By John McCann, Global Senior Director of Marketing at BridgeHead Software

When we talk about interoperability in healthcare, there is often a tendency to focus on text-based elements of the patient record, such as physicians’ notes or patients’ current medications. While these are critical components, text-based information doesn’t always offer a complete view of a patient’s health or a particular episode of care. Let’s explore how image-enabling your EMR improves clinical workflows and patient experiences.

Images can be an essential piece of the patient medical record. However, historically, centralized access to medical images has been difficult for healthcare organizations to achieve. When If we look at digitization in healthcare, hospitals first focused on migrating from paper files to electronic medical records (EMR) systems; then, subsequently, to next-generation systems. During that initial period, radiology departments started to move from film to digital images. This article examines the challenges hospitals have faced in ensuring that medical images are securely integrated into the EMR and easily accessible to clinicians at the point of care.

Why Images Were Left Behind in the Scramble to Implement EMRs

Radiology was one of the first departments to make the transition to digital imaging about 20 years ago. This brought us DICOM, the first major standard for digital medical images. At the time, DICOM seemed to herald a bright new era of standardized imaging in healthcare. However, the reality turned a little different.

Today, even within radiology, DICOM does not ensure complete standardization due to the way tags and other meta-data are applied and interpreted by different departments, picture archiving and communication systems (PACS) and other applications. As a result, interoperability for medical images has remained an elusive goal for many hospitals. And, of course, radiology was just the beginning.

Across an entire hospital or health network, there are many different clinical disciplines and services that rely on images in diagnosis and treatment. You’ve got pathology, endoscopy, dermatology, ophthalmology, podiatry, ultra-sounds, sleep studies, and various photography and videography needs related to different types of surgery—just to give a few examples. Clinical requirements, specialist workflows, imaging modalities and associated systems, and the resulting file types, vary across all these areas, which has made it difficult for hospitals to bring all of their images together in one easily accessible repository.

Another challenge specific to medical images is the sheer volume of digital data involved. In our personal lives, we don’t usually think of pictures as very storage-intensive. However, in the medical world, this is a significant issue. The images from an X-ray or MRI must be extremely high-quality to be useful for diagnostic purposes. You could have a two-gigabyte file just for one study—and then you have to multiply that by the number of patients, add more files for follow-up visits, and ensure that everything is stored and managed in compliance with regulations and best practices. This material can fill up storage hardware incredibly quickly.

How the Lack of Interoperable Imaging Affects Clinicians and Patients

In the absence of a central repository, or comprehensive interoperability for medical images within EMRs or other clinical systems, images have largely remained siloed within clinical applications located in their respective departments and facilities (e.g. PACS for radiology and sometimes cardiology). As a result, physicians and patients have been forced to rely on various manual or ad-hoc methods for accessing or sharing images.


Please Let Me See My Patient Scans

Too often, this relies on extremely inefficient means. Porters push trolleys full of files from one department to another within the hospital. Patients end up being responsible for carrying their own images on DVD to outpatients appointments. This means the clinician has no opportunity to review images in advance, and those essential files are still not integrated into a complete patient record.

This approach makes it very complicated for a physician or specialist to review or compare images across a patient’s longitudinal history outside of one specific image or set of images. They’re stuck relying on written notes or reports based on the images. If a patient has had multiple images taken over a period of years—possibly at multiple different facilities—it is quite important for their doctor to be able to see how an injury or condition has changed over time.

The inability to access relevant images as part of the patient record through their EMR disrupts the clinical workflow. As a result, caregivers cannot make the best use of the limited time available to consult each patient. If images can’t be located in time, redundant scans or other imaging procedures may be required. This wastes everyone’s time and money—and reduces satisfaction for both patients and physicians. This is why it’s so important to image-enable your EMR.

How BridgeHead is Breaking Down the Barriers to Interoperable Medical Imaging

We all know clinicians need fast, secure access to complete patient records to deliver positive outcomes and experiences during each appointment or episode of care. BridgeHead Software is committed to meeting this need in the most comprehensive and practical way possible—so we made sure to address the specific challenges related to medical images when we designed HealthStore®. HealthStore is an independent data repository for healthcare, with inbuilt vendor neutral archive (VNA) and powerful data management capabilities offering hospitals and health networks one location to consolidate, store, protect and provide access to any and all medical images. Furthermore, HealthStore can also ingest data from disparate or outdated clinical or administrative systems that need to be retired or replaced, offering that information back to your primary EMR (or other systems) in patient context (if applicable).

Ultimately, our goal is to help make the sharing of images and patient information within the healthcare system as frictionless and efficient as possible. We envision a future where all parties—patients, doctors, consultants, hospitals, clinics, ambulances, and outside service providers—can access all critical patient records and information easily and securely, as and where required, and on any device. HealthStore enables hospitals to take a major step in this direction by providing a single repository for clinical and administrative data that is fully interoperable with your EMR, PACS, and other applications.


Is Your Organization Looking to perform its best in Every Patient Interaction?

In hospitals, a full patient history is often dispersed across EPR solutions, siloed departmental systems, archives of supporting paper documents, and the increasing array of legacy applications. Add to this the need to share patient data and the situation is exacerbated further. Ultimately, this complex web of data sources, and the associated workflows, inhibits clinicians from doing the job in hand, delivering quality patient care. In this previously recorded webinar, we will explore whether the idea of a 360-degree view of a patient is realistic or a pipedream?.

Webinar Recording: Is a 360-degree View Of A Patient Realistic or a Pipedream? →


Working in tech marketing for almost 25 years, and specifically in health tech for the last 10 years, John has and continues to learn about the real issues faced by healthcare providers and is convinced that technology, when specified and implemented correctly, can be a ‘game changer’ in the delivery of patient care. At BridgeHead Software, John is working to disrupt the myopia around healthcare applications instead supporting the view that data (and not applications) is the strategic asset by which patient outcomes and experience can be improved.

John caught the ‘technology bug’ after starting his career working for a marketing agency specializing in IT. Before joining BridgeHead Software, he held positions at Kerridge Commercial Systems, ADP Inc, Borland and Micro Focus.