by Roger Bird
Hospitals and health systems create, store and access images every day using proprietary picture archiving and communication systems (PACS). Radiologists typically must view and interpret images on-site because they cannot access their hospital's PACS remotely. Worse, their PACS cannot exchange images with other PACS, even when images in those disparate systems are stored in the standard DICOM format.
This lack of standardization and interoperability, combined with data security issues, makes it nearly impossible for facilities to assemble a complete imaging record for a patient at the point of care or seamlessly share data with other providers outside their walls. As a result, diagnosis and treatment delays may translate to duplicate and costly imaging procedures and expose patients to unnecessary radiation.
Change fueled by health policy
Until recently, most organizations endured those clinical and workflow inefficiencies. However, with the government leveraging health reform to transform the health system into an interconnected and collaborative ecosystem, facilities are looking to integrate imaging systems and electronic health records (EHRs). The objectives are to improve access, reduce costs and function in an environment that requires providers to coordinate care across the continuum to avoid financial losses.
Vendor-neutral archives for seamless integration
As providers replace aging PACS solutions, they should consider vendor-neutral archives (VNAs). Unlike proprietary imaging systems, the open architecture of VNAs enables facilities to view and exchange studies regardless of the modality that created the images or where the images are stored. This makes it easier for healthcare organizations to integrate PACS, EHRs and other clinical and financial solutions in weeks rather than months.
Take it to the cloud
Providers also should look for VNA technologies that are in the cloud rather than locally hosted. Cloud-based VNAs offer hospitals much more functional and flexible systems, at a cost that can be substantially less than inferior client-server systems. The former does not require hospiatls to install special hardware or software; the middleware simply connects to other third-party applications. Users just need a PC and access to the Internet, which makes it easy for them to receive and transmit images and radiology reports to referral centers or any healthcare professional involved in the care of a patient.
VNA's role in meaningful use and ACOs
Currently, PACS, as well as radiology and cardiovascular information systems, are not part of meaningful use (MU), but are essential to high-quality diagnosis and treatment. Many healthcare stakeholders are pushing hard for the systems to be part of Stages 2 and 3. The industry will receive an early indication of whether those efforts are successful when the HIT Standards Committee releases recommendations for Stage 2 criteria by fall and Stage 3 later in the year.
Still, regardless whether imaging systems officially become part of MU, imaging should be a critical component of a hospital's IT strategic plan, particularly as it prepares to form or participate in an accountable care organization (ACO).
Under the emerging ACO care delivery model, hospitals must ensure physicians and other ACO partners can seamlessly access patients’ complete medical records in real-time to enhance quality, safety, coordination and cost effectiveness of care. ACOs that meet these goals and Medicare's quality measures will receive a portion of the savings they generate for the Centers of Medicare and Medicaid Services (CMS). Those that cost CMS money must repay part of the cost overruns. Organizations that deploy VNAs will be better able to support real-time aggregation of the comprehensive information that is crucial to improving ACO care coordination and efficiency.
VNA solutions to improve efficiency
As pressure to coordinate care intensifies and insurer reimbursement continues to erode, hospitals must find every way possible to become more efficient. The interoperability, data exchange capability and architecture of VNA solutions help organizations improve efficiency by:
- Streamlining access to imaging data and reports, inside and outside the enterprise.
- Enhancing communication between hospitals and referring physicians, which leads to better patient outcomes and increased referrals.
- Decreasing storage and archival costs by having current and historical images securely stored and accessible on the Internet.
- Ensuring 24/7 access and business continuity, which is not possible when a client-server system goes down.
- Improving compliance with federal and state regulations involving privacy, record retention and data security.
Roger Bird, M.D., is a neuroradiologist at St. Joseph's Hospital and Medical Center's Barrow Neurological Institute, which is recognized internationally for its pioneering neurological treatments, procedures and research into complex brain- and spinal cord-related diseases and conditions. He also is a co-founder of DICOM Grid, a healthcare IT company dedicated to making digital medical imaging accessible and affordable to all medical facilities and physicians by leveraging cloud SaaS (software-as-a-service) technology.
by Roger Bird
This lack of standardization and interoperability, combined with data security issues, makes it nearly impossible for facilities to assemble a complete imaging record for a patient at the point of care or seamlessly share data with other providers outside their walls. As a result, diagnosis and treatment delays may translate to duplicate and costly imaging procedures and expose patients to unnecessary radiation.
Change fueled by health policy
Until recently, most organizations endured those clinical and workflow inefficiencies. However, with the government leveraging health reform to transform the health system into an interconnected and collaborative ecosystem, facilities are looking to integrate imaging systems and electronic health records (EHRs). The objectives are to improve access, reduce costs and function in an environment that requires providers to coordinate care across the continuum to avoid financial losses.
Vendor-neutral archives for seamless integration
As providers replace aging PACS solutions, they should consider vendor-neutral archives (VNAs). Unlike proprietary imaging systems, the open architecture of VNAs enables facilities to view and exchange studies regardless of the modality that created the images or where the images are stored. This makes it easier for healthcare organizations to integrate PACS, EHRs and other clinical and financial solutions in weeks rather than months.
Take it to the cloud
Providers also should look for VNA technologies that are in the cloud rather than locally hosted. Cloud-based VNAs offer hospitals much more functional and flexible systems, at a cost that can be substantially less than inferior client-server systems. The former does not require hospiatls to install special hardware or software; the middleware simply connects to other third-party applications. Users just need a PC and access to the Internet, which makes it easy for them to receive and transmit images and radiology reports to referral centers or any healthcare professional involved in the care of a patient.
VNA's role in meaningful use and ACOs
Currently, PACS, as well as radiology and cardiovascular information systems, are not part of meaningful use (MU), but are essential to high-quality diagnosis and treatment. Many healthcare stakeholders are pushing hard for the systems to be part of Stages 2 and 3. The industry will receive an early indication of whether those efforts are successful when the HIT Standards Committee releases recommendations for Stage 2 criteria by fall and Stage 3 later in the year.
Still, regardless whether imaging systems officially become part of MU, imaging should be a critical component of a hospital's IT strategic plan, particularly as it prepares to form or participate in an accountable care organization (ACO).
Under the emerging ACO care delivery model, hospitals must ensure physicians and other ACO partners can seamlessly access patients’ complete medical records in real-time to enhance quality, safety, coordination and cost effectiveness of care. ACOs that meet these goals and Medicare's quality measures will receive a portion of the savings they generate for the Centers of Medicare and Medicaid Services (CMS). Those that cost CMS money must repay part of the cost overruns. Organizations that deploy VNAs will be better able to support real-time aggregation of the comprehensive information that is crucial to improving ACO care coordination and efficiency.
VNA solutions to improve efficiency
As pressure to coordinate care intensifies and insurer reimbursement continues to erode, hospitals must find every way possible to become more efficient. The interoperability, data exchange capability and architecture of VNA solutions help organizations improve efficiency by:
Roger Bird, M.D., is a neuroradiologist at St. Joseph's Hospital and Medical Center's Barrow Neurological Institute, which is recognized internationally for its pioneering neurological treatments, procedures and research into complex brain- and spinal cord-related diseases and conditions. He also is a co-founder of DICOM Grid, a healthcare IT company dedicated to making digital medical imaging accessible and affordable to all medical facilities and physicians by leveraging cloud SaaS (software-as-a-service) technology.