As an industry, we should be long past the question of what we are trying to do; rather, we should be asking how, when and where. Your medical imaging vendor should be guiding you along this path. Unfortunately, in the medical imaging arena, some Picture Archiving and Communication System (PACS) vendors are notorious for being niche players. They know all the details of what to do at the radiology department level to improve workflow but get so caught up in those details that they fail to understand the big picture of how to spread imaging to the entire enterprise and when and where you store the vast amount of data. You need a medical imaging vendor who won’t miss the forest for the trees.
There are only a handful of companies, my employer included, that are translating their success with trees to the forest. McKesson, for instance, has a breadth of enterprise expertise including EHR adoption, billing and financials. We recognize how to economize and be effective in the ‘ology departments while at the same time understanding how to use the technology to connect your entire enterprise. We’re the kind of partner that can move you away from the silo of trees to the enterprise forest – all while bringing forward the medical imaging workflow benefits already achieved. We don’t neglect the trees for the forest, either.
As you embark on a long-term strategy for an enterprise archive, towards a PACS neutral archive (PNA), keep in mind the following five-point agenda to determine if your PACS vendor is ready to deliver what you need.
1. An enterprise imaging strategy must include an enterprise archive that can accept data from throughout the enterprise. And today’s definition of data has expanded to include all images and words used to see, observe, read and understand to make a patient diagnosis. The definition of enterprise has expanded, too, so all images and words need to be available to patients as well. One viable route to achieve an enterprise archive is a PNA — an image repository or archive that is PACS neutral. Regardless of the PACS the organization uses, images can be stored and retrieved from the neutral archive because it was built to exchange data with disparate systems.
When considering your archive, make sure the data is:
Readily available. You need to know what it is and where it is stored.
- Correctly identified. You need to be able to view any type of imaging data, including camera or motion, from all the ‘ologies.
- Easily accessed. You need to know what speeds and the technology used to bring it to you.
2. The enterprise footprint has already expanded to include storage, servers, networking and data centers. Now it comes down to broader participation with imaging. PACS vendors must recognize how much data is in a digital image and how important it is to the whole picture of the patient’s treatment. Many vendors that have proven successful in workflow and diagnosing patients at the departmental level are swimming upstream to take imaging to the enterprise. Make sure your vendor shows you how they are:
- Speaking the enterprise language
- Understanding the vocabulary
- Designing into the environment
3. Workflow gains cannot be forgotten. Your PACS vendor needs to introduce an enterprise archive solution that modifies the technology without breaking the workflow in the departments. As you broaden the enterprise footprint, your vendor must examine the nuts and bolts related to data. The leading questions should be:
- How do we get all of our data into the enterprise archive?
- Where do we put it?
4. Data migration is as equally understood as misunderstood in the market. Some still believe that if you put data in an archive for the enterprise, you never need to touch it again. The reality is we don’t know what the applications or storage requirements are going to be going forward. When your tires need to be replaced, you don’t throw away the car. You change the tires. Migration strategies for moving data out of silos and into the enterprise are also changing and expanding. The fact is that somebody should always be managing the data, and it is highly unlikely that the data will be permanently stored in one location.
Ultimately, where data is stored is a location that the enterprise archive has access to and understands. Whether it is costly or cheap, successful or unsuccessful all comes down to the quality of the data and the expertise available. Find a vendor who can talk to you about:
- How to get data from around the enterprise into a repository
- The importance of DICOM wrapping to manage the standard data everyone wants and the custom data some depend on
- Mass data move versus mass reindexing to save money and time
5. Don’t get lost in the chatter of cloud storage, which seems to be upsetting the market but is clearly a strategy that is here to stay. And there is a reason for that. Before the digital age, we used to put our data in filing cabinets. Now we need more options. The enterprise drives where data is stored. Large organizations continue to manage their own data centers. What about everybody else? Many are opting to outsource storage to a cloud provider to lower operating cost and capital cost. We have public cloud, private cloud or a blending of the two. Organizations using the hybrid cloud keep a primary copy of the data in the enterprise-owned data center and archive a second copy to the service provider.
If your vendor isn’t at least looking at a private cloud option, they should be. Ask them about the benefits of cloud. These include:
- Security when pumping data outside of four walls of enterprise
- Fast and easy access to data with resiliency and redundancy
- Data ownership to ensure control
Our paths to an enterprise archive may not be identical but every long-term strategy should consider the forest as well as the trees.
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