Image courtesy of Philips.
There is a growing need to exchange and share imaging studies with outside entities. Hospitals that have foregone the traditional merger and acquisition route to become affiliates, for example, have a need to share both individual patient and population health data, though their modalities for exchange and viewing may be very different. Patient transfers between facilities, specialty and professional consultations and even telehealth opportunities have created a new way of thinking about the delivery of images between two related, yet independent points of care. CDs, however, still remain both the most used and one of the largest bottlenecks in healthcare today.
Take for example the patient being transferred from one facility to another. Both critical care and routine transfer patients are often moved with CDs quite literally strapped to their chests. In critical care scenarios, this practice can create a delay in care planning; CDs cannot be read until they are received. If the receiving team of caregivers, however, had access to the patient’s images as soon as they were notified of the impending transfer, the images could be considered and the patient’s care planned while the patient was en route prior to arrival.
Patients who need specialty consultations are in a similarly difficult position. Patients themselves are commonly tasked with obtaining copies of prior imaging studies and bringing the images with them to their specialty consult appointment. Often, the patient forgets to bring the CD, or the specialty physician is unable to access the imaging studies on the CD; in either scenario, the result is a delay in care. When physicians have access to the images prior to the consultation, they can be more fully prepared for the time they spend with the patient in person.
As the number of clinical affiliations increases, there is a greater demand for professional consultations, and these physicians need to share images quickly and efficiently to coordinate patient care. When remote collaboration is augmented with real-time image viewing, treatment planning is enhanced. Similarly, as telehealth technology has shown, when providing care at a distance can improve quality of care and outcomes, new technologies coupled with a new generation of tech-savvy consumers are creating opportunities to proactively improve the value of care provided as well as the level of both patient satisfaction and engagement.
Moving Away From CDs
Until recently, CDs have been the media of choice when providing image access to patients as well as providers outside their primary care facility. From treatment delays and viewing difficulties to the inconvenience of tasking patients with physically transporting their own medical records, the use of CDs in the image exchange process has resulted in both patient and physician frustration, challenges that need to be overcome.
Aside from delays and frustration, however, the creation and management of CDs can also be a costly proposition. Industry research shows the average cost of producing a CD to be approximately $10. If an organization produces 20,000 CDs a year, that is an expense of $200,000 annually — and most medium to large organizations produce many, many more CDs than that. Add to that the cost of managing all the CDs that are received by an organization’s providers and the annual spend increases quickly.
To address these challenges, healthcare organizations are adopting image exchange and sharing technologies that can significantly reduce, and in some cases eliminate, the need to use CDs. There are several solutions on the market today that enable the efficient and secure movement of images between organizations and individual providers.
Recent developments show the imaging industry is taking a cue from data analytics technologies and beginning to leverage virtualization capabilities. This evolution allows for the viewing of images between organizations without first requiring a physical movement of the imaging data. This tactic is beneficial if a referential review of the images is needed without the consistent physical retention of images within the viewing provider’s local vendor neutral archive (VNA) or picture archiving and communication system (PACS).
Image virtualization tools often allow imaging studies to be viewed and also support the ad hoc movement of the study if the clinical decision is made to retain a copy locally. Thus, including virtualization as part of an overall enterprise imaging strategy can provide access to the imaging data much more quickly and at a fraction of the cost associated with more traditional move/retain exchange models.
Prioritize Use Cases. When considering how images should be exchanged in cooperative care environments, identify the variety of use cases that will be supported by the image exchange program and prioritize according to positive impact, with an emphasis on reducing time to treatment.
Make Strategic Workflow Decisions. A multi-disciplinary group of physicians, administrators and IT professionals need to evaluate workflow decisions to ensure the success of the image exchange program, answering such questions as:
• Will received images be triaged before presentation to a physician, and if so, what is the process?
• When and how will received images become part of the local electronic health record (EHR)?
• Will received images be viewed by the physician within the context of the EHR or in a separate viewer?
• When allowing patients to upload images, how will patients be given access, and what information will be required to ensure relevancy of the data received?
• What groups will be most impacted by the changes — patient transfer centers, radiology, others?
Carefully Plan the Patient Portal. Will patients be able to upload or access images through the patient portal? If images are made available to the patient, will the entire study be presented or only key images referenced in the diagnostic report?
Kim Garriott, principal consultant, healthcare strategies for Logicalis Healthcare Solutions, helps healthcare clients develop enterprise imaging strategies that maximize the value of their healthcare IT projects.