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LIVE FROM RSNA 2012: What Strategies Make Sense in a Landscape of Swirling Change?

November 26, 2012
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What Intermountain Healthcare’s enterprise-wide image archiving strategy says about the state of the industry right now

Meeting this morning (during RSNA 2012, being held at the McCormick Place Convention Center in Chicago, and sponsored, as always, by the Radiological Society of North America) with executives from the Salt Lake City-based Intermountain Healthcare, the Malvern, Pa.-based Siemens Healthcare, and from the Healthcare and Life Sciences division of the Round Rock, Tex.-based Dell Inc. , one thing was clear: those patient care organizations with an imaging informatics strategy—perhaps almost any imaging informatics strategy??—are already light years ahead of their peer organizations whose senior executives have no such strategy.

The Intermountain executives—Keith White, M.D., medical director, imaging services; Tammy Madsen, associate vice president, clinical information systems; and Geoff Duke, imaging information systems manager—were all able to articulate, individually, and clinically, where Intermountain is going. Not only is the 22-hospital, 180-plus-clinic integrated system moving forward with a comprehensive enterprise imaging archive, with Siemens and Dell as strategic partners; that enterprise imaging archive strategy is also closely linked to Intermountain’s broader strategy of creating a truly everywhere-available longitudinal patient record, or as Madsen calls it, a “birth-to-death record… accessible to every appropriate clinician anywhere.”

Of course, endless debates are taking place as to the “hows” of all this; for instance, should an organization focus on collaborating with one or two proprietary vendors; hand-create its own infrastructure; try to plug into a broader health information exchange (HIE) structure; or not even try to create an enterprise-wide, all-specialty imaging archive to begin with? Given the imperatives flowing out of healthcare reform (particularly around the creation of accountable care organizations, bundled payment contracts, and patient-centered medical homes) and the meaningful use process under the HITECH Act, it’s obvious that something must be done—but what?

All those questions having been posed, however, it’s also clear that having some kind of broader strategy, and a strategy linked to a patient care organization’s most comprehensive business and organizational strategic plan, is essential. Would it be foolish to say it doesn’t matter what the strategy is? Of course, the strategy does matter. But what is also clear is that the vast majority of patient care organizations still don’t have any overarching imaging informatics strategy; and they’ll need one.

Of course, it’s easy for the leaders of organizations like Intermountain Healthcare to talk about their strategy, on a certain level; after all, Intermountain was one of the very earliest hospital-based organizations in the U.S. to create its own electronic health record, literally decades before most of its peer organizations nationwide did so. And Intermountain has clearly been at the head of the pack nationally both in terms of its overall informatics strategy, and more broadly, in terms of its overarching care delivery strategy. But that’s exactly the point.

Because, as one dashes across the exhibit floor here at the immense McCormick Place, it would be incredibly easy to fall prey to the temptation to swim in technology and solutions and buzz, without understanding how profound the need is right now to develop a core, overarching imaging informatics strategy, tied to a core informatics strategy, tied to a core organizational business strategy, in order to survive the coming years of tsunami-like change in healthcare in the next few years. And whatever one might say about Intermountain’s specific strategy—and of course, Intermountain has been around as an integrated health system for decades, and is dominant in its region, so many other organizations simply would not be able to replicate it in any case—it is a strategy; and that automatically puts Intermountain ahead of the vast majority of its patient care organization peers nationwide, by a Rocky Mountain mile.