George Robbie of Lexmark Healthcare offers six top tips for medical image sharing
In this article, George Robbie, general manager and vice president of sales at Lexmark Healthcare, offers some timely tips to help trusts improve medical image sharing
From a healthcare information management professional’s perspective, there are six steps to supporting efficient, secure and cost-effective medical image release and online sharing:
1. Create a centralised infrastructure: Centralise medical images to deliver information in a patient-centric fashion. Establish an open system that uses standard Web services so that the information can be used within existing hospital systems to collect imaging studies from all PACS, creating a common infrastructure that serves as the foundation for the next four steps. A preferred option is to move all studies from various ‘ologies into a vendor-neutral archive (VNA), combining the medical image formats found in DICOM and non-DICOM data and allowing them to be stored in a common, unified environment
2. Implement a medical image exchange based on HIM principles: Position the exchange on top of the enterprise image archive. Ability to access all studies, both current and historical, is essential to supporting workflows, user demands and the release of information (ROI) process. Access, control and reporting functions often are detached, non-integrated components. Most of these systems were not designed to provide work queues to support release processes. A medical image exchange should enhance an organisation’s ability to share patient information both within the health system and outside the network. Become familiar with release workflows, checking patient consent and opt-in/opt-out procedures, checks and balances
3. Add a single enterprise viewer: The ability to view medical images from any desktop or device, stationary or mobile, and for any authorised stakeholder along the continuum of care, including attending physicians, specialists, surgeons, patients and primary care physicians, can make a tremendous impact on care delivery. Some viewers, however, are not considered to be high-quality, forcing exchanges to physically move images rather than providing the option to simply share a link. High-quality viewers with advanced visualization features will enhance exchange workflows and support a wider variety of user needs
4. Balance security with image access: When observing medical images through a zero-footprint viewer, users leave no trace of having visited the data. A complete solution should incorporate the ability to track all access to medical images while maintaining a rapid-access experience for the user. Including the viewer as part of the complete audit trail is a smart control to determine who viewed images, at what time, for what purpose, and to track what the viewer did next. Ask your radiology directors and imaging vendors these questions: How do you get confirmation from the viewer that someone actually opened the image and observed it? Can you track user views in an accounting of disclosure report? How do you match an e-mail address with a user name and credentials for the purpose of monitoring?
5. Integrate medical images into the HER: From the days of simply handing patients a copy of their films, we have evolved to a complex process of integrating medical images from several study types into the EHR, with workflows that require features of the image exchange to be extended to EHR screens. As physicians document patient visit results, they should be able to send an image link to another physician or directly to the patient. This scenario goes beyond image-enabling the EHR, opening the door to improving organisational strategies by providing exchange functionality at the correct point within the physician workflow
6. Apply Web services: With mobility advances, people are able to work virtually anytime from anywhere. Even when not working, system users are typically connected and able to react to critical issues. Technology to support these scenarios and connect image exchanges through a variety of methods should be cultivated. Applying Web services will support users during the many short windows of time they are available to respond. Physician portals, patient portals, HIEs and URL or smart links to key Web pages and hospital websites all are part of an optimal solution. HIM professionals must be actively involved in each step of the process to ensure that adopted strategies are appropriate for image release and security controls
Leaders from HIM, radiology, clinical departments and IT must work together to improve medical image sharing and exchange across departments, facilities and enterprise boundaries. Take time to carefully evaluate the impact of cost removal benefits or an ROI impact report. You may be pleasantly surprised at how strong your argument will be for moving to a unified and visionary approach.