A Vendor Neutral Archive (VNA), according to Mike Cannavo of Image Management Consultants, is defined as a standards-based archive that works independent of the Picture Archiving and Communications System (PACS) provider storing all data in non-proprietary, interchange formats. A VNA also provides context management so that information can be transferred seamlessly between disparate PACS. A VNA provides the following requisite functionality:
A Digital Imaging and Communications in Medicine (DICOM) storage platform that stores DICOM as it is received, unchanged and with all proprietary and optional DICOM tags present
Consolidation of multi-departmental imaging centers
The ability to morph DICOM header information so that they are “standardized” between facilities
A shareable database that is easily queried by different PACS vendors
Stores all DICOM SOP classes, and
The ability to import and export data in DICOM format
Myth #1: Vendor Neutral Archives are actually vendor neutral
The name is misleading. How does anything procured from a single vendor become vendor neutral? Every vendor has some proprietary mechanism or confidential code that makes the VNA not a VNA. The VNA uses a database to store the data and while it may be a commercial database, the schema and structure would be proprietary.
Maybe a better name would be PACS neutral archive as the intention of the VNA is to enable sharing of medical images between disparate PACS products. The only true VNA would be one acquired through Open Source methods like Source Forge or Tigris . The key to VNAs are the ability to accept the data in a non-proprietary format and to be able to ensure that the data can be shared between applications and users. Providers should look into the technical aspects of how their data is being stored and the efforts required to share it.
Myth #2: Purchasing a Vendor Neutral Archive means never having to migrate data
I don’t understand this claim. Data is stored on disk and information is recorded in a database. When a DICOM image has some form of structural change made to it, the typical workflow involves HL7 messages updating the database. DICOM headers are not changed - the change is recorded in the database.
What happens when the provider gets tired of working with their VNA partner (it does happen, you know)? If the hospital wants to move to another vendor they’ll need access to their data. If they just migrate the DICOM data from disk to disk all of the structural changes (merges, splits…) would be lost. Databases need to be updated. When a new VNA is installed, then the PACS that feed it need to know where the new data is; in fact, they need to know what data IS available. So how does a VNA eliminate the need for migration?
Myth #3: Infrastructure vendors can’t provide VNA functionality
If vendors can provide Vendor Neutral Archives, why can’t infrastructure vendors like Hitachi provide the same functionality? While a traditional PACS vendor understands DICOM and medical imaging, Hitachi understands the nuances of sharing data and the utilization of metadata to better utilize the information generated.
Hitachi’s capabilities expand beyond the medical imaging departments to other aspects of the hospital to include applications like SharePoint and Exchange, not to mention non-DICOM formats generated from laboratory, pharmacy and hospital information systems. What PACS vendor can make that claim - without DICOMizing the data? As we talked about in the previous blog post - Hitachi’s command of metadata is driving change throughout the provider space to maximize the use of information.
Myth #4: To implement Electronic Health Records (EHR) effectively, there needs to be an enterprise imaging archive that can consolidate all the different departmental systems.
OK - this is partially true. To enable access to the medical imaging component of the EHR, an enterprise imaging archive would make things easier. However, the imaging component only accounts for 20% of the patient information (it represents 60% of the storage requirements). Almost 80% of the patient’s medical record information is from sources other than medical imaging. Being able to consolidate information from all departments is critical to developing the EHR.
Providers need to look beyond the medical imaging component and ensure that when they are making infrastructure decisions that will support an Electronic Health Record incorporating all aspects of the hospital, not just medical imaging.
Myth #5: Hitachi Data Systems is a storage vendor, not a VNA provider
Hitachi has been around for over 100 years and has been involved in many aspects of healthcare. This experience has led to a deep understanding of how today’s challenges need to be addressed. Providers need solutions that help them solve the challenge of interoperable data between applications. They need to be able to build an infrastructure that will support their EHR strategies while delivering cost effective solutions. Hitachi has developed solutions that will enable the virtualization of information between these silos providing access to the EHR, portals and the longitudinal patient record.
Hitachi Data Systems will be at HIMSS 2011 in Orlando, Florida February 20-24 in Booth #6742, where we will make an exciting announcement. Hitachi’s capabilities around managing metadata from disparate information silos across a healthcare facility will be highlighted in Hall A (EHR/EMR, Booth # 263) on Monday, Feb 21st, 1:30 - 2:15 p.m. Come out and see how Hitachi is addressing the challenges faced by providers.