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The triumphs and pitfalls of integrating diagnostic imaging and the EHR

by Lauren Dubinsky , Senior Reporter
From the February 2018 issue of DOTmed HealthCare Business News magazine

The road to electronic health record (EHR) adoption has been anything but smooth as health care organizations grappled with significant cost and workflow challenges.

But, according to The Office of the National Coordinator for Health Information Technology, 96 percent possessed a certified EHR technology in 2015.

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Still, most experts agree that the work is far from complete as technological potholes and roadblocks continue to get in the way of establishing a cohesive, interoperable health IT ecosystem across the enterprise. As silos come down, one of the most daunting tasks has been integrating diagnostic imaging into the EHR.

“Each facility has its own PACS and each department such as cardiology, dermatology and oncology has its own devices that take the images,” says Mitali Maheshwari, health care information technology analyst at MD Buyline. “They store their images in their particular systems and those systems cannot talk with each other.”

Health care organizations are now working on making all of the patient records and images within each department available on demand. Some progress has been made with the introduction of the vendor neutral archive (VNA), which stores images in a standard format so they can be accessed by different systems, but it does give rise to important new questions for hospital decision-makers.

“PACS has traditionally been provided by a vendor [that offers] the network, workstations, storage and other components in one package,” says Dr. Eliot Siegel, chief of radiology and nuclear medicine for the Veterans Affairs Maryland Healthcare System. “But some might argue that the best approach might be to have the best workstation from vendor A combined with the best network from vendor B combined with the best storage from vendor C.”

That customized approach to imaging IT is sometimes called “deconstructed PACS,” and although it does put more control in the hands of the facility, it lacks the cut-and-dry simplicity of a single vendor contract. The question providers need to ask themselves is whether those added complications can yield a smoother experience in the era of enterprise imaging where that data needs to play friendly with the health record.
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