By John McCann – Senior Director of Marketing – EMEA, BridgeHead Software
Next generation Vendor Neutral Archives (VNA) are finding their natural home as a critical application in the technology stack as hospitals move towards the vision of a single patient record and a paperless future. Clinical requirements have and continue to evolve; the digital age brings many opportunities to streamline processes and increase efficiencies to save cost and, ultimately, improve patient care. Consequently, there is a growing impetus to change how data is stored, protected and shared. Many organizations are now looking strategically at how they can use a VNA as a central repository, across their healthcare economies, for all types of data (not just medical images that many incorrectly associate VNAs with) from clinical departments through to back office functions and, increasingly, marrying up primary care, secondary care, mental health and social care.
In this blog, we will examine some of the trends in general VNA adoption and explore what the future holds as the ‘next generation’ VNA becomes commonplace.
EMR integration of medical images
In order to provide clinicians with a more complete, rich data set by which they can consult, diagnose and treat patients, healthcare systems must be able to communicate with one another. Today, one of a hospital’s biggest application silos is found within medical imaging systems. Medical images are not easily accessible or shareable across systems, not even between imaging departments where you might expect there to be a level of interoperability. What we are increasingly seeing is the need for these medical images and associated data (such as reports) to be made available through the electronic medical record (EMR) system. Those organizations that have invested heavily in EMRs want to leverage that investment by integrating data from as many departments and disciplines as possible – imaging makes up a considerable percentage of a hospital’s overall data profile, so it’s not surprising that access to this data is high up on the list of priorities. As we have seen recently with our UK customer Homerton University Hospital NHS Foundation Trust, the hospital needed a central repository that could aggregate its medical images and associated data, starting with radiology (but, with the intention of extending this to cardiology and foetal medicine, among other disciplines). Ultimately, Homerton was looking to share these images and reports by integrating the VNA with its Cerner EPR solution. BridgeHead’s next generation VNA, HealthStore®, was implemented to provide the engine to store and protect the hospital’s data and, more importantly, making all of the information pertaining to the patient (from letters and documents through to imaging data) available to other applications and, thereby, accessible to clinicians at the point of care.
Interoperability through common data standards
Without doubt adherence to standards such as XDS, HL7, DICOM and CIFS will play a key role in ensuring that a VNA can not only collect data from multiple applications across the healthcare enterprise, but are also able to share that information, through these open standards, back to EMRs and other applications. Without standards healthcare organisations will struggle to make all patient data available to those that need it, when they need it. As a result, closed, departmental silos of information will remain.
Furthermore, a VNA that fully supports data standards is critical for integrating data with other applications; hospitals will essentially only need one integration point to access all medical content, imaging or non-imaging, DICOM or non-DICOM.
PACS deconstruction
Another driver for the uptake of VNA is PACS deconstruction. Many healthcare organizations are looking to adopt ‘best of breed’ applications for viewing data across the enterprise, managing workflow and storing, protecting and sharing data. VNA vendors are well positioned to take advantage of this trend by providing a solid, secure and searchable data source for use by ‘best of breed’ viewers and workflow applications.
Two years on from the dismantlement of the UK’s National Programme for IT (NPfIT), it has been interesting to witness the different approaches taken by hospitals as they seek to replace or renew their PACS contracts. While some have taken tactical decisions to extend their existing contracts to see them through to the end of the programme, giving them time to evaluate their options, others, such as Bradford Teaching Hospitals NHS Foundation Trust and North Middlesex University Hospital NHS Trust, have taken a long-term strategic approach to their content by looking outside of radiology and imaging and instead considering all of the hospital’s data.
In Bradford’s case, the hospital decided to implement BridgeHead’s Independent Clinical Archive (often referred to as a next generation VNA), HealthStore®, in advance of its PACS procurement. Bradford felt it was extremely important to get its data in order first before considering its future application choices. North Middlesex, by contrast, procured BridgeHead’s HealthStore® at the same time as its PACS and EDMS – largely, as it has ambitious plans to store, protect and share all of its imaging (and associated) data as well as its patient records, recognising the Independent Clinical Archive was the underlying infrastructure to facilitate this.
The birth of next generation VNA – or, as we like to call it, the Independent Clinical Archive (ICA)
With the deconstruction of PACS, the drive towards standards and encompassing all types of applications and data, the market is moving beyond the old definitions of VNAs, focused solely on radiology and imaging. Many analyst firms such as Gartner (in its recent report “Gartner Market Guide for Vendor-Neutral Archives”) and IDC (What is an Application-Independent Clinical Archive and Why Do Providers Need Them?) agree that the definition of the VNA has evolved and reported as such. However, no one can agree what that term should be. We believe ‘Independent Clinical Archive’ or ‘ICA’ for short, is a good description.
It’s clear, hospitals are increasingly examining their entire data footprint and considering the best ways to maximise the value of that data for clinical gain. And this phenomenon is not limited to the UK. In Europe, we are starting to see more hospitals adopting Cloud technology to better store, protect and share information. A great example is Oblak in Bulgaria, who recently offered healthcare organizations in the Balkan countries the very first Cloud solution for radiology. By implementing BridgeHead’s HealthStore on EMC Isilon within their Cloud datacentre, hospitals can essentially outsource their infrastructure to a world class vendor, using best of breed technology, and enable clinicians to find and retrieve their patient data in a timely and efficient way at the point of care. And there are numerous projects being carried out in the US where hospitals increasingly understand the value that an Independent Clinical Archive brings. As a result, we are in no doubt that you will be hearing more of the Independent Clinical Archive to store, protect and share all types of information about patients as it becomes more widely accepted, globally.
