8 reasons to move beyond a PACS-only approach to imaging

Healthcare organizations around the world are being forced to do more with less.

At the same time, a renewed focus on patient-centered care and population health is driving transformation of clinical and financial operations across the entire organization, including the radiology department.

In addition, more frequent mergers and acquisitions and ever-shifting partnerships and joint ventures are bringing more diverse systems into the mix, adding complexity to already complicated operations.

The traditional siloed approach to clinical care is costly, inefficient and no longer sustainable.

A key example: while efforts to build enterprise electronic medical records (EMRs) that readily share patient information have led to improvements in clinical and financial outcomes, the fact remains that 80% of clinical content sits outside of the EMR — much of it as non-DICOM images.

That leads to risky clinical blind spots. Important patient information is still widely inaccessible.

Decentralized systems continue to carry heightened security risk and protected health information (PHI) is at times more exposed than it should be.

Without a common way of incorporating images and data from radiology and the additional “-ologies” that also reside outside of the EMR (including cardiology, dermatology, ultrasound, radiation oncology, mammography and other departments), important information often isn’t considered during patient assessments.

And clinical decision-making suffers.

Departmental PACS are no longer enough

In the midst of this shifting environment, organizations with conventional picture archiving and communications systems (PACS) struggle to keep pace.

Most of today’s PACS solutions are built to store and manage DICOM-based medical images (e.g. x-ray, CT, MRI images, etc.) and streamline workflows for the radiology and cardiology departments that generate and interpret these studies.

As such, these systems are designed to manage the flow of DICOM images within these departments — not to extend and share these assets cost effectively with other clinical stakeholders throughout the enterprise.

Furthermore, many non-DICOM clinical images and videos (e.g. JPEGs, MPEGs, PDFs) captured in departments like dermatology, gastroenterology and surgery offer significant clinical value.

These images are typically stored in siloed departmental systems disconnected from the EMR. Some healthcare providers have attempted to add these assets to incumbent PACS systems in an effort to centralize management and control.

However, most PACS aren’t equipped to easily ingest and manage non-DICOM assets, making this initiative complex and costly. As a result, many diagnostic images aren’t easily extended to point-of-care clinicians and are largely inaccessible to external collaborative organizations.

PACS are also aging — in fact, many PACS implementations have fallen behind generationally, failing to keep up with advancing modality technologies, system changes and innovations as they are made available from the vendors.

All of these challenges compound each time a new organization is brought onboard, creating even more imaging silos, bringing along differing medical record number taxonomies, and adding costs and complexity.

Staying with a PACS-only approach is a sure way to keep the silo walls fortified, something no organization should risk doing in today’s environment.

But putting aside PACS systems in favor of fewer and/or newer technologies can present its own challenge. That’s because existing PACS solutions represent a significant investment — and familiar work environment — for the departmental imaging specialists and organizations that rely on them for clinical-decision making.

Enterprise imaging can build a strong bridge to the future

The good news?

For organizations committed to sustaining their existing PACS, modern enterprise imaging systems provide an excellent bridge, offering flexibility and scalability to reap the benefits of technology advancements while protecting the investment in current systems.

Simply put, enterprise imaging systems can greatly augment existing PACS offerings and help address larger institutional challenges around interoperability and information sharing.

That, in turn, can simplify the transformation path to patient-centered care and population health while easing transitions when further acquisitions and/or new partnerships take place.

Organizations today need an enterprise imaging strategy capable of merging platforms and augmenting siloed systems related to image acquisition, management, visualization and distribution across the entire organization.

While there’s more than one path to this transformation, and each organization requires an enterprise imaging strategy that’s customized to their unique needs, the following elements are required to help create lasting change:

• A centralized and patient-centered view of content across all organizations
• A vendor-neutral, highly interoperable approach that makes it easy to manage and share large volumes of healthcare data, including both DICOM and non- DICOM images specifically
• Specialty viewers that can support radiology and multiple other “-ologies” and visualizations to the clinical and specialty workstation and for high-volume workloads
• The ability to swiftly combine data and prepare for the next merger/partnership
• A solution that delivers legitimate ROI for radiology and the enterprise

8 reasons moving beyond PACS-only is important

A strong enterprise imaging strategy — one led by imaging leadership in partnership with IT — can help advance larger organizational efforts to build a patient- centered care model.

It does this by providing timely access to imaging records and data, while ensuring that organizations are able to accelerate information sharing and collaboration over time as population health evolves.

Enterprise imaging consists of image capture acquisition; a vendor-neutral archive (VNA); enterprise viewing; and information, image and data sharing.

> Read more | Why fast-paced enterprises need secure file sharing

The right solution is capable of addressing a broad spectrum of image types, including surgical video, wound photography, cardiology and ultrasounds, to name just a few. Completeness of content is also important, as is vendor neutrality at every level.

Combined, these tools work together to support a broader strategy than PACS, one that can surround and extend PACS capabilities throughout the enterprise.

Here are eight reasons it’s important to move beyond a PACS-only strategy.

They fall into three main categories: controlling financial performance, improving clinical outcomes and navigating regulations and mitigating risk.

Controlling financial performance

The ability to streamline systems and consolidate data reduces system costs while enabling greater efficiency through collaboration across the enterprise.

1. Improve flexibility and scalability while saving costs

A strong enterprise imaging strategy can help increase an organization’s ability to manage, maintain, upgrade and secure systems, bringing significant cost savings.

With it, organizations reduce — or even eliminate — the need for costly PACS data migrations and save substantial financial and human resources in the process.

They also have the flexibility to provide a better user experience for radiologists and other clinicians by giving them the ability to view information wherever they are — on desktop or mobile devices.

IT can also provide a higher-level of access, using zero-footprint viewers, while minimizing the number of supported enterprise viewers.

Not only can these viewers reduce the number of devices used across the enterprise, but they can also improve management of those devices across departments.

Enterprise viewers provide a strong foundation to support image management for both short- and long-term needs.

Enterprise imaging helps to better prepare a health system to adapt and scale as organizational changes occur including mergers and acquisitions, new partnerships, departmental changes, regulatory changes and more.

2. Simplify access to imaging data and deliver more content

Moving imaging data out of individual silos is one of the most important components of a solid enterprise imaging approach and is crucial to providing more collaborative patient-centered care and supporting population health initiatives.

Today’s enterprise imaging solutions support a wide range of clinical image and data formats, including images and videos kept on device camera rolls, USB drives, CDs, individual workstation file systems and more.

Most importantly, they support the sharing of this information in valuable ways.

Bringing this additional information front and center gives clinicians a more complete view of the patient.

Plus, by enabling organizations to include, view and collaborate on a wide range of unstructured data and images under an enterprise VNA additionally helps to reduce costs associated with duplicate data in multiple systems.

Furthermore, tools that integrate disparate data will be essential to maximizing reimbursement under new value-based care (VBC) models in the U.S., especially as diagnostic imaging procedures are increasingly included under incentive payment systems — from 10% in 2016, to 50% of them in 2020, according to Frost & Sullivan.

3. Streamline “-ologies”

With a strong enterprise imaging strategy, organizations can manage imaging content from radiology and all other “-ologies” under a secure enterprise VNA.

Enterprise imaging could centralize data and increase levels of interoperability between proprietary archives and other system-wide clinical applications.

This helps mitigate the barriers created in proprietary modality devices within individual departments, while creating a consistent and reliable imaging and video process no matter the department or file format.

All of this translates to one streamlined view of medical imaging information from a single location across the enterprise — the nirvana state for radiology and IT alike.

4. Improve clinical workflow and heighten operational efficiency

With PACS in existence across departments, many of which aren’t integrated with the EMR, the opportunity to provide truly coordinated care is limited.

By integrating with other systems, enterprise imaging solutions eliminate silos and provide a single point of access for radiologists and other clinicians, while also eliminating the need to log in to multiple systems for information or toggle between browsers.

More importantly, the holistic view of the patient record improves point-of-care interactions for all caregivers, and ultimately leads to better patient outcomes.

That’s because the automation available with enterprise imaging solutions consistently associate images with a patient and encounter and present it in context of a medical record. That saves time, improves productivity and facilitates more cost-effective care.

Within radiology, for example, radiologists have the ability to perform image interpretation from anywhere via a cloud-enabled diagnostic viewer.

This enables them to share large imaging studies with other specialists and supports stronger collaboration with other clinicians within the organization and across the care continuum.

Plus, reducing the need to manually import and index captured content into the EMR or other clinical systems creates significant efficiency gains for imaging teams.

The holistic view of the patient record improves point-of-care interactions for all caregivers, and ultimately leads to better patient outcomes.

5. Expand care coordination

With enterprise imaging, organizations can provide a patient-centered view of consistent information for everyone across the continuum of care.

That translates to a more coordinated patient experience within and across organizations, ever important for value- based reimbursement, where ownership of clinical content on behalf of the patient is a mandatory requirement.

With the ability to access historical images, clinicians can review images over a period of time, gaining the insight and context needed to improve decision making for their patients.

Navigating regulations and mitigating risk 

Protecting and extending technology investments while reducing risk across the organization is important when evolving imaging-related processes.

6. Ease system integration and maximize the ROI of existing systems

More than a quarter of hospital CIOs consider retrieving EMR information a growing problem.

Accessing medical images from an EMR can be particularly difficult considering common interoperability obstacles attached to PACS.

By image-enabling the EMR, enterprise imaging technology leverages an organization’s existing investment while providing a budget-friendly way to take advantage of the ability to connect, share, view and manage medical imaging data.

Organizations have the flexibility to distribute images and data at the point of care through image-enabled EMR viewing, a health information exchange (HIE) or other resources, enhancing the return on investment on those expensive systems.

Those efforts improve the ROI of EMR, HIE and PACS systems all at the same time.

7. Simplify the imaging technology approach

Streamlining imaging technologies with an enterprise imaging strategy can help simplify migrations and reduce costs, across disk-to-disk, app-to-app and data refresh projects.

Plus, it simplifies storage and other infrastructure changes, as well.

Simplifying your imaging approach can also support improved disaster recovery efforts across the entire organization, while supporting the development of high- availability options across the board.

Having an enterprise-wide strategy in place makes it easier to streamline imaging across multiple departments and organizations while simplifying the onboarding and consolidation process as new mergers and acquisitions occur.

Perhaps most importantly, it gives organizations a bridge while preparing for eventual PACS elimination as technology continues to evolve.

8. Improve security and compliance

With an enterprise imaging strategy, supported by a VNA, organizations can implement auditing processes to control system access, apply security protocols to all images and better protect PHI and sensitive images while meeting HIPAA compliance standards.

By eliminating departmental imaging silos, they can reduce potential points of attack.

Combined, these improvements help not only at the departmental level, but also across the enterprise.

Keep it simple and start where you are

Whatever your approach to building or enhancing your enterprise imaging strategy as you begin to move beyond PACS, it’s important to consider the effort a journey rather than a single destination.

Building an approach that continues to leverage your existing tools while advancing your efforts to improve information sharing and collaboration will position you to remain competitive in today’s constantly shifting healthcare environment.

That’s true within radiology and across the enterprise.

The good news with enterprise imaging is that you can implement key technologies in any order — improving the ability to connect, manage, view and share medical images and all related documents on your terms and timelines.

The result? A flexible, scalable approach that supports better outcomes, more effective care and streamlined workflows. That’s a change worth navigating.