PACS is so turn of the century.
When we used to talk about Picture Archiving and Communications Systems (PACS), it tended to be a very siloed discussion. The conversation centered around medical imaging technology used for storing, retrieving, presenting, and sharing images but Cardiology had their own and Pathology, Radiology, the ED, and other surgical specialties had their own too. And nobody’s PACS talked to each other making the sharing of files clunky at best. Easy access within a health system’s EHR? Forget about it.
Today, we’re working with dozens of institutions on creating a roadmap for transition to Enterprise Imaging, establishing a set of strategies, initiatives, and workflows across the healthcare continuum to capture, index, manage, store, distribute, view, exchange, and analyze all clinical images and multimedia content. It’s centralized, it’s convenient, and in the end, breaks down department silos and makes the delivery of care better.
Enterprise Imaging relies on a unified archive or VNA (vendor neutral archive), bringing images together into one place making provider access possible through a single point of entry. VertitechIT Senior Solutions Director Steve Merritt is leading Enterprise Imaging implementation projects across the country. “If a Radiologist is looking for an echo study that’s traditionally stored in a Cardiology system rather than a Radiology system, this gives them access to be able to get to that image in a more unified manner so they’re not hunting around and searching for things, wasting time and wasting money, at the expense of patient care.”
Merritt says the value of a VNA has been gaining traction for the past several years and that looking at things across the enterprise is key. “That, and governance. Organizations considering an Enterprise Imaging solution must focus on workflow and make sure everyone has a seat at the table from the get-go. Compared to a traditional PACS, we’re multiplying the planning process by a factor of 10.”
But where do you begin?
First thing’s first. This is a journey not a project.
1. Begin by taking an inventory of existing sources of imaging across the enterprise. Break it down between diagnostics, procedural, evidence, and image-based clinical reporting.
2. Form a committee… a large one. Engage stakeholders to understand their needs and workflows for generation and consumption of imaging data. This should include clinical representation from Radiology, Cardiology, Oncology, Endoscopy, Orthopedics, Dermatology, ED, Women’s Health, referring providers, etc.
3. Create a strategy starting with a vision, mission, and goals. Take into account all stakeholders and come up with unified, concise reasons for undertaking the project in the first place. If this were a private company, think of this as your business plan.
4. Establish a governance structure for Enterprise Imaging. Program, technology, clinical, data, and financial governance are all important. Who pays for it? Who owns it? Who makes the decisions? Who is held accountable? It’s a shared service that impacts the P&L of many departments so governance is critical.
5. Align strategy with existing portfolios and determine an implementation roadmap. Take into account the existing set of capabilities first, then consider in flight projects, service line growth strategies and other enterprise initiatives.
6. Determine gaps, write a request for proposal, and evaluate potential solutions.
7. Once you select a vendor partner (the keyword is “partner,” not someone selling you a widget), you’re ready to execute.
Merritt says the biggest challenge beyond getting stakeholders across the organization to be a part of the process is interoperability, assuring the technology platform is agile and open to new functionalities. “Sometimes that means looking to smaller start-ups or even internally if the big players in the market don’t have the complete solution. Whether it’s for research or clinical use, Enterprise Imaging isn’t talked about as often but when you start unifying all this data, it makes it much easier to collate that information for everyone.”
Breaking down silos and fostering collaboration. What a concept.