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information that corresponds with those images. And as meaningful use includes imaging, the requirements to integrate imaging workfl ows will only expand. It is expected that Stage 3 will require that as many as 50 percent of images be shared across the enterprise, putting further demands on systems to integrate imaging workfl ows. So, where does that lead us? T e

obvious answer is that imaging needs to be managed at the enterprise level. But how do we best accomplish this? In the delivery of care today, health systems across the U.S. and around the world fi nd themselves struggling to bring together data from various departments around the enterprise. Electronic health records (EHRs) are attempting to solve this problem for data that resides in a patient chart, but that solution still leaves images behind. As more departments generate imaging data, simply consolidating storage does not solve the problem. Clinical workfl ow is needed to acquire, distribute and review these images. Technologies that provide a comprehensive framework that

enable fl exible workfl ows to bring images into every step of the care continuum are needed. Only when clinicians have a single point of access for all imaging data, integrated into the EHR, can health systems truly reduce duplicate procedures and enable a highly effi cient care process. T e patient care process is thus not only improved by the physician having a complete centralized picture of the patient’s health record, but by also allowing for the physician to more readily engage with the patients about their prior studies and historical patient record. Enrichment of the physician-patient relationship with the sharing of these images during the care process leads to a better patient understanding of their care and compliance of the patient treatment plans. For example, a dermatologist and pathologist sharing live images during a procedure allows the dermatologist to know if the procedure has been successful, or if another layer of tissue needs to be removed. In addition, image-enabling the EMR leads to increased

productivity and effi ciencies. T e ordering and result-distribu- tion process today is inclined to result in errors. Most processes today require manual intervention and result in workfl ows that are ineffi cient and costly. With image and result access via the EMR, these processes are streamlined and become more ef- fective. Image ordering mechanisms can be standardized, and the referring community is further satisfi ed with direct access to patient images and results.

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A screenshot from ICIS.

IMAGE COURTESY AGFA HEALTHCARE

In this era of increasing regulatory pressures and effi ciency

focus, freeing images from departmental silos and putting them in front of the physicians who need them just makes sense. Adding an imaging layer to the EMR can deliver far-reaching benefi ts that go above and beyond expedited delivery of care and improved clinical confi dence. Redundant studies can be eliminated, and primary-care physicians can leverage it to deliver more detailed, image-rich patient consultations, also leading to a reduction in care cost and an increase in produc- tivity with more effi cient workfl ows. T e future vision of an image-enabled EMR includes a continued evolution in the number of departments that are integrated into enterprise imaging. T e complexity of inte- grations the market sees today will be reduced by providing single-access image data points, thus resulting in a single enter- prise imaging workfl ow for non-specialists across all imaging departments. Providers in departments that do not readily use images within their workfl ow today will be able to expand their diagnosis techniques to a visual empire of patient images and historical image records. T is move to enterprise-wide imaging access will drive us out of departmental silos. Hospital CIOs will no longer request information based upon departmental imaging needs. T ey will look to evaluate imaging repositories from an enterprise assessment. Non-episodic care and disease management will benefi t from the sharing of clinical data through health infor- mation exchanges (HIEs). T e end result will drive the market to deep diagnostic imaging systems with advanced algorithms that will expand far beyond traditional radiology, with more improved workfl ow and diagnosis techniques.

HMT HEALTH MANAGEMENT TECHNOLOGY May 2013 19

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