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The "Image" Perception

June 8, 2011
by Joe Marion
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Perhaps the healthcare industry could use the Rorschach test when it comes to what to include in imaging

Recent dialog on image management reminds me of the Rorschach Ink Blot Test. Psychiatrists often use this test in interpreting personality traits, with different people seeing different things in the image. Perhaps the healthcare industry could use such a test when it comes to the perception of what is included in healthcare imaging, as healthcare IT personnel can quickly become confused in trying to address all the different needs.

Those within the diagnostic imaging business naturally tend to emphasize diagnostic images such as Computed Radiography or CT images. Those now starting to promote enterprise imaging might perhaps have a broader base and include images from the other “ologies” such as GI, Pathology, or Ophthalmology. But what about other “images”? For example, scanned documents are certainly images. A growing use of kiosks and other point of entry devices will produce images as well.

Unfortunately, many of these images are produced by devices from a variety of manufacturers – each with their own methodology for managing the data. The result can be an array of image management solutions that can span different media, and make integration of that data difficult.

From an IT perspective, management is always looking for ways to simplify, aggregate, and consolidate. Hence, the ability to rationalize a number of image management solutions into a common data management strategy should be appealing to IT management. The goal is to define the extent to which this is possible, and it is paramount to the development of a vision and plan for data management.

The question however is what “image” or scope comes to mind when IT considers this? A simple common approach is to consolidate image storage on a common platform, perhaps using multiple partitions for different devices, but still gaining the economies of scale for the storage media. A slightly more elaborate approach would be to extend this to a “common” storage device that has enough intelligence to manage the data in a patient-centric approach.

But what if one thinks farther outside the box? There are certainly enough other data management applications within IT that require similar processes.” Might it be more appropriate to consider these processes and how one can get economies of scale as well as improve workflow? For example, what of the question of disaster recovery and business continuity? Shouldn’t there be a common strategy across all data? Should the recovery rules for say internal emails be significantly different than for other relevant data such as lab results or diagnostic imaging results? And how should data be accessible across the enterprise? Should there be a common viewing platform such as an EMR for all relevant patient data? How about data retention rules? Should these be applied to all data or are there separate rules required for different data?

IT organizations that step back and consider their data management requirements from a process perspective may find that there are greater opportunities for improvement. I am curious as to how many healthcare organizations are addressing this from a strategic versus reactionary basis. If one made a concerted effort to understand strategically what the requirements might be, would it have consequences for the acquisition of individual systems? For example, if there were a common strategy for data storage, would one look differently at the way that a PACS were configured, to assure that it met a facility’s data management requirements?

I am curious to know your thoughts. Has your organization ever contemplated a strategic look? Or, is this like “swallowing the whale in one bite” and too big an undertaking with too little return? My opinion is that most organizations may be taking too narrow a view – either from a budgetary or manpower limitation, and could benefit from a more reflective strategic view. As usual, your comments are encouraged!