Why purchasing your own VNA is an investment in the past, not the future
November 20, 2014 in Medical Technology
It is taken as gospel by most radiologists and hospital IT professionals that a vendor-neutral archiving application is critical for unifying diagnostic imaging workflows. And VNAs are a great tool. But that doesn’t mean you should buy one.
I fly all the time, and air travel is critical to my job. But I’m not going to buy an airplane. They are expensive, require operating skills that I don’t have, and maintenance is complex and highly regulated. Plus, as soon as you buy a plane, a new one comes on the market that is faster, safer and more fuel efficient, leaving you stuck with yesterday’s technology. Those are similar to the reasons that I don’t think a hospital should purchase a VNA application.
Instead, hospitals, health systems and outpatient imaging facilities should consider a new strategy for archiving: buy a ticket and let someone else pilot the plane. You’ll get where you need to go faster, more reliably and more safely. With this strategy, you can get all the control and functionality you need, without buying a system that you’ll be responsible for maintaining and updating. Plus, a VNA is only part of what a clinical imaging organization needs to meet the future.
Beyond VNAs: True integration of medical data
So what’s the alternative? Image archiving and data management delivered as a service.
In the model I think works best, once a clinical exam is reported, the job of the PACS is done. The exam file is transmitted to an on-site server (provided by your archiving service provider) that transforms it into a vendor-neutral format. Current files are stored on site for fast access and also uploaded to a secure cloud platform that allows clinicians to view images anywhere, from any device. Every specialty gets to use whichever viewer he or she prefers, and you have an off-site copy for disaster recovery.
The archiving vendor maintains a high-powered platform that allows for efficient workflows, provides best-in-breed security and offers integration with every major electronic medical records system.
If you want to give your IT colleagues a bad day, ask them to estimate the resources they would need to integrate all your clinical images with all the EMRs used by physicians who practice at your hospital or send patients to your facility for imaging studies. While there are some major health systems with the depth of talent and resources necessary for this task, most community hospital IT departments don’t have the time or the specialized skills needed to undertake this complex task. But an intelligent vendor-neutral archiving service can invest in the time and talent needed, because it can spread the costs over many customers.
That may be the most important reason for changing the way you look at clinical archiving. Integration with EMRs is fast becoming a requirement, not an option. You need a system that can seamlessly integrate with dozens of applications automatically. And there is no way you (or your IT department) want to deal with that headache.
An archiving service can also provide additional, very useful functionality in processing the data under its management, such as a dose monitoring application and an analytics platform that you can use for business intelligence and quality improvement. And because an archiving service deals with hundreds or thousands of customers, they may have the ability (now or in the future) to provide de-identified data for benchmarking and predictive analytics.
It’s also more affordable. Archiving as a service can be done one a per-study basis, which means that you pay one fee to store the images in a study and the service stores them for as long as legally required. You don’t have to invest capital to get high functionality. You also don’t have to predict how much storage you are going to need. Having excess capacity sitting around unused is expensive, while having too little can be a disaster. The archiving provider takes on that headache. Because they do it all the time, they are much better equipped to make the investments knowledgeably and prudently. With more outcomes-based and capitation-based contracts coming from insurers, being cost-efficient will be critical to survival for many imaging organizations.
Another important reason for getting out of the archiving business and letting someone else handle those details is that this function is only going to get more difficult for in-house IT departments. As diagnostic applications get more complex and become more integrated into the clinical workflow, the difficulty of maintaining and updating these applications will increase.
The future of healthcare lies in intelligent data repositories that incorporate clinical workflow functions and predictive and prescriptive analytics, and moving to a cloud-based archiving system is a step in the right direction.
For now, and certainly for the future, archiving as a service makes far more sense than keeping this function in-house.