Feature | June 21, 2011

Experts Address Limitations of CD/DVD Based Image Exchange

June 21, 2011 – Issues involving sharing medical images and possible solutions were discussed by vendors during an Applied Vendor Learning Session at the 2011 Society of Imaging Informatics in Medicine (SIIM) annual meeting, June 2-5 in Washington, D.C.

The session, “Image Sharing: A Vendor Perspective,” included three faculty moderators, including Paul J. Chang, M.D., FSIIM from University of Chicago, Pritzker School of Medicine; David A. Clunie from RadPharm and Khan Siddiqui, M.D. from Johns Hopkins University. Vendor reps included Emmanuel Cordonnier, president and CEO, Etiam Corp.; Noam Velan, M .Sc., Carestream Health Inc.; Raymond Chau of McKesson Provider Technologies; and Don Dennison of Agfa Healthcare Corp.

Emmanuel Cordonnier offered the following insights after the session:

Q: What were the objectives of this session?

A: The panel was assigned to address the limitations of CD/DVD-based image exchange, to discuss the emergence of personal electronic health records and how they impact the process of image exchange, and to analyze how to meet requirements pertaining to the new RSNA cross-enterprise document sharing for imaging. I was invited even though Etiam markets products for image exchange. [Etiam SMN (secure medical networking) provides cloud-based electronic study exchange. And Etiam Open Litebox is the only application available that can access images from every brand of CD.]

Q: Did you feel the subject matter was appropriate for the SIIM audience?

A: A number of very informative topics emerged, and I think the audience benefited from both the presentations and the discussions. Just as an example, Dr. Siddiqui of Johns Hopkins University introduced the session, positioning the topic of image exchange as part of the evolution from hospital centric image management to a patient centric approach — a very intriguing idea.

Then the vendor faculty members addressed some important factors relating to electronic image transfers.
- Don Dennison of Agfa talked about WADO (Web access to DICOM objects) that makes possible the independence of the location and its displays (via HTML5).
- Noam Velan of Carestream highlighted the interest of combining both DICOM and IHE XDS standards in addressing the image sharing needs.

- Raymond Chau of McKesson explained how gradually the EHRs and HIS are also dealing with medical imaging.

Q: Were you assigned a specific topic?

A: My contribution was to highlight the importance of the workflow before and after the electronic transfer of images and the role played by CDs in that process. If the PHR (personal health records) process of image uploads and downloads is positioned as “the” solution, it is in fact a “hype” because only a minority of patients can deal with and it requires in addition to manage additional workflow before and after the upload/download operation. If it simplifies the patient consent, it does not avoid the CD, which has to be burned before the patient is uploading its content. The final solution will see PACS communicating directly with PACS with patient consent and correct user authentication, as HIPAA compliance is a part of the process. We are not yet ready. In addition, the migration from CD to cloud will be gradual and long – typically ten years – and the good solution has to be able to manage both CD based and wired transfers. The good approach is to enable direct communication from institution to institution on the patient request, the receiving institution merging the two transfers (CD and wired) in one unique and coherent workflow.

As further evidence, Paul Chang, M.D., University of Chicago, launched a debate by asking how many of the 150 in the audience have already deployed electronic study transfer programs. A dozen people raised their hands. His next question was how many felt the need to improve the management of CD’s. Eventually, a majority acknowledged the many problems associated with the management of CDs, including the simplest challenge of inability to read images on received CDs. There was definitely evidence of lack of knowledge of available solutions, underestimating the need for good management of CD contents and concern about patients being able to collect and manage their own personal health records.

Q: From the panel and accompanying audience discussion, did you note any conclusions that may be helpful in the future?

A: The quality of the debate and level of interest was definitely high, showing the subject is still a hot topic. The panel and audience seemed to agree on four points:

1. That CDs will not disappear anytime soon — (a quantity of years)
2. That electronic study transfer from healthcare providers to healthcare providers is a good approach on the short/middle term.
3. That patient-managed transfers are a way of addressing some use cases but not a majority.
4. And clearly the management of the workflow inside the institutions is the key aspect of the evolution.

For more information: www.siim.org