Leveraging unified VNA strategy to break down organizational silos in a healthcare enterprise

Technology is swiftly changing across the globe. As seen in other business environments, healthcare providers are persistently upgrading their practices to remain sustainable and profitable in the long run.

Global healthcare digitization efforts are driving providers to opt for digital workplaces that rely on intelligent healthcare systems and automation tools to overcome inefficiencies in care delivery. Indeed, it comes as no surprise that digital consolidation of clinical contents is becoming a top priority, and medical imaging ‘ologies are no exception in this evolving market dynamics. Any health system paying attention to the field of medical imaging is certain to have noticed a growing trend of hospitals implementing unified vendor neutral archives (VNA) and enterprise imaging solutions. Every day, a provider somewhere investigates the potential investment and ensuing benefits achievable from enterprise imaging solutions with an objective to enhance their imaging specialties with effective and more robust diagnostic workflow. These explorative inquiries are likely to define enterprise imaging and unified VNA strategies for healthcare organizations.

The Challenges with Existing PACS Systems
Over the last two decades, picture archiving and communication system (PACS) have transformed radiology and cardiology practices, but the formidable challenge with existing PACS is lack of propensity to handle more and more imaging-based specialties like gastroenterology, dermatology, pathology, wound care, ophthalmology and few more that are joining the PACS bandwagon and demanding their own version of imaging workflows and archiving systems. Today, in many hospitals, medical imaging data is stored in discreet silos tethered to individual imaging archives, steering in contrast with the value-based care approach which illustrates seamless interoperability between systems. Although certain business needs can be met by implementing distinct image archives, the price tag for implementation, operation, maintenance and professional services like data migration can be quite expensive and time consuming. When it comes to medical image viewing, the industry demands vendor neutrality at both ends of the imaging workflow—the acquisition and the presentation (display) layer.

The complexity of PACS systems increases exponentially as user dependence grows, especially when radiologists expect existing PACS systems to handle new generation of multi-modality imaging data produced from the combination of computerised tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), and nuclear medicine. Image post-processing techniques is another crucial challenge. Clinicians require a robust 3D and 4D advanced visualization, multi-modality image registration capabilities and a powerful image post-processing platform to achieve accurate diagnosis. Many existing legacy imaging systems fail to address these evolving demands and do not produce expected clinical outcomes, resulting in poor productivity. Moreover, imaging fraternity is rapidly moving toward the adoption of evidence-based guidelines, artificial intelligence (AI), and machine learning capabilities built into their healthcare enterprise. These initiatives require a universal imaging platform with appropriate tools, systems, and configurable workflow solutions to conceivably address the evolving industry demands.

Enterprise Imaging: Beyond PACS and Siloed Clinical Image Archives
Enterprise imaging solutions encompass systematic tools designed to seamlessly obtain, organize, store, and deliver medical images and other longitudinal patient information from distinct healthcare information systems for reading and reporting on a single viewer. A complete enterprise imaging solution comprises 4 vital components: a universal image viewer, clinical workflow tools, collaboration tools, and a neutral storage layer.

Today, several clinical specialties generate imaging data and clinical information, which includes digital imaging and communications in medicine (DICOM) images, visible light images, ECG waveforms, digital pathology, lab results, and clinical notes. Multi-media contents include JPEGs, PDFs, text documents, videos, emails, and mobile app data that need to be archived electronically and made accessible via electronic medical/health records (EMR/EHR). Ultimately, to arrive at clinical decisions, providers expect contextualization of structured and unstructured contents in a healthcare enterprise. Non-DICOM data management can pose a tremendous challenge in a PACS environment as most of the systems are capable of handling only DICOM formats, leaving non-DICOM image producing departments under scrutiny.

As data becomes increasingly important to providers, VNA can help streamline clinical workflow by allowing a single point of access to relevant patient data from across the enterprise. One unified VNA solution can store and distribute clinical contents in standardized healthcare data formats supporting all clinical ‘ologies and can potentially help reduce storage costs with information lifecycle management tools and business continuity coupled with disaster recovery. These are some of the primary factors compelling hospital CIOs and IT directors to invest in enterprise imaging solutions.

Business Case to Justify Investment in Enterprise Imaging Solution
Cost reduction is a ubiquitous priority across the healthcare landscape, and there is a compelling need for providers to find intelligent solutions that can help improve patient outcomes and mitigate costs. When it comes to the question of What’s next after EMR/EHR implementation? Unified VNA strategy and enterprise imaging solutions could be the next positive ROI initiative for the healthcare industry. The resounding perception across the industry is that enterprise imaging solutions are best suited for large healthcare organizations with imaging specializations, but that is not true. Depending on the size of practices and volume of imaging studies produced, customized approaches for establishing enterprise imaging capabilities can help enhance clinical-decision making capabilities, reduce costs and optimize financial performance in a number of ways. Other benefits include built-in clinical collaboration tools, interactive image-viewing in the OR, and teleradiology capabilities to improve overall clinical outcomes.

By and large, enterprise imaging is more than just image-enabling the EMR/EHR, offering a neutral platform that allows independent systems to work in concert to centralize image management throughout the healthcare enterprise. Furthermore, a unified VNA implemented using standards-based protocols and configurable clinical workflows can be a stepping stone to health information exchange (HIE) initiatives. Healthcare organizations that have made significant investments in enterprise imaging solutions have reaped the technology’s benefits in numerous ways and enjoy a reduced total cost of ownership.

Enterprise consolidation of medical images within a unified VNA gives clinicians immediate access to patients’ comprehensive imaging contents, regardless of where the images were acquired. Moreover, enterprise imaging facilitates healthcare mobility with zero-footprint enterprise image viewers enabling organizations to compete more aggressively and improve patient and provider content rich consultations. Specifically, a mobile medical imaging capability allows clinicians to quickly capture and directly integrate visible light images, videos, or notes with appropriate patient health records. Cloud-based enterprise imaging solutions guarantee high uptime, enhanced scalability, and improved security factors, all of which allows the medical imaging data volumes to grow without necessary forklift upgrades. These assured long-term strategic benefits are driving robust investment activity in enterprise imaging solutions, in rural, regional and large hospital environments.

Harold Welch is the Vice President of Technical Solutions Worldwide at Novarad, based Utah’s technology corridor, the Silicon Slopes. Welch has worked in the healthcare industry for over 15 years, and is passionate about improving patient care and workflow efficiency for healthcare providers throughout the world.

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