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Data Repositories: Where to Draw the Line?

March 17, 2011
by Joe Marion
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Vendor neutral archives represent progress, but patient-centric architecture is needed

Reflecting on HIMSS and recent vendor announcements, I’ve been thinking about how difficult it must be for healthcare CIOs these days in terms of data management. Information Technology (IT) organizations have the unenviable task of dealing with all of a healthcare entity’s data, including operational and patient data. With HITECH and Meaningful Use initiatives, a lot of attention is focused on the Electronic Medical Record, or EMR. The EMR can be a forcing function to draw attention on how information is currently stored and how it can be accessed by the EMR. One of the EMR’s goals is to provide a single point of entry to see all of a patient’s record. The dilemma for the IT organization is how to architect data storage to allow that goal to be achieved.

Much of today’s IT infrastructure is based on silos of data that must be managed independently. A significant drawback is the number of potential interfaces that must be maintained, as well as the ability to present the data in a unified view. Great strides are being made on the diagnostic imaging front in the form of so-called “vendor neutral archives,” or VNA’s. The goal is a single platform for all imaging solutions. While such solutions represent progress, they may or may not represent a platform that can accommodate more than just diagnostic images. Therefore, IT organizations may still be forced to maintain multiple storage solutions if they wish to address documents and other forms of diagnostic information.

The issue is further complicated as information moves beyond a single entity, such as with the formation of Health Information Exchanges. In their infancy (or at least formative years), the HIE’s have focused strictly on non-image data such as lab and test results. Again, the significant differences in data types have made it difficult to include images.

My expectation is that as the storage industry starts to congeal, there will be greater attention on how to accommodate more data types in a single, patient-centric architecture. If that can be achieved, it should greatly foster the expansion and implementation of IT-scale data storage solutions. Take the efforts of Dell and ATandT. Surely their objective is broader than just imaging data? These are the type of organizations that have the breadth to address more integrated solutions. Vendors that think outside of their normal “comfort zone” will be better positioned to take advantage of this trend. Those that continue to emphasize just DICOM images will potentially find it more difficult to compete.

I believe the tipping point will be the finalization of Stage 2 (and ultimately State 3). Once the issue of diagnostic imaging’s role is determined in terms of Meaningful Use, there will be more incentive to address integrated data storage solutions. I welcome your perspective!

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