In order for enterprise imaging departments to move forward on the journey to value-based care, diagnostic imaging department leaders will need a plan to address the seven challenges to enterprise imaging, identified by the Society for Imaging and Informatics in Medicine (SIIM) and the Healthcare Information and Management Systems Society (HIMSS). We discuss four of the challenges today and potential solutions to address them below.

1. Linking Reports to Images

The reports and documents associated with images provide crucial context, and the radiology reporting workflow and requirements are well understood. But in other departments, a “report” could refer to any text that should accompany the image, for example a note on an operative photo or a referral letter from a dermatologist. These documents need to be added to a patient’s record and associated with the correct image.

Potential Solutions:

Four Strategies to Overcome Enterprise Imaging ChallengesIdeally, all clinical systems would let users associate images with reports throughout the workflow, regardless of when the report is generated. But many solutions can’t easily create an association between an image and multiple reports. This issue is exacerbated in departments that don’t use an order-based workflow. As encounter-based imaging becomes more common, solutions will likely follow suit with more functionality to address this issue.

2. Managing Metadata

Metadata also adds context to images and is automatically associated with DICOM images, like those used in radiology and cardiology. But as organizations implement enterprise imaging strategies, they’ll need to consider how to treat non-DICOM images. As different image types become part of the patient record, consistent standards for metadata should be created to complement the standardized workflows.

Potential Solutions:

The best way to solve this problem is for departments to collaborate and establish standard lexicons and relational structures to the metadata that is collected. Potential types of standardization include:

  • Body part
  • Procedure description
  • Department
  • Imaging Source

Since crossing organizational barriers can prove challenging, it can be useful to engage internal or outside resources to help them examine their overall strategy. This step can offer much needed perspective and insight on how to solve cross-departmental issues.

3. Legal Concerns

Legal concerns related to diagnostic imaging arise in multiple areas – including privacy, image fidelity, and others – and questions around maintaining and storing images require awareness of both the legal and technical perspectives. Often, facilities retain the vast majority of the images they create. But the increasing size of image datasets demands more storage, which in turn adds cost and complexity to an organization’s infrastructure. While there are devices – vendor neutral archives (VNAs) – that have the capacity to store all this data, in a medical context, does it make sense to keep everything?

Potential Solutions:

When organizations are implementing VNAs, they can also develop policies that define how long images should be retained. These policies can be driven by local legal requirements or by internal needs, and they might vary between departments. To support a health system’s legal and technical concerns, a VNA needs the ability to create and apply retention rules that are governed by facility and jurisdictional requirements. Additionally, it’s important for a VNA to support dynamic storage expansion regardless of location – whether it is local or in the cloud.

4. Mobile Device Use

Providers are increasingly using smartphones and tablets to capture patient data. Since most mobile devices are designed to enable information sharing, this practice highlights concerns about patient privacy. Rather than discourage the use of mobile devices entirely, health systems will need to acknowledge their use for clinical purposes and enact policies that protect patients and themselves.

Potential Solutions:

An FDA-cleared zero download viewer gives physicians access to images and diagnostic tools from any web-enabled location, including mobile devices. Solutions that offer server-side rendering help ensure the safety of PHI as no data is moved or transferred to the end-user device. When they are designed with a secure architecture, mobile viewers allow for ease of access without compromising patient privacy.

As you develop your enterprise imaging strategy, think about each of these challenges and how they might arise in your individual situation. While that prospect may seem daunting, the good news is that once your strategy is in place, it will enable collaboration and communication that drives quality care. These challenges are merely opportunities waiting to be addressed.

This post originally published as 4 More Ways to Overcome Challenges in Enterprise Imaging on the Medical Imaging Talk blog on November 10, 2016.

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Erkan Akyuz

About the author

Erkan Akyuz is president of Imaging and Workflow Solutions (IWS) for McKesson Technology Solutions. In his role as president, Akyuz interacts with customers on a daily basis and provides new opportunities for customers to learn about enterprise medical imaging technologies and achieve their healthcare IT objectives.