Getting the Most Out of RSNA By Using the RSNA 2013 Mobile App

Rich Pulvino, Digital Media Specialist, Carestream

Rich Pulvino, Digital Media Specialist, Carestream

Last year, we wrote a blog post detailing how to get the most out of RSNA using social media. Those tips are still accurate and make for a helpful guide before, during and after the meeting. This year, I’ve spent some time going through the RSNA 2013 mobile app (available for iOS and Android mobile devices) and see it as being a vital tool any attendee  can rely on at the event. The rest of this post will outline my personal favorite features of the app that also serve as being the most helpful to you while on-site.

App

1) Meeting Program: Select and manage your schedule using the meeting program feature. This provides a list of all of the meetings available for attendees, which can be a daunting list to manage. Once you arrive, you can bookmark the meetings you want to attend and then this will funnel into the “My Meeting” tab at the bottom of the app.

App Home 2

Once your schedule is selected, it will be loaded into “MyMeeting,” which you will find at the bottom of your screen. With “MyMeeting,” you will receive alerts about your selected meetings so you do not miss any on your list.

Meeting Program 2My Meeting

2) Virtual Meeting: Missing a meeting you had on your list to attend? The Virtual Meeting featured has you covered. As an RSNA attendee, all you need to do is enter your badge number and password (which is your last name by default) and you will gain access to the virtual meetings that RSNA will be streaming throughout the show. These virtual meetings will also be available on-demand through December 13.

App Home 3

Sign in screen

3) Info: This area will be key because it provides numerous resources devoted to transportation , McCormick Place dining, tours and events happening in Chicago, and RSNA Services that are designed to provide you with the best meeting experience possible.

Info

Additionally, you’ll want to remember the “Maps” tab to navigate the vast landscape RSNA covers.

Maps 1

Map 22

Map 2

4) Technical Exhibits: You can search exhibiting companies through by extensive list including “Featured Exhibitors,” “First Time Exhibitors,” donors to the RSNA Research & Education Foundation, or by product categories. This way, if you have specific products or services you need to research or demo while at the meeting, it can all be bookmarked in one, easy-to-find location.

App Home 22Technical Exhibitors

Product Categories

Finally, be sure to follow RSNA on its social networks in order to get real-time updates on news and happenings at the event throughout the week. The most up-to-date, real-time news will be posted on the organization’s Twitter and Facebook accounts, but also be sure to follow RSNA on YouTube and LinkedIn so as not to miss out on anything.

Carestream will also be one of the many organizations active on social media throughout RSNA. You can follow us on Twitter, Facebook, and YouTube where we will be posting interviews and updates, and you can stop by our booth, #4111 in South Hall, to say “Hello.”

See you at RSNA 2013!

Cloud Computing Moving to the Business Leader’s Agenda

Jeff Fleming, Carestream’s Vice President, Healthcare Information Solutions Sales and Service, US & Canada, Carestream

Jeff Fleming, Carestream’s Vice President, Healthcare Information Solutions Sales and Service, US & Canada, Carestream

A recent post on IBM’s Thoughts on Cloud blog caught my attention. Titled “Running at the Speed of Cloud,” the post reported results from a recent study by the IBM Center of Applied Insights of more than 800 cloud decision makers and users—finding that “pacesetters” are separating themselves from the pack by leveraging cloud for business transformation—not just IT transformation.

It’s this different viewpoint that is also moving cloud computing discussions and decisions from the IT department to the C-Suite boardroom. IBM’s study predicts that by 2016 cloud will matter more to business leaders than to IT.

Cloud’s strategic importance to business leaders is poised to double from 34 percent to 72 percent – blowing past their IT counterparts at 58 percent. ~ IBM Center of Applied Insights, “Under cloud cover: How leaders are accelerating competitive differentiation,” October 2013.

As our team meets with healthcare CIOs and CEOs, this is definitely a shift we’re starting to see as well. The current dynamics in healthcare have business leaders evaluating the cloud as an enabler of new care models, better decisions and collaboration.Cloud

Has the cloud made it to your C-Suite’s agenda? Here are my three tips for discussing the cloud with healthcare business leaders:

  1. Refocus the conversation – Avoid leading with the expense of purchasing, maintaining and managing hardware and software.  Identify opportunities for competitive advantage that can be achieved through cloud computing like the ability to drive deeper collaboration, make better decisions or change care models. For example, consider how cloud technology can play a role in reversing referral leakage or arming you with better big data for clinical decision support.
  2. Map to other priorities – Tie your cloud pitch to other business priorities and the ability to respond more quickly. For example, how could the cloud support your participation in an HIE? Or could your organization more rapidly react to patient demand for online image access and stage 2 meaningful use requirements with a cloud service for image sharing?
  3. Introduce potential for new services / business models – Explore how the scalability of the cloud can open the door to new markets and target segments grow revenue in light of changing reimbursement models. For instance, could your radiology department expand and leverage cloud services to take on interpretation and official reporting for urgent care centers in the surrounding area?

Is the cloud’s perceived value for your organization currently too narrow? Let us know your thoughts in the comments.

RSNA 2013: Right for Today, Ready for Tomorrow Thanks to Modular Solutions

Helen Titus

Helen Titus, Marketing Director, X-ray Solutions, Carestream

As much as we sometimes wish it would, unfortunately, nothing lasts forever. Don’t forget to include medical imaging and health IT equipment in that saying too. Technology moves fast. Radiology departments need to be aware of the solutions that are most appropriate for their facilities, both in terms of providing the best care for their patients and for their wallets. X-ray system and health IT solutions are no small purchases, and radiologists and radiographers alike need to be assured that the purchase is worth the investment.

At Carestream, our saying is that our medical imaging solutions are “Right for today. Ready for tomorrow.” We do not want radiology departments to buy a piece of equipment and then need to purchase a new one before its end of life. The facility and vendor should be working together to find the right fit so that the X-ray and IT purchases are future-proofed.  The mission should be to provide facilities with a bridge that appropriately provides the radiology department with the right technology at an affordable price, and also having them prepared for technological needs they will experience down the road. This means that the technologies that acquire and store images will be accessible and relevant in the future, and that the inevitability of changing needs and advancing technologies does not make current investments obsolete.

When implementing modular systems, users can expect to experience three main benefits:

Cost control: Because of modular capabilities, funds are only spent on the technologies needed instead of additional costs spent on hardware or software that is not needed, but cannot be dissociated from the original technology.Digital Continuum

Agility: Efficiency, flexibility—both of these also work as appropriate descriptors of modular solutions. One main purpose behind purchasing modular solutions is that they have the ability to be switched around and used with a variety of systems, no matter the vendor. For example, our DRX-1 wireless digital detectors do not have to be used on only a Carestream DR system. Sure, we’d prefer it that way, but for the sake of agility, the DRX-1 detectors work with the X-ray systems of other vendors. This agile capability means that you can purchase the detectors necessary without having to buy a new X-ray system.

Improved patient care: While the cost control and agility ultimately helps the healthcare facility, the improved customer care experienced through modular solutions is noticeable and vital. With the improved efficiency created thanks to modular systems, healthcare providers are able to capture, collect, analyze and access information much faster without compromising the quality of care. Thanks to the ease of implementation, healthcare providers can effectively install new technologies without breaking the bank. Certainly a win-win situation for the providers and the patients.

On December 2 at RSNA, I will be leading a session that will showcase examples of X-ray and health IT purchases that are modular to enable growth and expansion as technology and clinical needs change. The presentation will include examples illustrating clinical users’ experiences. The systems they use represent next-generation technology that helps avoid major platform upgrades, which are often time consuming and expensive.  Joining me will be Cristine Kao, who is the global marketing manager for our HCIS division. Together we will explain how organizations can set up their imaging departments in a way that makes right for today and ready for tomorrow a reality.

The session is expected to be heavily attended by RSNA attendees looking to gain objective insights on migrating from outdated X-ray and IT systems to powerful modular platforms that easily expand to offer new capabilities and services. Ample opportunity for audience participation will be a featured part of this session.

RSNA 2013: Mobile Connect —Image Viewers & Patient Access for Radiology

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

The patient has been an important focus in radiology throughout 2013. Dose efficiency, smart imaging, quality care, patient engagement and patient access have been hot topics and it has been fascinating to follow the trends and technologies being developed as the healthcare landscape changes at a consistently rapid pace. Focusing on healthcare information solutions, patient engagement and access have always been near and dear to me.

We made it a priority in 2013 to investigate the patients’ relationship with their radiological images and where the portals/access points fit into the healthcare process. The goal was to learn how patients truly feel about these technologies empower them with more medical information by providing access to it. One example of a valuable discovery we made showed that age plays no role in determining whether or not a person will want to use a patient portal—59% of respondents over the age of 71 said they were very likely to use an image portal.

We also found that patient portals can have benefits for physicians and radiology practices too.  Out of the 1,000 respondents, 79 percent of patients would be more likely to return to a facility that offers online image portal and 76 percent indicated they would recommend the facility to others. From statistics such as this, is has become clear that patient portals are becoming a vital component of both the radiology industry and patient care process.Vue Motion

Patient portals will need to be intuitive if physicians are to ensure they are providing the most value to their patients in terms of care. Studies have shown that if a technology is difficult to understand or learn, then users are likely to be turned off from it for good. For the patients to have the ability to use the technology, physicians must be able to explain its use simply with limited steps.

Additionally, the portal, since it is a zero-footprint technology, means it can be embedded to an EHR patient portal. This provides a significant value for the patient as they would log onto a single portal from their care provider, and while they are requesting appointments and paying bills, they can also view their imaging results. When it comes to providing value for the patient, with this integration, zero-footprint capability, vendors are ensuring that imaging does not become a stand-alone technology.

As an add on the the zero-footprint feature, portals also must be easy to access for the patients. Building these portals with HTML5 ensure that the patient can access the information via a variety of devices: desktop, laptop, or mobile device. As opposed to portals built as mobile applications, a HTML5, browser-based portal makes accessibility almost ubiquitous—by building portals using HTML5, the portal may be accessed using any browser that supports the coding language.

On Monday, December 2 at 9:00 a.m. in the Lakeside Ballroom, I will be participating in the RSNA Mobile Connect area by demonstrating the Carestream Vue Motion and MyVue patient portal technologies. With VueMotion, the medical image viewer for clinicians and physicians, I will also be showing the new 3D capabilities built into the iPad viewer (currently a work-in-progress) that we are premiering at RSNA 2013.

The Mobile Connect area will have technology experts on hand to help physicians get the most out of their mobile devices. In addition to one-on-one assistance for mobile device users, this area will feature a presentation area highlighting a diversity of mobile topics.

Tracking Effects of X-ray Radiation in Children

Helen Titus

Helen Titus, Marketing Director, X-ray Solutions, Carestream

We have known for some time that children are more sensitive to radiation than adults. And because children have less overlying tissue, the same exposure results in higher radiation doses to their organs than for adults.

Now a new study quantifies the risk levels for specific types of cancers. A report from the United Nations Scientific Committee on the Effects of Atomic Radiation states that children exposed to radiation were more likely than adults to develop specific cancers, including leukemia and thyroid, breast, and brain cancer.

The report also stated that the risk for about 15% of tumors, including those of the colon, was about the same in children and adults. And for about 10% of tumors, including lung cancer, adults were more sensitive.

Healthcare facilities across the globe are focused on reducing dose for pediatric patients across all X-ray modalities. For projection radiography, lower dose is enabled by highly sensitive, cesium iodide digital detectors that can capture high-quality images with less radiation. In addition to standard-size detectors, new small-format detectors that can fit into incubator trays and be used for a variety of exams enhance image capture for delicate premature and neonatal babies.

An ECRI study also highlights the risk of radiation to children and suggests minimizing exposure to high doses of ionizing radiation by use of nonradiation-bearing imaging exams, such as MRI and ultrasound, when appropriate. Providers should also limit use of CT to cases where other modalities cannot provide the required diagnostic information.

Healthcare providers are also starting to measure and track dose for pediatric and adult patients. New software is being developed to collect and distribute dose information from CR and DR systems to a healthcare provider’s PACS. This new software will help expedite the ability to track dose values for each patient. Healthcare providers will also need to track dose for CT, nuclear medicine and other modalities.

In addition to reducing radiation exposure, the ultimate goal is to create a cumulative dose record for each patient. Both healthcare providers and equipment suppliers are working hard to make this a reality.

Does your institution have imaging guidelines for pediatric exams that are designed to reduce dose? And are you tracking dose for pediatric patients?

RSNA 2013: Preparing for the Annual Feast

Cheryl Proval, Vice President, Publishing, imagingBiz, and Editor of Radiology Business Journal.

Cheryl Proval, Vice President, Publishing, imagingBiz, and Editor of Radiology Business Journal.

When viewed over time, the themes that have marked the annual meeting of the Radiological Society of North America might be seen as signposts indicating the way forward for radiology. From Personalized Medicine in 2010, to Celebrate the Image in 2011, and Patients First in 2012, we can witness radiology moving from an internal focus to a more outward-facing stance.  In 2013, the RSNA signals an even greater transition ahead with its Power of Partnership theme.

Expect the theme to recur throughout the meeting, with several keynotes exploring the potential of clinical partnerships both within and outside the specialty, to improve, optimize, and perhaps even revolutionize patient care.

As medicine grapples with the transition to new payment models on the business side, I see partnership (and its corollary, collaboration) as one of the most potentially transformative concepts working in medicine today.

The trend is evident in the consolidation occurring across the health-care landscape, as former rivals become partners in community health. Not all of these partnerships involve the integration of assets; some simply entail shared mission and IT resources, proving that there are multiple ways to partner.  How well diverse organizations work togethRSNA2013_RGB_Logo_Dateser to deliver health care more effectively and efficiently has great bearing on the future viability of our hospitals.

The same principles likely are at work in the vendor community, which is subject to many of the same forces that are reshaping health care providers: regulatory change, diminishing reimbursement, the need for economies of scale and better access to capital, and the emergence of new, disruptive business models.

Aside from the above pressures, radiology practices are experiencing the additional threat of commoditization.  Everyone who works in radiology understands that there is tremendous variation and complexity involved in the practice of radiology, hardly a ripe environment for commoditization—one would think. Nonetheless, the perception is real, and there are limited clinical quality metrics to counter that belief.

How practices employ the “power of partnership” to combat this perception and to weave themselves into the fabric of care at every level will determine whether the specialty continues to prosper. I see inspirational examples of radiology practices working with other specialties to develop clinical care pathways and standardize imaging protocols. I hear encouraging stories about how practices are working in partnership to develop external as well as internal peer evaluation and other methods of cross-practice quality collaboration. I think that radiology has a great deal to offer its partners in care.

While I often sit on the sidelines and make observations on subjects that others must grapple with, the issue of partnership is one that I will actively live and explore in 2014. The company I work for, imagingBiz, publisher of Radiology Business Journal and a portfolio of digital journals, has merged with TriMed Media, publisher of Health Imaging, and other publications. I have a head start, as I have grown to respect my new partners over the years: We have worked together beneath one banner in the past and competed for business under separate banners more recently.

If radiology does not exactly resemble the Peaceable Kingdom, that is nonetheless a lovely image to take into the Thanksgiving holiday and on to Chicago, as we all investigate partnership and collaboration as a means to succeed, prosper, and meet health care’s new challenges in the year, and years, ahead.

Big Data, Big Opportunities – Identifying Use Cases before Requirements & Gaps

Steven F. Fischer, CIO, Center for Diagnostic Imaging, Minneapolis

Steven F. Fischer, CIO, Center for Diagnostic Imaging, Minneapolis

Buoyed by the April 2013 McKinsey & Company report titled “The ‘big data’ revolution in healthcare: accelerating the value and innovation” many healthcare leaders are pushing their teams to harness big data to drive innovation and change in how they care for patients.  But much of the discussion at medical conferences, and in the media focused on the challenges of managing and using immense quantities of data, healthcare’s lack of preparedness and roadblocks hampering big data’s use.

The Institute for Health Technology Transformation (iHT²) recently gave me an opportunity to present a different viewpoint in their Big Data, Big Opportunities Webinar. Joining me was Chris Gough, Lead Solutions Architect, Intel Health & Life Sciences, to share our positive experiences as first movers in big data.

You can download our full presentations and the interactive Q&A here.

Beyond demonstrating that healthcare’s big data potential is achievable, there was a common message in both CDI’s and Intel’s projects – big data success was dependent upon a clear definition of a use case before requirements, gaps and technology solutions were developed.

Both Chris and I know organizations that sent their IT staff to expensive, intensive training courses or restructured resources to start up a big data cluster in their data center.  But when asked about their strategy a common response is “Not sure. We just know we need it.”

Without a real organizational question you want to answer, big data will be a big problem.

Webinar attendees were urged to focus their efforts around a defined use case and where possible, to resist letting the regulatory complexities of today’s environment hinder their ability to be proactive versus reactive with big data.

Let’s look at some of the big data use cases / opportunities for providers:

    • Clinical Decision Support Models – Systematically reviewing clinical data and making treatment decisions based on the best available information.  Tracking similar conditions and outcomes to establish treatment protocols based on evidence.
    • Population Management – Aggregate individual data sets into larger samples to identify opportunities to change population behavior and bring down costs.
    • Risk Stratification – Compare past patients to current patients and segment those that are high-risk, high-cost and resource intensive to determine which patients require high- touch care.
    • Patient Engagement – Tracking consumer social media behaviors to understand their preferences and shape a patient engagement strategy

Only with a defined use case can you understand what to collect, where it resides and what to analyze. Then you can determine your data requirements, gaps and the technology solutions you’ll need to be successful.

Make sure your teams not only understand the data and how it’s structured, but also the process. Significant work will likely need to be done on data normalization and rationalization to ensure that data from different systems translates apples to apples.  A really good analytics tool will help you review the use case requirements and identify the data gaps so you can close them before you begin. You may have to bite the bullet and determine how to get the information you need into data stream upfront.  Review or define your data management policy before tackling anything.

Where possible smart small, but think big. Consider a phased approach that leverages your existing investments and infrastructure. This allows you to scale out versus up and is an easier framework to accommodate growth.

Pursuit of MORE: Ferrara Hospital Sees Success with Patient Portal

Fabio Tigani, HCIS Sales Manager, Italy, Carestream

Fabio Tigani, HCIS Sales Manager, Italy, Carestream

Ferrara Hospital in Italy is an impressive healthcare facility that treats a large volume of patients spanning a wide geographic region. The healthcare provider serves a population of about 350,000 and provides about 15,000 radiographic exams each year across its 10 diagnostic rooms.

In 2012, Ferrara Hospital conducted a trial test of the MyVue patient portal. The organization believed the conditions were right for this trial as more patients were becoming invested in their own healthcare. The portal gave would ultimately give users the ability to view their own radiological exams and reports. The ability to access these images and reports provides patients with a close connection to their own radiological procedures, and hence to their clinical pathways. Exams became easier to access with just the click of a mouse.

The trial with Ferrara began with MRI exams and extended gradually to other patients. As proof to how intuitive and helpful the portal was to the users, by the end of the trial, more than 98% of patients who participated were so enthusiastic that they decided to continue using the technology.

The main reason that Ferrara Hospital wanted to participate in the MyVue trial was the because of the possibility of making diagnostic medical imaging more efficient. Healthcare providers recognized the potential for several advantages.

  1. The patient portal was able to provide a direct link between the patient and the radiology department, enhancing the relationship between patient and healthcare provider.
  2. Patients found navigating the portal to be as easy to understand as it is to access their files.
  3. Patients are informed upon examination and receive a series of notifications that alert them to updates such as new images/reports to view

When patients began the MyVue trial, clear and complete navigation tips and instructions provided. After access their images, patients then had the ability to save the files to their computer, copy them to a DVD, all while fully maintaining patient confidentiality. If they wanted, patients also had the ability to access the portal via an iPad in addition to their computer.

Patients were able to completely navigate the MyVue patient portal via a self-guided tour that required no special knowledge, and contained explanatory windows in each section so users could easily understand functionalities. After the trial, Ferrara Hospital felt confident that is was on track to prepare in becoming a radiology department built for future needs, both for the patients and the radiologists.

For more details about how you can empower your patients through the use of a patient portal, such as MyVue, you can download a free ebook, “The Pursuit of MORE: Patient Empowerment.”

You can also watch the case study about Ferrara Hospital’s MyVue trial below:

[youtube=http://www.youtube.com/watch?v=suxwkjcpNtM&w=560&h=315]

International Day of Radiology: Recognizing the Importance of Radiologists and Medical Imaging

Andrew Hartmann, General Manager, Global X-ray Solutions, Carestream

Andrew Hartmann, General Manager, Global X-ray Solutions, Carestream

Thanks to the European Society of Radiology (ESR), the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), we are proud to be celebrating the second International Day of Radiology (IDoR) today. This day was created last year with the following mission, according to the IDoR website:

“…aim of building greater awareness of the value that radiology contributes to safe patient care, and improving understanding of the vital role radiologists play in the healthcare continuum.”

This is an initiative that many associations and organizations within our industry can get behind, but we are especially proud of the focus of IDoR 2013: lung imaging. Our enthusiasm in this area of medical imaging tends to be focused on lesion management, an application that is part of our Vue PACS offering, and one that is certainly of the utmost importance to the technicians and radiologists who are analyzing and tracking these measurements for their patients.

For radiologists, it is not only the image that is of importance. Reporting and analytics are now just as, if not more, important than the image itself because it provides the data that leads to the appropriate diagnosis for the patients. Lesion management is a key component of that data because it offers comparisons between localization, measurements and follow-up data. The main goal is to eliminate inaccuracies in diagnoses, so with these capabilities, on the top of the ability of the radiologist to leave comments and bookmark data, the odds of avoiding inaccuracies are improved.IDOR_Logo_rgb_ESR

At its core, IDoR is about providing the best quality of care to patients. In lung imaging, the ability to rely on lesion management stems allows radiologists to track the growth or shrinkage of a lesion over time. Once measured, recording and reporting the details becomes essential, particularly when the radiologist needs to share this information with other physicians. The communications and collaboration between physicians, related to the lesion data, is what ultimately provides the patient with a diagnosis that is timely and accurate.

In addition to lesion management, a collaborative project between the University Health Network (UHN) and Carestream is investigating the potential for a simpler and cheaper technology called tomosynthesis to provide improved detection of lung diseases in the developing world. The project is also exploring the use of dual-energy X-ray imaging. This is a technique that uses two X-ray images acquired at different energies (kVp) are combined to produce different images for soft-tissue and bone—results that can provide oncologists with a better view of the lungs to make a proper diagnosis.

On this International Day of Radiology, we are proud to be part of an industry that plays such a vital role in patient care. In a few short years, we have seen impressive advances in medical imaging technologies that have led to better and faster diagnoses, and it will only be more interesting to see where the industry will be in a few more years.

RSNA 2013: Three Considerations for Mixing “Ologies” in Image-Enabled EHRs

Doug Rufer

Doug Rufer, Director Technical Marketing and Clinical Sales Engineering, Carestream

Many sites that have successfully implemented certified EHRs have evaluated or potentially integrated a medical imaging portal to view images and comply with the image access measures in Stage 2 of Meaningful Use (MU) standards.  This exercise likely included tackling a major “ology” obstacle – how different departments like radiology, cardiology, oncology, etc. store, retrieve and share information.

At most hospitals today, each “ology” owns their own domain and silos of information with no cohesion and little sharing of information across departments.  Not only did each department find their own independent storage and viewing solution based on their immediate needs, but departments also routinely competed with each other for precious dollars to expand their domains and many times, cooperation between departments was non-existent.

These turf wars must come to end and a common backend and synergistic viewing platform must be built to adapt to the shifts occurring in our healthcare system today, meet the demands of MU standards, and improve patient care.

As you begin to plan your enterprise-wide imaging strategy, consider these three components:VNA

  1. Implementing a Vendor Neutral Archive (VNA) for storage across “ologies” – Consolidating disparate imaging systems from different departments into one repository using interoperability standards is a critical step to building a unified back-end that allows multiple domains to remain independent.  A single archive drives costs down, fosters continuity within an organization and can help clinical users get a unified view of patient clinical information across disparate systems.
  2. Finding a viewer or portal to handle all image types for display and access – Stage 2 MU standards set a threshold of 10 percent or more of imaging results accessible through certified EHR technology. However, the standards clarified that images do not have to be stored in the EHR, but there must be a link to where the image and information can be accessed.  To comply, many providers will enable image access and sharing by pairing their VNA with a zero-footprint viewer that can be embedded in an EMR system to provide access to reports and images alongside the patient’s other medical information. Moreover, the viewer must provide access to DICOM, as well as non-DICOM image related data, such as JPEG images and PDF documents. The viewer’s use must not be restricted to a single department system or facility, but offer extensive compatibility to provide secure access to images across and beyond the enterprise.
  3. Determining an approach to assignment to patient longitudinal record – Even though VNAs solve storage problems, they don’t resolve the different workflows that exist across different departments.  And sure, multiple integrated viewers can give you secure access to images from a variety of departments, but  how does a caregiver view and compare multiple images across various “ologies” without  a common means to tie to images to a single patient?

Consider this: radiology has long used accession numbers, generated by orders input into a RIS, to deal with identification of images once acquired and stored digitally. Some organizations may require ancillary imaging departments to use the facility’s RIS system to generate an accession number so all images stored in a VNA have a standard numbering schema.  Other imaging modalities like cardiology or ophthalmology don’t use accession numbers and may not even require an order to acquire or store the image. Neither approach offers a viable solution because requiring an accession number could disrupt departmental workflow, and without an accession number or standardized numbering schema it is cumbersome to view a patient’s longitudinal imaging record and compare cross-department images.

One mechanism that can help bridge the gap between associating images to the correct patient and the workflow within individual departments is simply changing the method for retrieving those images.  Typically, providers will work off a worklist when selecting an exam or launch it directly from within the EHR based on the integration capabilities available today.  However, changing how data is retrieved via search tools could be one method to solve this problem in the short term.  Most search algorithms in today’s software are based on a structured search.  Data is stored in a relational database in a highly organized fashion with a specified data model.  For example, searching by a patient’s last name, accession number and birthdate.  All three data elements are exact and located in a specified area of a database. Using an unstructured search model may bridge the gap to finding different studies across various “ologies” while allowing the independent imaging departments to continue with their existing workflow. Unstructured searches query for information that is not well defined or organized and does not have a precise data model.  It can leverage “look ahead” capabilities, “term weighting” or semantic expansion (applying similar meaning words to the text being “searched”) to assist with patient association and retrieval.

You can be assured that as the field continues to evolve in our sophistication of patient healthcare access and sharing, new tools will become readily available to assist caregivers in their ability to see everything they need in a patient’s longitudinal record that is relevant to their current condition being treated.

Eliminating departmental silos of information should be an urgent goal for healthcare providers – of which storage and viewing plays a large role. But your image-enabled enterprise is not complete until you address assignment to and retrieval of the patient longitudinal record across “ologies” to deliver a cohesive, patient-centric view of medical data that allows caregivers to make better and more informed care plans.

How does your organization plan to address image access and sharing across departments?