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Enterprise Imaging: The “New World” of Clinical Imaging & Imaging IT

April 24, 2015
by Don Pittman
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A serious paradigm shift has surfaced throughout the world of medical imaging, being described as “Enterprise Imaging” (EI). What is EI? Why is it important? What are the benefits? How does one construct and effectively manage an EI strategy / program?  
The foundations for building an effective EI program can be leveraged from traditional imaging and IT best-practice fundamentals. The following lays out the deliberate, innovative alignment between “imaging & imaging IT Fundamentals,” such as acquisition, management, distribution, archive, and governance, with evolving industry conditions impacting imaging and IT, such as the demand for centralization, standardization, interoperability, data integrity, and governance. 
Evolution of Imaging Technology 
For decades, medical imaging technologies and services have evolved in technology, service delivery models, and user expectations. The once siloed, analog, film, paper and manual process-based product, service and radiology-centric model has now evolved into an instantaneous, on-demand, interoperable, yubiquitous, and enterprise access-expectant demand for the most sophisticated of imaging datasets; anywhere, anytime, on any approved device, from any appropriate location and to/from any/all authorized users, internal and external to the organization.  

At the same time, medical imaging has also expanded into dozens of disparate, decentralized clinical imaging services, loosely interconnected (or not) through a maze of integrations, shared management and governance models. These are often void of imaging-centric, workflow and best-practice models. Clinical acquisition, distribution, archive, asset, and workflow management exhibit disparate environments, often without seamless interoperability. The challenge is how to effectively secure an enterprise longitudinal patient image record, throughout an enterprise environment that unites these disparate environments.  
Enterprise Imaging (EI) – Strategic Self-Assessment 
Healthcare executives are entrusted to deliver the highest quality, performance-driven imaging services throughout the enterprise, while at the same time, combat diminishing reimbursement and ever-increasing costs in doing business. The growing demand to secure physician and patient-centric access to PHI (patient health information), of which imaging data constitutes a rather significant proportion, further illuminating consideration for the development of an enterprise imaging strategy / program. To achieve this we must first clarify current state and consider the following: 
Are you confident in your organization’s ability to manage, govern, sustain, and advance imaging technologies, systems, integrations, distributions, assets, data content, services and support that meet and/or exceed your physician and patient imaging demands across the enterprise for all clinical imaging disciplines?  

Is there a recognizable EI strategy that effectively mitigates pains resulting from redistribution of imaging workflow processes and data integrity governance from a local to an EI services environment, which limits your ability to secure a data-integrity rich enterprise longitudinal patient image data record? 

Are you equipped with talented and accomplished EI professionals, well positioned to lead and govern this “new world” of imaging, while collaboratively aligning with, IT and other allied healthcare professionals influencing, or influenced by, imaging programs?  

Does your imaging information management system(s) lifecycle, SLAs (service level agreements) and image data content integrity effectively serve your entire enterprise? 

Traditional Imaging vs. Enterprise Imaging (EI) 
Let’s compare traditional imaging (TI) with the emerging trends in EI leveraging current “imaging foundations,” which are deemed essential, regardless of clinical imaging discipline:
Acquisition - (Clinical Imaging Modalities & Technologies) 
(TI) Medical imaging services have often been recognized as radiology disciplines, such as radiography (now CR or DR), CT, MRI, ultrasound, fluoroscopy, PET, Interventional, etc., or cardiology such as Echo, Cath, EP, etc. (EI) We have witnessed an explosion of clinical disciplines (gastroenterology, ophthalmology, oncology, pathology, dermatology, etc.), generating ology-specific image data; exhibiting workflow, dataflow, image data formats, archive, image management, distribution and integration models (or lack thereof), unique to each ology.  
Management - (Workflow, Dataflow, QC, Systems Administration, Integrations, Normalization & Neutralization) 
(TI) The TI model exhibits mature best-practice and standards-based processes and integrations; patient data entry, and integrity, image acquisition & QA/QC, imaging equipment and system vendor selection and management, report management, image data management, image archive and distribution. (EI) Non-traditional, disparate clinical imaging “Ologies” often reveal non-standardized, non-best practice clinical imaging workflow, dataflow, and image data management processes and practices; designed for each siloed ology workflow model.