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Jay Backstrom, practice leader, EMC (healthcare consulting) We are approaching a shift in the market that is driving the next evolu- tion of PACS imaging. Initially, PACS systems were implemented to move to a fi lmless environment. Additionally, imaging standards were developed to


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get images into a PACS system. Now, with organiza- tions implementing EMR/EHR for stimulus funding, healthcare organizations are trying to determine how to get images out of their proprietary imaging systems and integrate them with their electronic health records initiatives. To accomplish this, clients will need to build a

vendor-neutral imaging platform encompassing ven- dor-neutral distribution, archiving, work list, viewing and analytics that enable this information interchange. With that in mind, we fi nd that the main road block our clients face is building a strategy that leverages their existing technology investments and prepares their technology environment for this transformation to a vendor-neutral platform. Our clients look for guidance on the best way to develop an actionable technology roadmap to move to the next evolution of PACS.

Jeffrey Kennelly, RT(R), CIIP, senior sales engineer, NovaRad Currently, imaging informatics re- volves heavily on the use of DICOM and HL7. Standards exist in both languages, but the implementation of these standards varies dramatically amongst all vendors and products. IHE (integrating the healthcare enterprise) standards have helped to start paving the way for obtainable cross- platform integration, but they still must be completely embraced by the developers of new generations of current products, as well as future offerings. HL7 requires interfacing between disparate systems, as it identifi es no specifi cs for what fi elds must be used for what information in the transmission process. For true integration to ever exist regardless of system maker or use, standards must be agreed upon by the industry and adhered to precisely. Without intelligent design and standards across all imaging offerings, the dream of true, cross-platform/cross-information system integration will continue to be unrealized outside of single-vendor solutions.

Implementation roadblocks can be many in to-

day’s market. Roadblocks tend to be associated with hardware and infrastructure. Others revolve around training and acceptance by users. However, the ma-

jority of issues hindering successful implementation revolve around work fl ow. Identifying and agreeing upon work-fl ow processes by all parties involved is key to being ready for “go live” and being successful in the implementation of any system. Customers and vendors must involve users from every area that will use the system. Every process and procedure utilizing the new system has to be considered, and the trans- lated steps to use it effectively and effi ciently vs. the outgoing process or system have to be identifi ed. No stone can be unturned in this process. If every step, no matter how insignifi cant or infrequent, is addressed, implementation success is almost certainly assured. Finally, consolidating and integrating systems can mitigate another roadblock to a successful imple- mentation. By selecting a system that can seamlessly connect with other systems, operational effi ciencies can be signifi cantly increased while, at the same time, reducing costs signifi cantly. Selecting systems from vendors who provide standards-based systems can save hundreds of thousands of dollars in administrative costs alone. This is probably the most overlooked and under-planned budgetary consideration when select- ing systems.

Betty Otter-Nickerson, president, Sage Healthcare Division Interoperability has become one of the key drivers in health information technology. As such, it’s such a critical factor of the decision-making process that it’s also been written into the federal meaningful-use requirement. Needless to say, the evolution of imaging informat- ics will include interoperability, which, in turn, will continue to have a substantial impact on imaging informatics. The tie-in of imaging will be crucial to the overarching objectives as measured by meaningful use, as well as improving patient care and allowing improved communication between physicians and, ultimately, to patients. Additionally, medical imaging has a substantial tie-in to quality outcomes, as it is already among the most common adjunct technologies used for assessing anatomy and pathology. To achieve the goals of the practitioners in the space and for continued evolution of improvement of care, quality outcomes will rely on clear and effi cient communication between physicians – those that request medical imaging studies and those that provide reports on these investigations. Bottom line when selecting, adopting and using health IT: Employ options that allow you to pull in imaging informatics that provide interoperability with


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