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DIGITAL TECHNOLOGIES


Medicine (DiCOM) image exchange with other systems, but also facilitate the sharing of non-DiCOM images from other parts of the organisation or external parties.


Digital health strategy


Universal viewing technology can also help untether images from PACS workstations, for example by providing radiologists with “anytime, anywhere” access to diagnostic images. Enabling clinicians across the organisation to view medical images is a key precursor to a unified digital health strategy, as it helps to facilitate clinical collaboration while eliminating the need to burn images to CD, DVD, or from device to device. Meanwhile, storage platforms can be a disruptive technology, often resulting in upgrades every four to six years to meet increasing system demands and overcome costly storage maintenance that can result from legacy platforms. As a result of an increasing number of patient examinations to a growing number of images per appointment, coupled with new storage systems and upgrades, reinvesting in PACS is both necessary and required to maintain necessary quality and efficiency. However, upgrades of these storage solutions can be expensive, and maintaining traditional


proprietary PACS just adds to this cost. Exacerbating these challenges further, data migration is also needed as PACS become outdated and require upgrades or need replacement, which can be a time-consuming process, and very costly from both a financial and resource standpoint. Hospitals are already starting this process but would be well advised to look at alternatives based around centralised – or cloud - storage, and universally compatible enterprise imaging software. For example, radiology department typically change or modify PACS on average twice a decade. This traditional archive strategy, including conversion, migration, and project management, costs organisations millions. However, healthcare delivery organisations such as The Children’s Hospital of Philadelphia, have reported a savings of nearly $3 million over five years by adopting a universal enterprise image viewing strategy.


Vendor neutral archive


At the same time as addressing the PACS cost conundrum, healthcare organisations must shift from departmental views of medical images to a unified, enterprise solution that delivers a unified view of all medical images. Implementing a vendor neutral archive


(VNA) can be an effective first step to lowering this overall spend and move beyond a PACS-only approach to medical imaging.


A true VNA is a mature technology that can be implemented either in conjunction with traditional PACS or increasingly, as a replacement to traditional PACS solutions, to improve access and significantly reduce storage and migration costs. Importantly, it can eliminate vendor lock and block, improve data and imaging exchange, consolidate and centralise imaging storage and improve overall IT management.


Evolving demands for imaging


It’s clear that PACS is no longer enough to fulfil today’s evolving imaging demands, while its cost-saving credentials have been reversed. Healthcare providers should therefore look to implement enterprise- imaging technologies that can complement and optimise existing PACS investments. By providing effective enterprise access to medical imaging information, clinicians gain a more comprehensive view of their patients that can improve treatment and diagnosis. Improved image visibility can also enhance care and reduce costs by eliminating nuisances, such as unnecessary repeat imaging tests.


The VNA and enterprise imaging approach does not need to be implemented over a challenging project timeline, or require a huge initial investment. Indeed, change is best rolled out in an evolutionary rather than revolutionary manner, allowing for adaptation as stakeholders come on board and are emboldened by the usability of the new system to seek new ways of working. The changes will be cultural as well as technological, as increased inter- departmental collaboration becomes possible and clinicians are able to channel their expertise to colleagues with ease, using from portable devices to share content. Further upgrades can then be introduced as required - for example, by replacing PACS in radiology with a true VNA that allows easy sharing and use throughout the organisation and beyond. Or, more specialised and smaller departments can lead the process, with lessons learned then passed on to larger divisions. While the roll-out may be gradual,


An enterprise imaging strategy, underpinned by a centralised system such as the one in the earlier example will produce benefits and savings immediately.


56 I WWW.CLINICALSERVICESJOURNAL.COM


however, some benefits will be felt immediately: once an organisation has committed to the enterprise image approach, any technology issues that do arise can be addressed with the flexibility that brings. A hospital or healthcare group that is using enterprise imaging will have full freedom going forward: freedom to choose hardware and software vendors across the full market spectrum; freedom to pick the solutions which are best for each department and group, without worrying about compatibility; and freedom to access and use all its legacy PACS and other DiCOM images, without the need for expensive migrations and storage upgrades.


CSJ MAY 2019


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