Putting Image-Sharing in the Patient’s Hands

Ge says PCARE also leverages patient participation in its privacy and security practices, given that the patient authorizes the information exchange by being physically present at both healthcare organizations. “We can then physically link the IDs together by the patient’s direct confirmation,” adds Ge, “and therefore we believe it will be much more accurate than an MPI.”

“In most cases based on our survey data, and based on our anecdotal evidence, patients are very comfortable authorizing the sharing of their ongoing medical records with the healthcare providers that are part of their team,” says Carr. “People become more reluctant with the open-ended sharing of their data, say from a group of healthcare providers from the entire state.”

Infrastructure Needs

Carr says that the PCARE system is ideal for where most healthcare imaging is performed—at small physician practices or outpatient imaging centers. The PCARE system was designed to have a small footprint, and assuming the organization already has a broadband connection and a PACS, all that is required is a small server placed at the facility, and a kiosk or computer for patient authorization, all of which could cost the organization approximately $15,000, says Carr.

“There might be a competing network or groups of physician practices and smaller players that your patients see that you would like to collaborate with in a very rich way, and right now that is very difficult,” says Carr. “The advantage of PCARE is that you don’t have to set up an agreement between the two hospitals to open up all your databases and image archives.”

A prototype was implemented during a feasibility study between the 800-bed Wake Forest Medical Center in Winston-Salem, N.C. and Lexington Memorial Hospital, a 90-bed community hospital in Lexington, N.C. The performance test showed that, even including the slower network of Lexington Memorial Hospital, PCARE could move 1 gigabyte of data within 15 minutes, which Ge notes is satisfactory compared to most hospital wait times that are at least that long.

Next Steps

PCARE’s next phase hasn’t been completely finalized yet. In the next three to six months, the investigators will partner with a healthcare economist to begin interviews with patients, families, and providers to ascertain what they would like to see in the PCARE platform and how much they would be willing to pay for it.

There are also plans for a regional demonstration project to implement the system to document its challenges and successes. However, more funding is needed for that, and the team is currently in active exploration with interested parties.

Ge emphasizes the cost and time benefits of PCARE; not only can organizations save money on the CDs themselves, but the costs of management of the CDs in storage and personnel. Ge is excited about the many possibilities for this image sharing system and how it can be applied for other purposes like sharing a longitudinal virtual electronic health record, since the token in the PCARE system can link to lab data or any other medical data, for that matter.

“If you look at Stage 2 meaningful use, with the necessity to facilitate real exchange of information between providers and patients, and how that happens, I think our solution can play a role in several scenarios that are likely to be high volume exchanges of information,” says Carr. He adds that beyond enhancing interoperability, another strength of PCARE is that it can maintain an audit record, as well as document patient authorization for the exchange of their medical information, which is necessary for Health Insurance Portability and Accountability Act (HIPAA) requirements.