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.