The Three Essentials of PACS Integration through Enterprise Imaging.
The patient story is an ever-evolving and complicated driver in healthcare.
Patients move their care between hospitals and regions due to different service requirements, different illnesses or injuries, and the location of specialists and equipment.
As a result, patient data is constantly shifting and changing. It is forever in a state of flux and must be updated with the latest information. New medical images are acquired from various sources, whether it be computed tomography images, ultrasound scans, videos of surgeries, or photos of a wound taken on a cell phone in an emergency room.
This has implications for a patient’s electronic health record (EHR) and requires the integration of PACS spread throughout a healthcare enterprise.
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Clinicians need the most up-to-date information to deliver the best diagnosis and course of action for the patient at that moment. The patient’s EHR must evolve along with the changing story.
The matter is further complicated by the growth of hospital enterprises in the United States. Acquisitions and mergers in hospital organizations also mean the appropriation of PACS with petabytes of patient data spread across departments and scattered in various locations.
These PACS are made available and require the thoughtful absorption and connection into the newly expanded health enterprise.
To synthesize all this data and make it easily accessible to clinical and administrative teams requires a highly versatile technology that can capture the information in real time. It demands technology that makes this information easily retrievable, but is smart enough to orchestrate all the data so that the correct anatomical information is provided in a way that matches the particular viewer a doctor is using.
The technology must also provide the appropriate tools to analyze and deliver a diagnosis. It is much more involved than simply finding the right patient study among various PACS in an enterprise, some of whom speak different computer languages, and retrieving it quickly.
Fortunately, there is a way to integrate all this data across different PACS. And it can be done not only throughout large hospital enterprises, but also across regions, entire states or provinces, and even nations.
The answer is an enterprise imaging solution that includes three elements:
1. A vendor neutral archive (VNA);
2. The ability to federate queries;
3. And, a data orchestration engine.
Related article: Read our article about Gartner’s report on imaging content management for more information about enterprise imaging strategies and challenges
Essentials of PACS Integration: The Vendor Neutral Archive
A VNA is similar to a PACS in that it is an archive for DICOM images and content, but there is one important distinction: it allows the integration of viewing and storage of different health IT systems, regardless of the vendor who made them.
In essence, an enterprise imaging solution incorporates a VNA that sits on top of a hospital’s storage device and decouples the PACS and workstations at the archival layer, using an application engine that receives, integrates, and transmits the data. It is a powerful device that provides one viewing experience regardless of where the images come from.
Without such integration, a physician wanting to see patient information stored in four different PACS must open four viewers, log in four times, search for the data in four different ways, then look at four datasets and assemble the information in her head.
This is clearly inefficient, especially in an urgent situation.
A VNA offers even more benefits if it can also accommodate non-DICOM images and patient data. By allowing the retrieval of artifacts beyond radiology or cardiology, clinicians may be able to see images that are generated by surgery, emergency room wound care, endoscopy, and others.
Essentials of PACS Integration: A Federation of Queries
To integrate the data, a VNA uses a “federated search.” As a part of the EI technology, federated search retrieves information and allows the simultaneous search of multiple searchable resources. It allows a user to make a single query request which is distributed to search engines, databases, or other query engines that participate in the federation. The federated search then aggregates the results and presents them to the user.
Federated search can be used to integrate disparate information sources such as various PACS spread across a large organization like a hospital enterprise, or even the entire web. At the same time, a VNA must be able to federate queries, regardless of where the query originates in the system or where the data resides.
This requires centralized coordination of searchable resources, and it involves the coordination of queries and the fusion of results.
Federated search is an essential tool that allows a growing enterprise acquiring new hospitals to integrate its PACS and gain access to a wealth of patient data that can help improve care.
Essentials of PACS Integration: Data Orchestration
To complete the power that is a VNA and the ability to federate queries, one more piece of technology is needed in an EI solution: a data orchestration engine.
Working unseen, like the plumbing in a house, a data orchestration engine renews and refreshes all the relevant patient information from disparate sources in real time and delivers it to the applications at the point of care.
Such an engine must be engineered to perform well in a multi-facility, multi-PACS environment, such as a large healthcare enterprise.
A data orchestration engine will include:
• centralized storage of all medical images and associated data in a common enterprise archive;
• seamless data sharing and collaboration;
• access to and orchestration of data from all sources through an open standards-based platform;
• protection of data from unauthorized access and the effects of unscheduled downtime;
• simplification of data migration;
• facilitation of artificial intelligence to aid clinicians;
• and, routine operational support through an intuitive user interface.
Essentials of PACS Integration: The EI Solution – Bringing It All Together
Integrating data across a variety of digital systems is a healthcare reality today. That data is changing by the hour as patients’ health status alters, requiring the electronic health record be updated in real time.
In order to deliver effective care, clinicians must know the ever-evolving patient story.
This means that PACS must be integrated through an elegant, efficient EI solution that incorporates a VNA, query federation, and data orchestration.
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