Issue link: https://beckershealthcare.uberflip.com/i/576097
156 Executive Briefing: side, such objectivity between departments and an enterprise- wide approach are key for successful image exchange adop- tion. "The image exchange needs of departments are different and they all have to be considered — radiology cares about a different set of priorities than do cardiology or neurology, oncology, trauma, and others," Mr. Tabatabaie says. IT can step in as a third-party, unbiased player to facilitate discussions and ensure selection of a solution apt for the whole organization. What's more, IT leaders are already tasked with implementing enterprisewide change and handling such issues on a larger scale. "IT is busy, in fact too busy," says Mr. Tabata- baie, adding, however, that they know how to implement a new technology and deal with the implications of change, and they are department neutral and by definition have a mandate to think about the entire enterprise. From Dr. Halamka's point of view, the provider side, IT should take the reins on such a project because these profes- sionals speak the languages of all parties involved and serve as the go-between for clinical and business needs. "Every business owner at BIDMC, or any hospital. has a clinical need, but they're often not bilingual in the terms of both the clinical need and the technology necessary to support the need," Dr. Halamka says. "There's nobody outside the IT department who can be that translator of clinician require- ments into technology tactics." The gaps of vendor-neutral archives As Dr. Halamka pointed out, there are a number of image intensive departments within the enterprise that today hold their own imaging repositories. Cardiology has its own PACS, as does gastroenterology (GI) and so do dermatology and the emergency department and so on. "There's no doubt that creating larger and smarter reposi- tories such as a VNA is beneficial as opposed to various imag- ing data sitting on its own [in departmental imaging devices]," Mr. Tabatabie says. "It's a good idea to have those repositories be neutral from the image generating system, but because VNAs aggregate data, there is a misconception that vendor neutral archive also does image exchange." Oftentimes vendor-neutral archive systems get confused with medical image exchange, Mr. Tabatabaie says. Ven- dor-neutral archive systems are large repositories to which different departments send their images for storage. Storage and retrieval is where VNA capabilities are focused. Its focus is not on exchange of images with the outside or the distribut- ed collaborative care environment of which Dr. Halamka, Mr. Weschler and Mr. Tabatabaie speak. Mr. Tabatabaie continues, "It's important for IT departments to see beyond [this] and make imaging and non-imaging data available across the boundaries of their health system's net- work, not just among entities that participate in a VNA." Three stages of medical image interoperability Sharing images across organizations is certainly a critical part of electronic data exchange, but Mr. Tabatabaie says it is just one of many steps on the path to interoperability. To be interoperable, images need to do three things, according to Mr. Tabatabaie. First, images need to be able to connect to the host's EMR so imaging can be integrated locally. Secondly, images need to "ride the same rails" that EMRs do when patient records are exchanged. For example, Mr. Tabatabaie says vendors like Epic and Cerner exchange patient records using networks like Care Everywhere and the CommonWell Alliance, respectively. This is a solution medical imaging is still figuring out. "Ideally, a doctor sending lab results and pathology results to a patient using Ep- ic's Care Everywhere, should not have to switch screens and go to another application to exchange images," he says. "Image exchange can be integrated into the interoperable transactions of the EMR." Mr. Tabatabaie says the healthcare industry is currently approaching this second stage of multisite, multivendor ex- change. The third stage of medical image interoperability is exchange between the medical image networks themselves, such as between lifeIMAGE and other platforms that also offer image exchange. "You have to be able to talk across those two networks, similar to how I'm on a Verizon [cellular] network today and [can talk to somebody] connected to an AT&T net- work," Mr. Tabatabaie says. "That's the ultimate component of interoperability." The future of imaging While the industry doesn't know what the future holds, it can take some precautionary measures to try to be as best equipped for whatever is ahead. Investing in a new software platform is a significant undertaking, and hospitals run the risk of purchasing a system that will be upgraded or outdated in a handful of years. "It's like a car: The moment you drive it off the lot, it drops in value," Mr. Weschler says. To combat this, healthcare organizations should consider solutions that are malleable and flexible enough to provide the infrastructure for the changing technological environment. Dr. Halamka says this capability is one of the key benefits of the cloud. "The cloud isn't going to solve every problem for everyone, but it creates an architecture that is flexible enough to adapt to multiple different business needs," Dr. Halamka says, adding that solutions like lifeIMAGE that function on the cloud are the types of solutions that are going to last long-term. "There is potential for different kinds of workflow once you have that capability." n Sponsored by: lifeIMAGE is the nation's largest and most utilized network for sharing medical imaging information. Its services allow hospitals, physicians and patients to securely connect and exchange exams, anywhere, leading to faster, better quality care that is delivered at a lower cost. The Big Picture: Interoperable Medical Image Exchange