Musings from the SIIM conference – VNA left, front and center

David C White

I have been a regular attendee and speaker at the annual SIIM conference. Over the years I have seen the discussion shift from traditional topics on PACS and Imaging workflows to EMR integration, mobility, cloud and big data. This year, while not new topics, Vendor Neutral Archives (VNAs) and management of non-DICOM content seemed to be all-pervasive themes. I was fortunate to represent GE Healthcare IT on two speaker panels for these topics – one being “The Challenges of Archiving Non-DICOM Images in a DICOM world” and the other “Enterprise Imaging: The EMR and VNA Roadmap”.  Both of these sessions touched on best ways to deal with Non-DICOM content in today’s healthcare market.

It is a well-known fact that healthcare data is growing at a rapid pace and that unstructured medical data is growing at an even faster rate. With the need to make patient records available and accessible to everyone in the enterprise, it is no longer sustainable to maintain siloes of data or to postpone a data management strategy for the growing Non- DICOM content in the organization. Yet today the adoption of standards is sluggish and it is painful to still hear some providers insisting on the older ways of DICOM wrapping to store and access Non-DICOM content. But this may soon become a thing of the past. The healthcare industry is definitely coming around to the adoption of standards. The panel discussion revealed how other vendors are making it a part of their VNA offerings, primarily driven by healthcare providers’ requests to embed IHE standards such as XDS.

Another popular topic was the capture of visible light images into the EMR with the patient-associated meta data such as body parts, even to initiate the upstream workflow.  One of the initial use cases is seen in the wound care department when nurses try to capture pressure ulcer pictures and document them in EMR for follow-up. The current processes are time consuming and can often result in missed documentation or errors, which in turn may result in loss of revenue for the healthcare provider.  Simple point of care workflow-centric mobile applications, when built on standards, can address this problem. These visible light images as well as other non-DICOM data will soon be referred to as Medical Multi-Media Objects. As we start to see this adoption blossom in the US market, I noted on the panel that each department (Dermatology, Plastic Surgery, and Emergency Room etc) will have unique workflows, so a “BIG BANG” approach will not work. The applications need to be tailored to the workflows in order to truly become a productivity saver for clinicians.  That said it is highly recommended that the organizational leader drive the governance of these images around length of retention, access, risk and so on.

I am encouraged to say that GE Healthcare IT has already moved ahead on this path to evolve mobile applications that can simplify the ingestion and documentation of visible-light images and make them available as part of the patient record in EMR or an XDS compliant viewer. GE Healthcare IT VNA solution, CentricityTM Clinical Archive1, now accompanies a handy mobile documentation and image capture application – to help solve the growing problem of visible-light image ingestion into the EMR.

A few years ago, vendor neutrality was a vague and less-understood concept. Now definitions are clearer and requirements have been established. There is less room for debate. Today VNA has taken the leap from being just departmental or multi-ology archive to more of a standards based Enterprise or regional repository and accessibility solution. Tell us how you have begun to think about managing the tsunami of non-DICOM data in your organizations. Are you thinking about adopting standards yet? Why or why-not?


1 Centricity Clinical Archive includes the following product components: Centricity Enterprise Archive, Universal Viewer ZFP client, XDS Registry, Centricity Clinical Gateway, NextGate MatchMetrix EMPI, and PACSGEAR PacsSCANTM

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