Ten Reasons Why Traditional VNAs Fail To Deliver

Are you ready to re-imagine your Enterprise Imaging strategy?

This guide for imaging managers, PACS administrators, clinicians, and IT explains how an independent, next-generation vendor neutral archive (VNA) differs from traditional VNAs and tethered PACS archives. We aim to highlight how a next-generation VNA can help you re-imagine your Enterprise Imaging strategy by consolidating, storing, protecting, and sharing all of your medical images and associated data from across your healthcare organization.

Introduction

As clinical departments adopt new and enhanced imaging technology, the fidelity and volume of medical images are growing at an exponential rate.

Today, approximately 30% of the world’s data volume is generated by the healthcare industry; and it’s understood that 90% of this consists of medical images. This is set to continue with the emergence of digital pathology and personalized medicine (to name a few); that are already generating huge datasets.

In the United States alone, around 600 million imaging procedures are carried out each year. An average hospital produces 50 petabytes of data annually comprised of clinical notes, lab tests, medical images, sensor readings, genomics, and operational and financial data. 90% of this data – around 45 petabytes – comes from medical images. And across NHS England, 40.3 million imaging tests are carried out each year – the most common being x-rays, diagnostic ultrasonography, CT scans, and MRIs.

With these ever-increasing volumes of medical images, there clearly has to be a strategy to address the challenges of storage, retrieval, and sharing of data. But it’s also crucial that opportunities, such as how we tap into AI and big data, are recognized.

At BridgeHead, we’re 100% focused on healthcare and see first-hand – ‘day in, day out’ – the constant drive to streamline healthcare. We understand the value of data and the important role it plays in improving the patient experience and clinical outcomes. That’s why healthcare organizations must ensure data is:

  1. stored efficiently and intelligently
  2. fully protected, particularly with the increased focus on healthcare by cybercriminals
  3. readily available by those that need it, when they need it.

Changing the way things have traditionally been done is hard. But we believe it’s now more essential than ever.

This guide has been compiled to help you strengthen your knowledge on how an independent, Clinical Data Repository (featuring a vendor neutral archive) can underpin your Enterprise Imaging strategy.

Imagine if… your next imaging migration is the last major one you ever do

Implementing a next-generation VNA removes dependencies between the application and the management of the information it creates. Traditionally, your PACS has been the main store for radiology images and, sometimes, data from some other clinical disciplines, such as cardiology. But, with an independent, interoperable VNA, you can migrate all of your imaging data (whether DICOM or non-DICOM) from across disparate clinical departments and applications into a vendor agnostic, central repository without affecting imaging workflows. The images are stored in their native formats (ensuring file integrity) and can be accessed by the originating application as well as any other application or viewing technology capable of reading the file format.

If you decide to change your PACS, the incoming PACS is pointed to the VNA and made aware of any changes or new content by a simple manifest. As a result, many healthcare organizations choose to implement an independent, next-generation VNA before switching PACS.

Similarly, replacing or upgrading your imaging storage hardware also becomes seamless. The VNA becomes the custodian of all imaging data and can move content from legacy hardware to new storage without impacting clinical services, which is important when considering the life of a storage device averages around 3-5 years.

In most cases, we expect that when you transition to an independent, next-generation VNA, it’ll be the last major imaging migration you’ll ever need to do.

“No matter how efficient your PACS is, there are things it can’t do. It can’t share your images with other departments. It can’t migrate your studies to another facility. And, if you change the system, there’s a good chance you’ll pay between $200,000 and $300,000 for your vendor to migrate the data because the DICOM is different. Vendor neutral archives (VNAs) offer many departments and practices seamless image storing and archiving capability across any PACS.”

 

Chris Tomlinson

Radiology Associates of The Children’s Hospital of Philadelphia

(writing for diagnosticimaging.com)

Imagine if… you could easily search and retrieve all images, reports, treatment plans, and associated data, when you need them, from one place

Collaborative working, second opinions, consulting with patients, and participating in MDTs or tumor board meetings require easy access to medical images. Yet, for most healthcare organizations, images are not readily available to clinicians who tend to rely solely on clinical reports. Even the Electronic Health Record (EHR) does not have easy access to this data. And, where it does, it relies on an API to a single PACS where many PACS or imaging systems may exist.

Radiology is still one of the largest producers of diagnostic images, but this is changing. As more clinical departments complete their digital transformation journeys and implement new specialist imaging systems, more data is being created by departments, such as cardiology, ophthalmology, dermatology, medical photography, and sleep medicine. And pathology is set to dwarf the current volume of radiology images in terms of the number of slide samples digitally captured, the high resolutions applied in the scanning process, and the resulting data footprint.

Independent, next-generation VNAs can manage all of your medical images and associated documents residing outside of the EHR, whether within a hospital, a group of hospitals, or even part of a shared clinical or regional network. By taking data from all of your imaging systems, and connecting it to the correct patient ID, clinicians can easily search and retrieve the images they need, when they need them, all from one place.

Benefits

  • Instantly access all images and associated data directly through the EHR
  • Simplify access to patient data residing outside of the EHR
  • Support departmental workflows
  • Store files in native file formats (e.g., DICOM, JPEG, PDF, PNG)
  • Zero footprint web-viewing, approved for clinical diagnosis
  • Improve quality of patient care

“The faster clinicians can access unstructured data to use at the point of care, the more successful they will be in diagnosing and treating a patient quickly. As value-based care initiatives continue to influence health IT decisions, the more significant VNAs are to IT infrastructure.”

 

Elizabeth O’Dowd

Journalist, HIT Infrastructure

healthcare-interoperability

Imagine if… you could eliminate application ‘vendor lock-in’ and free your imaging data

Application ‘vendor lock-in’ in medical imaging is common, occurring when proprietary applications, such as PACS, ship with their own dedicated hardware and software.

Indicators of ‘vendor lock-in’ include:

  • restrictive contracts that impede innovation
  • inability for applications to work with other systems (as they don’t adhere to open healthcare data standards)
  • PACS vendors offer their own ‘VNA’ for imaging (but it’s often a ‘tethered archive’ that only manages DICOM as opposed to a true VNA).

‘Vendor lock-in’ also rears its head when healthcare organizations choose to move away from their incumbent provider, demonstrated in the complexity and cost of migrating years of data away from the source application.

Independent, next-generation VNAs help to free your data by bringing back the choice, flexibility, and control that many healthcare organizations lose when they are ‘locked-in’ to a contract and/or technology. An independent VNA is both software and hardware agnostic and can, therefore, work with any chosen technology. It separates the imaging data from both the application that created it and the storage on which it resides. This enables you to make decisions on how your images and associated data are consolidated, stored, protected, and shared – all independent of the originating application, (e.g., PACS) or the storage hardware in place. And, by adhering to healthcare data standards, such as FHIR, DICOM, HL7, etc., imaging data is more readily accessible to clinicians within a hospital or across a healthcare network.

“PACS vendors may offer a tethered archive. Next-generation VNAs are exactly what they say they are – vendor neutral and, therefore, able to work with any PACS. So, when you come to replace your PACS the migration of images is seamless.”

 

Tim Kaschinske

HealthStore Product Manager, BridgeHead Software

Imagine if… your Enterprise Imaging strategy supported your best-in-class, specialist imaging applications

Each clinical department wants its own, dedicated, ‘best of breed’ applications. Specific requirements and specialist workflows demand it. But a consequence is that departmental data silos are formed where patient information is not easily accessible outside of that specialty.

Independent, next-generation VNAs consolidate, store, protect, and share imaging and associated data created by clinical applications across the healthcare continuum. Whether the data is structured or unstructured, proprietary or utilizing healthcare data standards, an independent VNA will ingest data from your specialist applications so that it is available throughout your organization to those that need it, when they need it.

Benefits

  • Aggregates data from across clinical specialties to support collaboration, e.g., for multi-disciplinary teams and tumor boards
  • Clinical teams can easily view and share a wide variety of imaging and non-imaging data
  • Maintains a 360-degree view of the patient’s history and progress for ongoing monitoring and treatment throughout the continuum of care

“A VNA needs the ability to ingest and manage data across imaging disciplines, including both DICOM and native non-DICOM formats, spanning radiology, cardiology, orthopaedic surgical planning, surgery, wound care, dermatology, point-of-care ultrasound, emergency ultrasound, as well as other care settings with imaging needs.  Common non-DICOM formats [typically not handled by PACS] include scanned documents, waveforms from ECG and EEG, visible light JPEG images from the emergency room, wound clinics and dermatology, microscopy images from pathology, and video formats for behavior health or neurology. As telehealth expands, images or video from patients may need to be integrated as well.”

 

Dave Fornell

Imaging Technology News

Imagine if… you had a system where your imaging data is fully safeguarded, accessible, and recoverable.

Clinicians and support teams rely on continuous access to patient data. And this doesn’t change even when a healthcare organization has suffered from data corruption, data loss, system outage, or a more serious disaster. With healthcare increasingly the target for cyberattacks (often in the form of ransomware and malware), data protection has risen much higher on healthcare IT’s agenda. Ultimately, should a hospital fall foul of such an event, clinicians need systems to be recovered to an operational state as quickly as possible to reduce risks to patient safety and ensure care continuity.

Independent, next-generation VNAs offer an imaging downtime solution. Consequently, should a PACS or other imaging application go down, imaging data can still be accessed and viewed from online copies directly from the VNA, via the EHR, or by pointing an alternative PACS to the VNA, depending on the circumstances. A next-generation VNA is self-protecting with data centrally managed and ‘always available’. This means images and associated data continue to be accessible to your clinical teams, even when the PACS or other imaging system is unavailable, whether planned or unplanned.

Benefits

  • Data is always available to clinical teams, even when your PACS or other departmental system is down (provided you have an internet connection)
  • Reduce your security, regulatory and legal risks by providing comprehensive data protection

“Every day, millions of new medical images containing the personal health information of patients are spilling out onto the internet. Hundreds of hospitals, medical offices and imaging centers are running insecure storage systems, allowing anyone with an internet connection and free-to-download software to access over 1 billion medical images of patients across the world. About half of all the exposed images, which include X-rays, ultrasounds and CT scans, belong to patients in the United States”.

 

Zack Whittaker

TechCrunch.com

Imagine if… you could take back control of your storage choices

Imaging systems, such as PACS and ‘VNAs’ provided by PACS vendors often ship and are tethered to their own storage. This creates storage silos and leaves storage assets underutilized. These clinical systems usually demand expensive and fast performing hardware, even for rarely accessed data.

Independent, next generation VNAs are storage agnostic. They provide the mechanism to separate your imaging applications that create the data from the storage on which that data resides, enabling them to work with storage from any vendor and any media. With an independent VNA, you can adopt a tiered storage architecture, moving data around your storage estate based on its value and usage – from your expensive tier one on-premise SAN arrays to private and public Cloud and even tape.

Independent VNAs provide you with the freedom and choice to decide where your images will be stored, as opposed to being restricted by your application provider (such as ‘forced buying’ that often comes once capacity on a tethered storage device is reached). This helps you make the most of your underutilized hardware assets, delaying storage refreshes, as well as saving you time and money.

Ultimately, an independent VNA firmly puts you back in control of your data management and storage choices.

Benefits

  • Optimize use of your existing storage assets across your environment
  • Delay expensive and unnecessary hardware refreshes
  • Eliminate ‘forced buying’ of tethered storage devices
  • Adopt a tiered storage strategy, moving data to the appropriate hardware or media based on its characteristics
  • Leverage modern storage options, such as private and public Cloud

“To ease the burden and costs associated with long-term data storage, systems should have a way to automatically determine how long a piece of data is stored and when it can be purged.”

 

Dave Fornell

Imaging Technology News

Imagine if… you could retire your older applications whilst retaining access to their data.

There are a litany of legacy imaging and other clinical applications found in healthcare organizations today. These arise in many ways: some are replaced applications following a move to implement more modern, fuller-featured systems; some are duplicate systems inherited via mergers and acquisitions; some are outdated, home-grown systems; and some are old, rarely used applications that are no longer supported. Whichever the case (and usually it is a combination of the above), these systems are a significant burden in terms of time, resources, and money. They cause issues such as limiting data access to support clinical decisions, they open up organizations to cyberattacks, all in addition to the high overhead associated with the costs, maintenance and support of these systems.

Sadly, managing legacy applications has become ‘business as usual’ for many healthcare organizations – often because there are no obvious alternative solutions.

However, using an independent, next-generation VNA enables healthcare providers to extract data from these legacy systems, transform it into an open data standard (if required), where it can then be stored, protected, interrogated, and accessed by the EHR, enterprise viewer, or clinical portal. Once moved into the VNA, the originating application can be decommissioned, saving the hospital all of the associated costs and resources described earlier. And the risk of cybercriminals exploiting security loopholes found in in these legacy systems is significantly reduced.

Benefits

  • Eliminate or significantly reduce the cost and resource associated with running and maintaining duplicate, replaced, or legacy systems
  • Mitigate security and financial risk by retiring vulnerable systems increasingly targeted by cybercriminals
  • Enhance clinical workflow and reduce patient risk by integrating valuable data from legacy systems where it can be used to better inform care decisions

Imagine if… your medical imaging data workflows (and more) aligned with the patient.

No patient journey is the same. While there are established care pathways and common recurring patterns, ultimately every patient journey is somewhat unique. Patients not only move around hospital departments, but across disparate organizations and care settings.

As the patient navigates their respective care pathway, it is important that their medical images and associated data (patient notes, referral documents, patient correspondence, clinical reports) are available to the clinical teams involved across the consulting, diagnosis, referral, and treatment stages of care, regardless of location. In the interests of quality care delivery and efficiency, the data must flow with the patient.

An independent, next-generation VNA offers a central integration point for all medical images and associated data from across the hospital network, including primary care, mental health, community health, and specialist tertiary organizations. So, when it comes to offering a holistic view of a patient and their journey, information is readily searchable, accessible, and available to clinicians and support staff, as and where needed, from whichever facility they are located.

“Using picture archiving and communications systems (PACS) is the biggest obstacle clinicians face when viewing patient medical images. PACS don’t allow clinicians to look at patient images from different departments at the same time. Clinicians have to log into separate systems to see a single patient’s images from different departments such as radiology, cardiology, dental, and pathology.”

 

Elizabeth O’Dowd

Journalist, HIT Infrastructure

Imagine if… you had one quick and easy-to-use system for all staff.

The volume of structured and unstructured data living outside the EHR continues to grow. This valuable patient data, such as database records, images, videos, and documents; is scattered across disparate departmental applications, making it challenging for clinicians to access all the information they need to effectively diagnose, refer, and/or treat their patients. In turn, this also contributes to staff burnout, reduced patient satisfaction, and decreased quality of care.

An independent, next-generation VNA provides your clinicians and support staff with access to a unified, 360-degree patient view, that brings data together from multiple sources, all available via the EHR and in ‘patient context’. This requires little or no training as it utilizes the solutions and workflows your teams use every day. And the solution allows easy navigation, using intuitive filtering to enable staff to easily find the data they are looking for.

The VNA not only provides access to all of the imaging and associated data living outside of the electronic health record system, it also integrates with your primary and/or departmental applications (typically, the default systems users will go to in the course of their everyday duties).

By adopting an independent, next-generation VNA, you reduce the number of applications that staff need to access the patient information they require. And, it decreases the number of integrations needed for a hospital to deliver data interoperability across their application ecosystem.

“The faster clinicians can access unstructured data to use at the point of care, the more successful they will be in diagnosing and treating a patient quickly. As value-based care initiatives continue to influence health IT decisions, the more significant VNAs are to IT infrastructure.”

Elizabeth O’Dowd

Journalist, HIT

Imagine if… you could leverage your medical images for clinical decision support, AI, machine learning, and precision medicine.

Artificial Intelligence (AI), machine learning, and advanced analytics are already being used in healthcare settings around the world. To begin to leverage and apply these new, and emerging technologies, first you need to know that your data is complete and can be easily accessed.

As independent, next-generation VNAs aggregate data from clinical and administrative departments across the healthcare economy, you effectively have a larger, more accurate dataset to analyze – the results of which can be put to work for clinical, business, and operational benefits.

Examples of how data analytics and AI are being used in healthcare settings:

  • Using predictive analytics to reduce staff burnout
  • Identifying patients at risk of falls
  • Addressing the challenges of hospital-acquired infections
  • Improving hospital workflows
  • Analyzing patient satisfaction.

“Electronic Healthcare Record (EHR) systems are largely not compatible across government-certified providers that service different hospitals and health care facilities. The result is data collection that is localized rather than integrated to document a patient’s medical history across his health care providers. Without large, high-quality data sets, it can be difficult to build useful AIs. This, in turn, means that health care providers may be slower to take up the technology.”

 

Avi Goldfarb and Florenta Teodoridis

Why is AI adoption in health care lagging

What’s next?

In this guide, we’ve demonstrated ten scenarios where an independent, next-generation VNA can help you achieve your organizational and clinical aims.

BridgeHead’s independent, next-generation VNA, HealthStore® enables healthcare organizations to provide the foundations for their Enterprise Imaging strategy and more. With HealthStore, you can:

1. Reduce the pain of migrating your applications and storage
2. Make all of your imaging and associated data commonly accessible
3. Eliminate ‘vendor lock-in’ and free your imaging data
4. Unite your imaging applications while breaking down data silos
5. Protect your imaging and associated data so it is recoverable and always available despite cyberattack, outage, or serious data issues
6. Gain from more efficient storage management
7. Retire older imaging or other applications whilst retaining access to your data
8. Align your imaging data (and more) with patients across your healthcare ecosystem
9. Offer users an intuitive and easy to use solution requiring little training
10. Leverage your data for clinical decision support, AI, machine learning, and analytics.

To learn how you can re-imagine your Enterprise Imaging Strategy with BridgeHead’s next generation Vendor Neutral Archive (VNA), HealthStore®…