Enterprise imaging has the potential to transform the way health care professionals make diagnostic and treatment decisions. But before these benefits can be realized, there are significant challenges to overcome.
Earlier this year, the Society for Imaging and Informatics in Medicine (SIIM) and the Healthcare Information and Management Systems Society (HIMSS) collaborated to identify seven major challenges of enterprise imaging.
Today, we’re summarizing the first three challenges, as well as our thoughts on potential solutions, and we’ll follow up in our next post with the last four.
1. Standardizing Workflow Across Departments
A radiology workflow is order-based, and the physician who requests the scan is not the patient’s primary physician. When the ordering physician requisitions a procedure, the order itself serves as a touchpoint between radiology and the ordering physician. It ensures continuity between the initial request and the image.
Different department or specialty areas have their own unique processes to capture and use medical images. Regardless of these methods, the images must still be accessible from the EMR. For example, a dermatologist could create a medical photograph without an order, and the photograph needs to be added to the patient record.
There’s more than one way to attack this problem. Some health systems are starting to use an encounter-based workflow, while others are modifying their order-based workflow for other departments. For more information about this philosophy, you can read the HIMSS and SIIM white paper collaboration that addresses the issue in depth: Orders- Versus Encounters-Based Image Capture.
2. Patient Identification
Every image must be linked to the correct patient. DICOM images use information from the modality worklist as metadata that is subsequently sent to the PACS. For some non-DICOM images, (for example, photographs which might be captured on a phone), there is no standard way to collect this information. The lack of system introduces an unacceptable possibility for error.
Some health systems use manual workarounds, like bracketing the image with scans of the patient’s intake form, or attaching physical stickers. But these temporary fixes aren’t foolproof since they rely on human effort.
Automating patient identification is the ideal solution since it reduces the chance for human error. A vendor neutral archive (VNA) can be part of this solution, provided you have carefully considered how to implement it as part of your overall enterprise imaging strategy. McKesson Software Architect, Kinson Ho, identified three important questions health systems should ask about patient identification when implementing a vendor neutral archive (VNA) as part of an enterprise imaging solution:
- Can the VNA consume the patient identifier?
- Can the VNA use context to qualify the patient?
- Can the VNA use any patient ID to provide the full patient record?
Answering these questions will put you in a good position to implement a VNA as part of your overall enterprise strategy.
3. There Is No Set of Defined Imaging Quality Standards
Imaging requirements vary between departments. For example, radiology and cardiology images are generally reported in shades of gray, but color is an important consideration in dermatology and pathology, and it is important for an enterprise imaging strategy to include multiple sources and formats.
Since color can change depending on lighting and camera type, departments could create a set of procedures or guidelines for physicians who use consumer grade cameras to ensure red eye removal, blemish correction, and any other filters are turned off. Then, for departments where color is of clinical interest, a color wheel could be added to each picture for calibration. Once collection methods for images are standardized, they can be added to the EMR using standard workflows that are developed as described in point #1.
Enterprise imaging is a key component for health systems moving to value-based care. It enables collaboration and communication that helps increase quality for both care and outcomes. The challenges that arise along the way can be seen as opportunities to create more efficient and effective workflows of the future.
To learn about the last four challenges and potential solutions described in the SIIM HIMSS white paper, come back for Part 2 of our discussion. To find out more about how we can help you overcome these challenges, visit us at www.mckesson.com or www.conserus.com.