There is a growing expectation that quality healthcare depends on the ability to securely deliver clinical information to anyone who needs it, anytime and anywhere. This requires healthcare providers to provide authorized users with flexible, easy access to all types of clinical images and data.
This goal is challenging for several reasons. Rapid advancements in information technology and a growing health IT marketplace brought a rush of vendors into the arena. The proliferation of different systems achieved a huge growth in both the volume and variety of information. Much of this data is unstructured and often is stored without appropriate clinical context, which inhibits the ability to efficiently identify and access it across the enterprise.
EHRs are inherently built around structured digital data, including patient demographics, admission status, physical and diagnostic notes, prescriptions, discharge status, and many other fields. However, true interoperability requires providing integration with access to unstructured data as well. Images, videos, mobile uploads, scanned documents, emails, and many other forms of clinical data that are needed for healthcare decisions may not have a structure that makes them easy to incorporate into an EHR.
Achieving universal image and data access requires a new generation of healthcare IT resources. For example Carestream’s Clinical Collaboration Platform enables interoperability so that information generated by different systems, on different networks, and for different purposes can be federated into a framework that enables collaboration among users. The goal is to remove any barriers of time, place, or technology and enable healthcare providers to deliver relevant clinical images, presented in a meaningful context, to any stakeholder who needs to review them.
Until recently, departmental imaging and workflow systems have largely existed in silos that were segregated from EHR, payer, administrative, telemedicine, and other systems—with availability limited to specific networks. New solutions for clinical collaboration are specifically designed to open up these silos, so medical images and data can be shared as needed throughout the healthcare ecosystem.
A new generation of information-sharing platforms can overcome departmental barriers that currently inhibit access to images with a system that can provide universal access to images of all types. One study in Europe showed that the average cost for maintaining and supporting each departmental archive is around €40,000.
Healthcare providers are looking for a modular, scalable architecture that can be implemented as a complete platform for patient-centric management of clinical images and associated data. In addition, select services can be implemented with existing systems to provide EHR-enabled access, vendor-neutral archiving, departmental workflow management, and/or a universal viewer with enhanced distribution capabilities for physicians or patients.
Standards-based communication is essential
In order to maximize interoperability, this information-sharing platform must be able to communicate internally and externally using well-established standards such as IHE, HL7, DICOM, XDS-I, and web services. It also needs to provide a pathway forward to even simpler sharing of clinical images such as by incorporating latest HL7-FHIR and offering standards-based support for mobile applications.
This platform should also provide capabilities for ingesting images and data captured by existing departmental systems while minimizing disruption to existing workflow. Data in the form of JPG, MOV, MP4, PDF, CCR, and ECG files needs to be tagged with metadata and ingested into the system for easy management, storage, and distribution alongside DICOM images in standard formats. For example, there’s now an increasing need to ingest data from mobile devices for wound care or triaging patients and from remote modalities for telemedicine.
Healthcare providers also need to link their information-sharing platform with an intelligent vendor-neutral archive (VNA) that provides advanced workflow capabilities for management and distribution of both structured and unstructured clinical data. Different workflows can be maintained through department-specific interfaces, but the underlying data needs to be federated in a single record that eliminates duplication of effort, inconsistencies in data content and quality, and communication gaps that would otherwise require developing complicated and expensive interfaces. This type of data exchange is especially critical as healthcare administrators work within large systems that may have multiple legacy systems.
Departments can add the modular services they need to achieve the desired level of interoperability without the expense of replacing existing systems. These optional services may include order-entry, ingestion and data-upload workflow, and a universal viewer for images and supporting documents. Zero-footprint, web-based interfaces are preferred for easy integration.
Make images manageable and meaningful
The ultimate goal is to equip healthcare providers to accept clinical images from any source, add the appropriate context to make images manageable and meaningful, give them a permanent home in a patient-centric repository, and securely deliver them to physicians, patients, executives, payers, and other stakeholders with the right clinical relevance on their preferred systems.
Achieving this goal can equip clinicians, nurses, and other hospital staff with rapid, easy access to patient information that can help enable them to deliver the highest standard of care.