I recently read an article in Advance for Imaging & Radiation Oncology, July/Aug 2012 by Shannon Werb, Chief Strategy Officer/COO for Acuo Technologies, entitled “The case for VNA.” Shannon makes the case for differentiating between a PACS vendor VNA (Vendor Neutral Archive) and a VNA offered by a truly independent vendor. The differentiation is made on how interoperable the VNA is in terms of working with all vendor solutions (i.e. “Vendor Neutral”), noting that some so-called VNA’s may merely be an extension of the PACS vendor’s PACS archive.
I concur with the basis of such a differentiation (between a vendor and vendor neutral vendor), but I believe the real differentiation must be made on the basis of intent and purpose. In an ideal world, all healthcare providers would have a common IT policy, and all system acquisitions would interoperate. Unfortunately, we don’t live in a perfect world! As recent consulting engagement experience has taught me, in the real world, there are multiple objectives at hand, and they don’t always complement one another. Hence in the absence of a clear-cut IT policy, departmental goals are often the basis for system decisions.
In one situation I am aware of, an overriding need for radiology and cardiology services was an integrated image archive for multiple disparate PACS that improves physician accessibility to patient studies. Ideally this could be met by a true enterprise archive (VNA) solution that creates a foundation upon which other imaging services can build as they need an image archive, as well as forming the basis for a common image platform for the EMR. Unfortunately in this situation, IT has other system priorities and at this point is not interested in an enterprise solution, leaving radiology and cardiology services little choice but to focus on their own needs.
As I noted in a previous blog (“Framing the VNA,” May1, 2012), there needs to be a framework for understanding the intent of the VNA. If the intent is merely an extension of an existing PACS, then it may be an appropriate definition. On the other hand, if the need is creating a true multi-vendor environment for an EMR, then one might consider vendors differently.
I also subscribe to the belief that a lot depends on who is the target customer. A departmental-led initiative might be viewed entirely different from a CIO-led initiative, and it will have an impact on potential vendor considerations. I have seen this in many client situations where a vendor may have a strong position in an imaging service and be a natural candidate, but at the corporate level, there may be an enterprise-wide system vendor who might also be a more viable candidate.
As Shannon states “Technology buyers must not fall prey to misleading offers when it comes to PACS vendors offering VNA solutions.” Granted, vendors have a way of embellishing in the sales pitch. But more importantly, it is imperative on both sides to know who the target audience is; and to know what the intended application is. All of us must work hard to create more informed buyers and more skilled sellers who can both effectively educate and differentiate. This will go a long way toward clarifying the differentiation.