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IT Matters: time to tackle the toughest part of enterprise imaging

November 24, 2016
Health IT
From the November 2016 issue of HealthCare Business News magazine

By Michael J. Gray

The concept of enterprise imaging can cover a considerable amount of ground, depending on who is doing the talking. In my experience, “enterprise imaging” can mean any of the following:

Providing physicians and other caregivers access to the images being managed by their radiology, and possibly cardiology PACS through their smartphones and tablets. This is what many PACS vendors mean by the term enterprise imaging.

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Consolidating most of the organization’s medical image data (in addition to radiology and cardiology) in a vendor-neutral archive. This is the VNA vendors’ concept of enterprise imaging.
Image-enabling the organization’s electronic medical record system. This is what the independent clinical viewer vendors mean by enterprise imaging.
Enterprise imaging can also refer to the introduction of more standardized digital imaging processes into the many other departments that create images for either diagnostic, procedural or evidentiary purposes.
Providing PACS-like functionality to imaging departments other than radiology and cardiology. I refer to these other imaging departments as the “ologies” and the “oscopies.” Facilitating the exchange of medical images with affiliated (outside) health care organizations, clinics or physician groups.
Capturing, managing and displaying clinically relevant, digital photos and video clips taken with mobile devices (personal smartphones and tablets), often referred to as multi-media or mobile imaging.

In my opinion, focusing on any one of the above six categories is shortsighted, as all of the above will eventually become the objective, assuming the ultimate goal of the health care organization is to provide all physicians and caregivers access to each patient’s complete longitudinal medical record. This would include the patient’s medical images (structured data); diagnostic reports, laboratory results, prescription details and care summaries (unstructured data); and the multitude of health details collected during years of office visits, such as age, weight, smoking status, etc. (discrete data).

Now is the time to tackle multimedia or mobile imaging, despite the fact that it is arguably the toughest part of our expanded concept of enterprise imaging. The urgency is driven by the fact that it is already underway, and the consequences of inaction can be far more expensive than the cost of the necessary technology.

Data security is the major concern. In the old days of film-based radiology imaging, it was not an uncommon practice to sequester borrowed original films in lockers, desk drawers, car trunks and briefcases. Ironically this was considered more of an obstacle to sharing those films than a HIPAA violation. In the era of computer-based digital image management, data security is considered a much more serious issue.

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