Answering the Complex Questions of VNA Implementation with an Enterprise Image Viewer

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How an enterprise image viewer can solve access problems

The concept at the foundation of vendor-neutral archives (VNAs) appeals broadly to today’s healthcare providers: a non-proprietary archive of patient images of any type and any image-related data that can be accessed from any PACS or enterprise image viewer. With their promise of access to all images and image data regardless of provenance, VNAs are becoming a central element of enterprise image management strategies.

Healthcare Reform, Health System Mergers Generate Spur Growth of Enterprise Imaging

Several elements are impacting the growing need for enterprise imaging. Value-based reimbursement, cost pressures and patient-centered care all contribute to the need to share images. The ability to share images supports coordinated care, allows providers to deliver faster, better care and helps eliminate the need to repeat imaging studies.

In addition to these factors, which arise from healthcare reform policies, the acquisition of smaller hospitals by large health systems also impacts the need for better, more reliable image sharing. The acquired providers, whether a hospital or clinic, will have their own PACS archives of patient images spanning many specialties including radiology, cardiology, dermatology and more. These images need to be accessible by everyone within the health system no matter what their origin.

In this new environment, patient images can no longer be stored in silos. They must be made available to any provider that needs access to them. The end result is a new discipline, enterprise image management, which includes VNAs as an important component which separates the archival function from PACS.

Market for VNAs to Reach $210 Million in 2018

The net result of this demand is a growing market for VNA, which Frost and Sullivan, says will hit $210 million by 2018. While this market is still smaller than that of traditional PACS, Decision Resources Group predicts in a recent report that by 2025 VNA and enterprise image viewers will overtake the PACS market to become the standard for dedicated image exchange. Already, as reported in a recent study by BridgeHead Software in 2014, about one-third of American hospitals had adopted a VNA and another 19% planned on implementing one in the next two years.

VNA Implementations: Workflow and Image Data Use

While market demand for enterprise image management solutions in the form of VNAs is growing, the complexity of VNA technology and the environments into which they are installed makes their implementation incredibly time consuming

Just the first step of migrating data is time consuming and complex. The data needs to be “cleaned” so that it is accessible to multiple systems and then decisions need to be made about which data to archive first.

Then workflows and data use need to be analyzed so that once the data is in the VNA it can be accessed by those that need it on whatever platform they use. Every organization has different goals and needs for ingesting, normalizing, storing, providing access to and ultimately managing patient images. In addition, the types of imaging data differ significantly from one organization to the next based on services, lines and specialties.

Enterprise Image Viewer Can Gather Data Before Implementing a VNA

An enterprise image viewer can provide a solution for answering the questions of what data to archive when, as well as which workflows and platforms to support. A platform-agnostic enterprise image viewer can offer the VNA benefit of access to any DICOM or non-DICOM image without requiring migration of image data from the PACS platform. A viewer that is interoperable across multiple platforms, including desktops, laptops, tablets and smartphones, allows all potential users of a VNA to access images no matter what platform they use.

By implementing a viewer with these features before deciding on a VNA strategy, health IT departments can gather information on which images are accessed most frequently, from what platforms, and from where, i.e. remotely or locally. In addition, an enterprise image viewer enables hospitals and health systems to realize the benefits of an enterprise image strategy, such as giving providers access to patient images at the point of care. An enterprise image viewer can also help during transition by enabling practitioners to access images without needing to track their location, fulfilling the vision of anytime, anywhere access while migration may be underway.

“Standards” Create Barriers to Implementation

Another complication in this new world of enterprise imaging is whether or not a VNA is actually “neutral.” That is, does the VNA add any proprietary data that keeps it from interoperating with other standards-based technology and other VNAs. Many VNAs are add-on tools from PACS vendors and are not truly neutral.

At the same time the standard for medical imaging, Digital Imaging and Communications in Medicine or DICOM also comes with its own complexities that can make DICOM images non-standard. Specifically, information used to identify and annotate images, called metadata, has been interpreted differently by individual vendors, creating incompatible formats within DICOM.

This lack of clear neutrality and true standards puts the burden on ensuring interoperability on individual providers, adding yet another layer of complexity to implementation.

Enterprise Image Viewer: Support for Vendor-Neutral Image Access

It may not be possible for a provider to solve the interoperability issues of VNA without added costs and customization. A better place to focus true platform-agnostic access is at the enterprise image viewer layer of the image management stack. If the VNA middle layer creates any kind of proprietary format, a true vendor-neutral image viewer will solve the access problems, allowing health systems to implement a VNA with the knowledge that all providers will have access no matter what the format of the image is.

Jonathan Draper is the director of product management, healthcare at Calgary Scientific. Jonathan directs the product roadmap and works closely with healthcare partners and institutions globally to develop innovative solutions that address clinical needs and meet the technical requirements of healthcare enterprises.

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