’m to be able to help the radiology industry in IT, I really needed to know the workflows inside out. What is the business? So since I was an accountant, before I became an IT person, it was easy for me to figure out the billing side of things. While it didn’t make any sense at all, right, it’s so complicated. I don’t understand why it needs to be so complicated, but I did get a good handle on how a patient gets scheduled, to registering, to arriving, and then the technologies, doing all the questionnaires, doing the exam, the radiologist interpreting it, and how finally a diagnostic report comes about, and then, it goes to billing and how the follow-ups go with the referring doctor. Now, that’s one part of it, but the other part of it that I really got involved is the modalities, because you had to know something about the modalities. And as you learn things, you realize that the MRI of 20 years ago and the MRI today is so different, right? To the user group and to referring doctor, if you do MRI of the brain, MRI of the brain, you know, 20 years ago and MRI of the brain today, the same CPT code, but the image sets that come out of a modality is very different now, right? So you got to know, you got to plan for storage, you got to plan for the proper networking. And then one of the things, great things you do, we were the first to actually do remote scanning, and we went with three different, I’m not going to name the vendors, they are big time and big guns in the modality field, and they failed at it. And then we did our own, and we were very successful, and today, all our sites by default for MRI and CT, we can remote scan those things anytime, and we’ve done some, a little bit of DevOps create macros on those cameras so that they can zoom in and out by just pressing some buttons.
Tim Kelley:
That’s great. You mentioned that you were an accountant. How did you come to get to SimonMed from, or how was that progression from accountant to where you’re at today?
Duleep Wikramanayake:
Yeah, I came here with $300 and a suitcase 40 years ago, and I had a job with Save the Children Federation, and they had a mainframe at that time, and so everything that’s happening on that mainframe, and suddenly this PC was introduced into the finance department where I worked. And at that time, Lotus 1-2-3 was the Excel of that time, and I really got good at Lotus 1-2-3 and automated a lot of the accounting functions, including like payroll, categorizing payroll. And because we had different regions, and it was a large company, so we had the American Indian region, we had the Asia Pacific region, we had the Latin American region, we had the Middle Eastern region, we had the African Region, so you’re dealing with all these different sites that are sending reports. And so what I did was I started automating them, putting them into and uploading them into the mainframe. And I didn’t realize that at that time that a lot of folks didn’t even know how to connect a PC to a mainframe, but somehow had figured out reading the manual to get out, oh, this is how you connect this thing up, and this is how you do these things. And so this was 1983, and then, by ’84, I got a true interest in computers, and I bought my own computer, a Tandy 1000, and then the rest were, everybody thought I was nuts because I spent my last penny buying the computer and actually got into debt because it was 2500 bucks, and that’s all my credit card would hold, and got the computer and probably learned a lot because I really wanted to find out how the hell this thing works, right? And eventually, computer department decided, hey Duleep, instead of being, doing that, why don’t you come and be part of the computer department? I’m like, yeah, don’t have to be an accountant anymore. And so I went down there and got into application development and did a lot of kind of migrations. And one of my biggest, what I call niche was moving data from systems to systems, regardless of what the system was, and I got very good and learned what I call a lot of pocket money doing data transfers of people, right, data migrations of people. And I didn’t know that this was an expensive item, and I used to charge people like 20 bucks an hour and people, and I would get all this business, right, and didn’t realize that the guys who are hiring me were charging 200 bucks an hour, making a fortune.
Tim Kelley:
… in radiology. Completely crazy, yeah.
Duleep Wikramanayake:
So when I came to radiology, one of the first things I did was, we were one of the first to move system, from one pack system to another pack system, and they said it couldn’t be done. And then also the risk system, and they’re like, well, how are you going to get the reports out? And I’m like, it’s a database, let me get it out for you. And then I got it out, and we got it into the new system, and word got out, oh, we got this maverick who can do this stuff. And I’m thinking to myself, wow, that’s when I realized healthcare was so behind the times because I got into radiology as a fluke. I was in between jobs, and one of my good friends, whose friend was a CEO of the radiology group, said, hey, they’re having a lot of problems with IT. Why don’t you go for it? Go, go while you, go help them out. So I was director of operations at Columbia House, the record …, by far …, by like 12 records, whatever it is. So I went from there, and I had a stint down there for about a year and a half, and so I was always in the publishing industry where I learned to move large files, didn’t realize that this, when I walked into radiology, what the hell it was, and it was about moving large, yeah, so that helped me set up the networking in the radiology space. So we were the first advanced radiology, in 2003 was the first radiology group, to do, acquire anywhere, read anywhere with multi-slice CTs. They were reading multi-slice CTs on consoles. We were reading it anywhere on the network, so people from all over the country was coming to see what the hell I had built. And I’m looking at them saying, Oh my God, I got them all fooled. This is a normal network, you build a normal network. Because they were used to T1s, and I said, No, you can’t do this with T1, and I’ll show you why. And so we had at that time we didn’t have any, any MPLS or anything ATM network, very old technology, but it worked.
Tim Kelley:
So that’s when you learned that Dicom was a universal language, whether it was Japanese OEMs, German, or Milwaukee. Certainly …, doesn’t it?
Duleep Wikramanayake:
It doesn’t, yeah. And the thing is, Dicom is a standard, but nobody’s adhered to those standards. So one of the things.
Tim Kelley:
They claim to.
Duleep Wikramanayake:
Yeah, they only claim to, and our … packs didn’t have what I call electrician numbers, so I would take the Dicom headers and match it with the race, and if it didn’t match, I would set up my user groups and say, okay, I ran these 1000, about 30 of these are not matching, manually match them and give them give, some numbers. And then we would match it, and then we would do the migration so everything matched. And so people are like, wow, this is such a cool thing. And then I started doing, earning pocket money on the side, right? And then I realized, I’m charging somebody like 15 grand for a big project, and then I hear that they’ve charged the client like half $1 million, and I’m like, I’m not doing this. I should, get me in front of the client, I’ll do it. I’ll do it for the $15,000, but I’m not doing, I’m not, making sure somebody’s ripping somebody off because it’s, really my philosophy is add value, right? It has to be win-win, right?
Tim Kelley:
Sure.
Duleep Wikramanayake:
Because if I charge those amounts, I’m sure would have been able to retire a little earlier than I did. So I retired in 2018, and I went back because I wanted to move to Arizona, end up when Dr. Simon called me. So it’s been a kind of a good mix-up for our radiology group. So I came and added value, and then they were growing, and as we got acquired, they didn’t feel I was the right guy, and I’m okay with that because they are looking for somebody who is way more strategic in a larger healthcare arena. And, of course, what, I put my ego in my pocket every time I go to work, so that’s fine with me. But the CIO who’s here now recognized my value and asked me to stay, which is nice. And so I’m really thrilled that he’s there, and I’m helping him grow it to the next level with him.
Tim Kelley:
I’m sure you can help the CIO with some answers about, with your experience, how to handle data integrity, and HIPAA in these times. So how do you guys manage that?
Duleep Wikramanayake:
Yeah, so I think he’s actually more well-versed in the governance part of it than I was because I was more on the technical side of things. It’s not that I don’t understand the governance, but he understands the importance of it, and he’s pushing that part to make sure that we are staying HIPAA compliant and that, whatever we need to do. And it’s a challenge because if you’re not going to do what I call awareness training in that area, in what I call a frequent basis, once every six months, a refresher course and once a year full course again, because you tend to forget what’s compliant, what is not. Even me, when I was at the health organization, you get that HIPAA test, and you’re like, Oh my God, I got to go through this again? Let’s see how good I am. And then you realize, oh, you’ve forgotten certain things you knew, and you fail the test, and you go, God, I got to go sit this test again so I can pass it. So you’re now you’re carefully reading it, you’re understanding it to make sure you pass. And I think it’s a good thing, because by awareness, I think privacy and HIPAA privacy, that is really important because at the end of the day, you know, patient privacy is really important, right?
Tim Kelley:
A lot of people, when institutions get marketed to, by companies like we’re at right now, Zoom, which is an awesome product, except they claim to be HIPAA compliant on their website, and they are not.
Duleep Wikramanayake:
They’re not, because HIPAA is not, it’s a very loose standard as opposed to HITECH. HITECH, you have people, you can’t be HITECH certified unless you have certified people in that, and then there’s a little rigor that goes on with that to make sure that you stay high-tech compliant. HIPAA, on the other hand, it’s how you interpret it, so people tend to interpret it the way they want it, even though it’s pretty clear guidelines. But again, it’s not set in stone, and that’s a problem.
Tim Kelley:
So here’s a good one for you, Duleep. What’s the biggest lesson you’ve learned in all these years working in radiology?
Duleep Wikramanayake:
I think one of the biggest problems in radiology is that they are stuck in the ways they do things, and there is really newer technology that comes and makes it better. And almost every aspect of every department says, this is how we have been doing it for all our lives, and this is how we are going to do it, and so that becomes a challenge. And how do you change somebody’s mindset, and how do you become the champion? How do you do that change and say, Hey, but if you do it this way, it works a lot better? And unfortunately, to prove that and to get buy-in from people, there isn’t a lot of good, what I call, healthcare applications, that follow what, that, what I call intuitive. It’s really very, it’s good money, and people haven’t really written it well and intuitive enough to make it easier for somebody to go, okay, if I’m registering a patient, I need to be able to put the insurance. I shouldn’t be able to go, okay, where in the application should I go to put that insurance? How do I make it a guarantor? All those things are incredibly important. However, most of the risk applications other than the big guys like Epic and the Cerner’s have a little bit maturity. In the med informatics of the world, I have maturity. Unfortunately, while they have matured in their application, their stack, the software stack is pretty legacy. Even though they make a lot of money, I’m surprised they haven’t spent rewriting that in a much better stack that makes it like look like Amazon, right? You go on to Amazon, have you ever seen Amazon run slow? Not in my lifetime yet because, and they are doing so many transactions, right? I know healthcare is more complex and complicated, but that doesn’t mean you can’t write something that is intuitive for the user, that you can easily have a user, guide the user right through the process so that it takes the, what I call the, what’s the word I’m looking for, the fatigue of using an application.
Tim Kelley:
Oh, this stuff is old. There’s a lot of old stuff. You go in the doctor’s office, they’ve got the old CRT screens, certain situations, and it’s crazy. But people think healthcare is always way ahead of the time, and in many areas it’s very slow.
Duleep Wikramanayake:
Yeah, I think there are some hospitals that are really doing automation, right? They’re doing automation with AI. There are a couple of hospitals that I know. I went to a couple of what I call executive briefings, and the hospitals are talking about bringing in cameras and getting AI so they know when somebody’s in the prep room is prepping the patient for OR, they already know, hey, let’s send the alerts, people to get ready because they’re coming so there’s no wait time, so making it efficient. And when the room is used, then they alert that what needs to go out of there and be cleansed, right? And then if somebody left something, based on that camera, it’ll say, hey, you missed this, or and when they came back and said, hey, you didn’t bring this. So that’s amazing.
Tim Kelley:
It’s all data sets.
Duleep Wikramanayake:
Yeah, it’s all without a human being doing anything, having to double-check. This is all done through normal cameras and AI going and saying, and the way they did it, they showed a demo when people are walking in, their faces are blurred out, so there’s total privacy, it’s insane.
Tim Kelley:
With all of that information, what would be your last thought that you would give our listeners today? As far as what we’ve talked about today, …, you’re going to wrap up and say this is what you need to know.
Duleep Wikramanayake:
Think from a patient perspective. I think what we have not done is made it easy for a patient to access their own record, regardless of where they are. And that is because sometimes it’s politics and sometimes it’s software, right? The systems, they’re not intuitive enough. But at some point in life, right, look, you can have a Chase Visa card or a Bank of America Visa card, or whatever bank Visa card, and you can go anywhere in the world and click it and pay for it and it hits your bank account. Your health record should be similar. It should be secure, right? Just like a credit card, not that credit cards are not. It’s secure most of the time, but you should have something where, you know, you can click something and whatever system goes, oh yeah, we got your health record, we got access to health record from wherever it is. And I think that would be the, what I call the utopia of patient care, right? Where, well, the patient has access to go anywhere. All they have to do is take that card and you scan it into whatever their system and they’re like, yep, you got your medical records. You don’t have to go ask 10,000 referring doctors or physicians and say, hey, can I please have my records? I haven’t got my records yet.
Tim Kelley:
Yeah, I’ve not heard that credit card anecdote before, but I do like it. So to wrap up here, Duleep, I’m gonna ask you one more question. What’s your favorite Teleray product? Because I have to have my shameless plugs in here.
Duleep Wikramanayake:
Yeah, you know what? We experimented with your product. I know we’d love to get your product in for the remote scanning because it’s at a hardware level, so it doesn’t get involved with the software. And so it makes it much easier to manage a modality without, really, the modality vendor putting blocks on it. So I think that could be a really good gadget, especially for us. And I think more people getting into remote scanning is to be able to manage that device remotely and securely from a central place that people can access and help because there’s a tech shortage.
Tim Kelley:
I completely agree. And hopefully, we can show that to you again at … coming up here, making it to cold Chicago.
Duleep Wikramanayake:
I am making it to cold Chicago, believe it or not. My boss wanted me to go the tenth, so I actually booked the tickets so I should be there Monday through Thursday. I’m coming in on Monday and leaving on Thursday, put it that way. So I got good two days to look at all the stuff that’s out there.
Tim Kelley:
All right, we’ll plan on getting together.
Duleep Wikramanayake:
Awesome.
Tim Kelley:
Thanks, Duleep. We will see you then.
Duleep Wikramanayake:
All right, Tim, thank you so much for this opportunity.
Tim Kelley:
Thanks for joining us today on Imaging and Teletech Innovations, brought to you by TeleRay. We hope you like this episode. If you have any questions or feedback, please don’t hesitate to reach out to us at info at TeleRay.com. Be sure to subscribe to the podcast so you don’t miss any future episodes, and stay tuned for more insights into Imaging Solutions and Teletech with TeleRay.
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