Can A PACS Vendor Really be Neutral?

2013-04-05
 

PACS Neutral Checklist

After years on the customer side of the coin, I’ve flipped to the vendor side. Don’t worry: the water here is just fine. I like to think that I bring all of you with me – all of our questions and concerns when dealing with today’s ever-changing technology. Really, who better to be entrusted with formulating healthcare strategies and solutions than those of us who have been in the industry’s driver’s seat?

As an infrastructure architect at a large health system in Iowa, I had a top down view of the parts that make up an application solution. In the case of picture archiving communications systems (PACS), that meant assembling the people, pieces and technology that go into rolling out imaging to radiology, cardiology, oncology and so on. I have asked the same questions you do — questions such as: Where is the data? How do clinicians get to it? Who owns it? How do we protect it? What is the optimal solution design? When you can address these basic questions, then you can determine how to make the information available so it is not only fluid but requires a minimal amount of resources.

This basic understanding becomes more important as organizations continue implementing electronic health record (EHR) systems. Medical imaging, of course, is a key component to providing the complete picture of the patient’s health. With the help of our PACS vendor, and ahead of an EHR implementation, we were successful in setting up an architecture that not only had the workflow and technology in sync but the management of the radiology image archive was as well. We considered the possibility of expanding the manageability and size of the image archive to include all imaging sources and types, but with the reality of time constraints and varying definitions of “archive” and “vendor neutrality,” we refocused on just radiology. It was, and is, all about the right terminology, the right time and the right technology.

Right Terminology

Think of a search engine. The whole of the Internet is indexed and archived in anticipation of a specific request. In the world of healthcare, a radiologist conducts a search when he or she interacts with the PACS and requests the history on a patient in order to make a thorough diagnosis. The PACS is likely organizing recently acquired data and pulling from an archive. But which archive?

Increasingly, organizations, either through acquisition, expansion, updates or maybe specialization are likely to have multiple PACS or PACS-like medical imaging systems. And other “ologies” are increasing finding that some data collected in these other imaging systems may have value in a diagnosis. As a result, a trend has been building in our industry to separate the PACS application from the image data, earning the title of vendor neutral archives (VNAs.)

When I hear this terminology, I tend to cringe in unison with you. Can a vendor ever be neutral? Of course not. Or maybe more appropriately, can you ever be neutral from a vendor? Not often. But the image repository or archive can be neutral.

Regardless of the medical imaging system that we use, our images can be stored and retrieved from a PACS neutral archive (PNA) because it was built to exchange data with disparate systems (where such sharing is legally permitted). Access to this archive data is not only important to the hospital’s EHR but will also ease the difficulty of broadening to the more universal image sharing of a Health Information Exchange (HIE) throughout a community.

Right Time

There are a number of reasons why now is the right time to look at your organizations global medical imaging archive strategy;  continually growing imaging volume, the complexity of adding EHRs and HIEs and the rapid consumption of imaging resources.  These business challenges can be minimized with a PACS neutral archive (PNA.)

  • The ability to migrate from multiple silos of imaging storage to one consolidated archive helps to minimize the space and cooling requirements and helps to reduce all of the associated costs for storage and archiving.
  • PNAs participate in the advanced infrastructures being implement with today’s EHR projects and can influence performance through network optimization opportunities and a single point of access for EHR integrations while helping to reduce maintenance tasks through centralized system management.
  • Life cycle management enables your organization to determine retention rules according to your jurisdictional requirements in order   manage risk while having a positive effect on storage consumption.

Right Technology

Many organization’s PACS have been collecting imaging data for more than 10 years. Now technology is available to help provide a better means of archiving, managing and delivering that information. You need an enterprise-wide, consolidated image storage strategy to manage the data and the risk.  A diagnosis is not just about words and numbers. It is about seeing the problems and affected areas as well. They need a picture of the wound, the reports that include the different scopes that were used, images from digital cameras, voice clips and any piece of paper that was part of the workflow.

With the right technology, there are opportunities for larger strategies. My company’s product uses the latest technology to archive and manage image data while not locking you into a specific imaging system. We want you to be able to leverage and choose whatever workflow makes sense for radiology, cardiology and the other ‘ology’ departments at your organization, so we have built a solution that is scalable, accessible, manageable and operates in physical and virtual configurations.

We apply a standards-based approach to DICOM imaging – excluding any proprietary compression or image storage formats — that creates true neutrality between disparate systems. In addition, we are applying cross enterprise document sharing (XDS) standards to index and manage many other data types. This solution also enables information lifecycle management in the archive for recovery of storage resources governed by retention policies in your enterprise.

Our industry specifically, and image archiving in general is at an important crossroad. I’ve been on both sides of the coin as a customer and a vendor, and I think we have taken steps in the “right” direction.

Let me know what you think by posting a comment below.

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