Vendor Neutral Archiving: Putting Healthcare Back in the Data Driver’s Seat

For most hospitals, there’s nothing neutral about Vendor Neutral archiving — except perhaps the data itself. After years of relinquishing some, if not all, control of the Picture Archiving and Communication System and other important data to IT vendors, a VNA puts healthcare facilities back in the driver’s seat. Its benefits are significant: automatic access to a patient’s full clinical history across all providers; electronic medical records enriched with all patient images and reports — no matter the department or source of image generation; upgrading to a new PACS in just hours; and simplified and secure lifecycle management of the entire enterprise of clinical images, which account for the lion share of data storage demands.

VNAs are predicted to store 31 percent of all new imaging studies across the globe within four years, according to a major new report by InMedica, the leading independent provider of market research and consultancy to the global medical electronics industry. Christopher Roth, MD, associate chair of radiology for health information technology and clinical informatics at Duke University Medical Center and director of imaging IT strategy for Duke Medicine, says, “Having a technology that is fully compatible with the DICOM standard, and also provides flexibility for storing and managing our own data in both native and DICOM formats is essential. The ability to store such things as enterprise digital pathologic slides, visible light photos and DICOM radiology and cardiology clinical and research images is important to the success of our clinical and research missions.”

In addition to data control, the fundamental benefits of the VNA include interoperability among IT systems, easy medical record sharing and analysis and use of information in ways never before possible. In short, the VNA enables imaging sites to declare their data independence from the proprietary IT systems that often restrict the value of important medical information. That is why VNA has become one of the most talked about healthcare IT new technologies.

Standards-based storage
Unlike most PACS and other healthcare applications, a VNA follows storage methods and data formats that objectify healthcare information by adhering to industry standards. Additionally, IT applications are no longer tied to physically addressed storage and proprietary communication.

Underlying many of these benefits is a consistent metadata format, which enables identification of all data for a particular patient, wherever the information entered the IT system. VNAs typically unify data from HIS, RIS, PACS and EMR, as well as information from numerous specialty departmental systems into a single archive.

Proprietary PACS problems: solved
Because diagnostic images and reports are among the most frequently shared information across the continuum of care, the isolated and often proprietary PACS archive has long posed a particular problem to hospitals — and to radiology departments that wish to upgrade to new PACS applications. The VNA provides an answer to PACS problems with implications across the enterprise and beyond.

The promise of an EMR enabled with DICOM images and related information is even more complex. This can require custom interface engines to link unrelated systems and possibly data transformation. It may even require the duplication of entire archives. Interfaces are costly to acquire, implement and maintain and create security risks and scalability issues. Data duplication significantly multiplies the storage and maintenance costs.

Moving all information to a truly standard DICOM eliminates most of these problems. With a VNA, sites can share images across systems, migrate to a new PACS and manage their data much more easily.

PACS beyond radiology and DICOM
The VNA’s benefits do not stop with images — nor do the problems of PACS. Currently, a PACS is often called upon to store a growing variety of data — both DICOM and non-DICOM — from within radiology and from other medical specialties.

DICOM data stored may include cardiology, neurology and an ever-growing list of the “-ologies.” The departments that generate this data often have their own identification numbers, requisition systems and even accession numbers that all must be reconciled and managed within the PACS just to create an integrated record in this single application.

Adherence to IHE standards
A VNA takes advantage of standards developed by the widely recognized Integrating the Healthcare Enterprise initiative. In addition to DICOM, these include XDS and XDS-I, HL7 and others. Using this shared data format, the VNA provides one comprehensive archive as the single point of information access for all the healthcare IT applications connected to it.

Medical sites weary of the ongoing cycles of data conversion that accompany a move to a new IT application will be pleased to know that this will be the last data migration they will ever have to perform.

Applying standards to nonimaging DICOM objects and other data
The VNA also stores and manages non-DICOM information from other specialty IT systems across the healthcare enterprise. This typically involves such files types as JPEG, PDF, waveforms, various video and audio formats and MS Word — in short whatever modern medicine sends its way. In particular, these versatile storage capabilities make the VNA an appropriate repository for data from specialties as diverse as lab and ophthalmology to speech pathology and dermatology.

Some VNA providers can store non-DICOM data in native format, which provides for easy exchange of the originating system and allows departmental IT systems to retain some autonomy. Whether and how this is accomplished may vary significantly with the VNA vendor and has important implications for the true neutrality of the archive.

Interfacing with the EMR
Often, a key goal of the VNA is to provide access to complete, accurate and timely patient data at the point-of-care, typically through an EMR system. A VNA simplifies the task. A simple link to the standards-based VNA archive will bring up all these images and imaging-related data for a particular patient. Embed a lightweight DICOM viewer, and the result is an easy and elegant hospital- wide image viewing solution. Naturally, this same link and viewer can bring VNA information to any physician portal connected to the archive with a simple click.

Streamlining PACS migration
As a result, a site also has the ability to elegantly switch to any new standards-based PACS or other clinical system without costly data migrations or significant data reconciliation and cleansing. The VNA ends the era where a medical facility was tied to a particular vendor simply because its data was held captive in a proprietary format. Typically a new PACS can be connected to the VNA with a simple plug-in with little interruption of department functions.

Medical sites implement a VNA to achieve a wide range of goals, and the technology varies widely. Careful planning and an examination of the VNA marketplace will help ensure satisfaction with your VNA implementation.

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