NEW ORLEANS—Transitioning from siloed imaging to an enterprise environment delivers multiple benefits and costs can be reduced by leveraging existing technology, according to a March 4 presentation at the Healthcare Information and Management Systems Society (HIMSS) annual conference.
Daniel O’Malley, MS, director of informatics for radiology at University of Virginia (UVA) in Charlottesville, shared lessons learned during the academic medical center’s progress toward an enterprise imaging strategy.
Imaging is siloed at many academic medical centers, said O’Malley. However, UVA started transitioning to an enterprise model approximately seven years ago.
An enterprise imaging model can bring multiple benefits, according to O’Malley. These include making imaging data more easily accessible, meeting later stages of Meaningful Use, providing a more complete patient picture and delivering economies of scale.
In addition, as organizations build experience, a more mature enterprise imaging strategy, characterized by enhanced collaboration and exchange, or an imaging HIE, becomes possible. Other features of this third phase of de-siloed imaging include patient portals and imaging analytics.
After seven years, UVA has completed two of the three phases of the de-siloed imaging project and wrapped digestive health, fetal obstetrics, dentistry and radiation oncology into PACS. The first phase centered on DICOM modalities and imaging, which allowed EHR integration. The second, the vendor-neutral archive, added non-DICOM modalities and converged DICOM archives.
The process has been a partial success; imaging has been de-siloed, said O’Malley. However, the approach has forced clinicians in other specialties to employ a radiology workflow and begin the imaging process with an order, even for items such as digital photographs. And the center has not fundamentally changed how it uses PACS, he continued.
O’Malley concluded with suggestions for reducing the cost burden of enterprise imaging. “Take an organizational view and reuse, repurpose and recycle storage.” UVA redeployed excess radiology storage as a private cloud within the vendor-neutral archive.
Other strategies for bettering the bottom line include migrating "ologies" outside of radiology to the vendor-neutral archive before radiology and cardiology as these are likely to be more manageable, working with a vendor as a partner and scrutinizing service contracts.