By Tim Kaschinske
In February 2012, Marian Community Hospital in Carbondale, PA, said good-bye to its patients and closed its doors for good. However, the hospital’s responsibility for medical images and other patient data would continue for some time. State and federal regulations required Marian’s c-level executives to ensure the successful migration of DICOM images, before they could move on to new positions. To help address these requirements, Marian selected BridgeHead Software along with Laurel Bridge Software for migration of DICOM data to Catholic Health East (CHE), another provider in the state.
The migration process for DICOM included many steps, to help ensure secure handling according to the rules governing disclosure management. There are many reasons why DICOM data migration is not simple, despite the fact that DICOM is an industry standard intended to assist with image migration. First, DICOM was invented over 20 years ago when images were held on film rather than being stored digitally. This means that there are parts of the standard which are not a “perfect fit” for the modern radiology workflow, and this creates complexities in the data which must be managed during migration. Second, each PACS vendor implements its support for the DICOM standard with slight differences. This means that migration of images into a VNA or between one PACS brand and another includes the need to examine the image data and properly classify and tag it.
The process of migrating DICOM images for Marian required establishing a BridgeHead VNA repository at CHE to receive the data. Also, in this instance, the CIO at Marian was required to stay at the datacenter to oversee the migration activity throughout the process. The process continued for many months, and was impacted by equipment problems which caused frequent server and network outages.
CHE was required to agree to take on responsibility for the PHI as part of the process. Using the BridgeHead VNA serves CHE clinicians and patients, while the migration work continues.
This type of project is not unique to Marian, but is what any hospital can expect to go through when they close their doors. As regulations surrounding the secure handling of PHI data continue to increase hospital c-level executives can be expected to be more involved with health IT professionals in making decisions about disclosure management, not only in circumstances such as Marian experienced in closing down but also to meet requirements to share PHI with patients and partner hospitals across regions.
In short, responsibility for the preservation and migration of patient health information (PHI) is a key consideration for hospitals. Hospital c-level executives may be personally responsible for PHI until such migrations are complete.