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Enterprise Imaging Catching On?

March 14, 2012
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Will ARRA/MU usher in greater acceptance of VNA's and Enterprise Image Management applications?

I am currently engaged with a number of clients in various stages of the acquisition of some form of enterprise image management application.  In some recent conversations with several vendors, I am surprised at the number of “Request for Proposals” or RFP’s that these vendors are receiving from various facilities.  As a result, I am rethinking the acceptance rate of healthcare providers for addressing image management in the enterprise!

Granted a significant portion of these are likely addressing shared archives between a number of service areas, or the so-called “Vendor-Neutral Archive” or VNA.  This in itself is encouraging, as it says that facilities are looking for common ground between service area applications, and the economies of scale that come from it. 

More intriguing is facility activity on the part of enterprise image management ahead of the recent announcement that ARRA/Meaningful Use would include some degree of imaging!  With the advent of imaging’s inclusion, I would expect activity will only accelerate as providers begin to plan for the inevitability of inclusion of images in ARRA/MU. 

My prior thinking had been that so much effort was being placed on Stage 1 of ARRA/MU that there was little attention being given to imaging.  It is encouraging to think that imaging is receiving more attention, but I continue to be concerned that the cart may be in front of the horse!

As I have previously blogged, true enterprise image management solutions are early in the development cycle.  For example, most vendors are just now beginning to actually implement the XDS/XDS-I profiles to accommodate cross-document sharing of images.  The reality is that few existing legacy IT systems are probably capable of supporting XDS.  Consequently, it will be a while before there is widespread use of the profiles. 

Given the time frame for ARRA/MU Stage 2, I am hopeful that it will be addressed with the implementation of standards such as XDS, and that it will hasten their acceptance.  This will represent an interesting challenge as providers and vendors wrestle with integration of imaging into Health Information Exchanges (HIE), as there has been no requirement to date to do so. 

Facilities will be wise to carefully think through how to implement these solutions, and they will most likely need to do so from a broader perspective, as the whole premise of an HIE is the exchange of information between healthcare providers. 

So, while the future of enterprise image management is rosy, providers need to proceed cautiously with well thought out plans lest they find their investment does not match emerging requirements.  As usual, your perspective is always welcome.



Joe, excellent post! I shared your concern about prior MU requirements and your optimism about MU Stage 2, specifically the imaging tie-in. Although imaging isn't necessarily a requirement in the proposed rule it is at least mentioned as one of the possible 5 requirements (3 of 5 must be selected) and my hope is that the final rule goes further into defining how this is achieved.

Currently is is my understanding that imaging needs to be published via the EMR, but we need to take this further in order to prevent lock-in and truly enable image sharing at enterprise scale. XDS not only helps to facilitate this but it also helps to drive the availability of related clinical content - not just medical imaging (very important in my opinion).

Although the VNA (+ XDS) may not directly fulfill the requirements of MU Stage 2, it is definitely an important indirect component that drives for standards based adoption, freedom and flexibility for the customer in how they acquire, distribute, manage and "share" their clinical content.

Shannon Werb
Acuo Technologies