Greg Freiherr, Industry Consultant
Greg Freiherr, Industry Consultant

Greg Freiherr has reported on developments in radiology since 1983. He runs the consulting service, The Freiherr Group.

Blog | Greg Freiherr, Industry Consultant | Enterprise Imaging| May 11, 2016

Will Enterprise Imaging Save Hippocratic Medicine?

Will Enterprise Imaging Save Hippocratic Medicine?

Hippocrates Examining a Child, a painting by Robert Thom, 1950s. Illustration courtesy National Library of Medicine (no changes per creative commons)

Hippocrates viewed the patient as a whole. Today physicians tend to see the patient as a collection of parts — cardiologists hearts; orthopedists joints.

Generalists may refer their patients to specialists who may hand them off to subspecialists, leading many to lament about the practice of modern medicine in silos.

Enterprise imaging could change that. It is being groomed to break down the barriers that keep medical disciplines apart, presenting to all involved in healthcare a picture of the patient as a collective rather than individual parts.

This will happen only through a concerted effort, one that combines multiple technologies — enterprise viewers (see “The Impracticality of a Truly Universal Viewer for Enterprise Imaging”) and vendor neutral archives, workflow engines and advanced analytics. What might be achieved is a complete picture of the patient. Included will be digital stills and videos; smartphone pictures and PowerPoint charts; EKG graphs and radiology reports; speech pathology recordings and dictation.

Archive Magic

In the words of British science fiction writer Arthur C. Clark, any sufficiently evolved technology is indistinguishable from magic. Enterprise imaging is the most advanced form of picture archiving and communications, unlocking the value of the myriad of technologies that capture, archive and transmit digital medical images. In the coming era of medicine, with its emphasis on value rather than volume, it promises the sleight of hand that will bring the many disciplines of medicine together.

The vendor neutral archive (VNA) is critically important to realizing this potential. Adopted early as a way to avoid migrating data from one picture archiving and communication system (PACS) to the next, it was soon recognized as a central repository for multiple types of patient data. Today VNAs are welcoming DICOM and non-DICOM images into a common management structure that can be supported across the lifecycle of the data.

To be truly vendor neutral, archives must be hardware and vendor independent; based on standards; central to all clinical and business content relevant to the patient; and interoperable. To live up to expectations in enterprise imaging, they must be integrated with the electronic medical record (EMR). The importance of a seamless connection with the EMR system is hard to overstate.

The electronic medical record is the catalyst for the exchange of images among medical disciplines. Without it, no such exchange can occur.

In this, archives serve as a kind of “community hall,” where images and other patient data are stored for clinicians and diagnosticians to access in ways calculated to benefit the patient and make healthcare more efficient. Neither the malady nor the location of the patient should matter — be it a rash examined in dermatology, a gaping wound photographed in the ER, or a standard uptake value calculated using positron emission tomography/computed tomography (PET/CT) in the nuclear medicine department. The physician should have to care only about the clinical value of the patient data, not from where it came or how it was captured.

To be of greatest use, the archives should be scalable to support the smallest clinic, the multi-site enterprise, and everything in between. The driving concern of their makers should be to support their agnostic functions and to increase their operational speeds.

Better Living Through Technology

Fifty year olds in the U.S. in 2007 could expect to live six years longer on average than those in 1950, according to Human Mortality Database. We have reached this point in large part thanks to the plethora of imaging devices that allow physicians to look noninvasively inside the human body.

Technological advances have shown how the data captured with these machines and others can be gathered, stored and transmitted. This has created demand for the many healthcare practitioners — generalists and specialists alike –to see what has traditionally been available to only a few.

This is the grandest promise of enterprise imaging: that it will lead medicine back to its roots, where the patient is treated as a person rather than separable parts.

How ironic would it be if technology, which has fomented a revolution in healthcare while dissociating care into many parts, were to provide the means by which medical practitioners recommit to the Hippocratic ideal?

 

Editor's note: This is the second blog in a four-part series on enterprise imaging. The first blog, “The Impracticality of a Truly Universal Viewer for Enterprise Imaging,” can be found here.

 

 

Related Content

Infinitt PACS 7.0 is a faster, more powerful viewer that was built from the ground up to support AI for image analysis and for operational/ workflow improvements in radiology
News | PACS | November 19, 2019
November 19, 2019 — Infinitt North America will be highlighting a next generation,...
RamSoft has been a proponent of the cloud since over a decade; the reason – patient data protection
News | Information Technology | November 18, 2019
November 18, 2019 — A recent report by security firm Emsisoft stated that
 Carestream Focus 35C Detector

Image courtesy of Carestream

News | Digital Radiography (DR) | November 06, 2019
November 6, 2019 — Carestream’s new Focus 35C Detector with Image Suit
Sectra
News | Artificial Intelligence | November 01, 2019
November 1, 2019 — At RSNA 2019, Sectra will showc
 Emergent Connect pneumothorax image

The partnership will bring the power of AI to Emergent Connect's growing customer base, leaving zero-footprint on the client side and eliminating the need for on premise installation and local workstation configurations. 

News | Artificial Intelligence | October 31, 2019
October 31, 2019 — Zebra Medical Vision, a deep learning medical imaging ana
WEBINAR: Using Data Driven Healthcare to Drive Transformative Change with Philips Healthcare.
Webinar | Information Technology | October 24, 2019
Today, health systems are continuously striving to improve performance, utilization, and workflow in order
The webinar Avoid the Pitfalls – How to Make Sense of Security and Compliance in the Enterprise Imaging Landscape is sponsored by Change Healthcare.
Webinar | Cybersecurity | October 24, 2019
The webinar "Avoid the Pitfalls – How to Make Sense of Security and Compliance in the Enterprise Imaging Landscape" w
Intelerad Expands Cloud-based Managed Services Offering Worldwide
News | PACS | October 23, 2019
Intelerad Medical Systems announced the worldwide expansion of its Nuage Cloud Managed Services offering. Medical...