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RSNA PACS Roundtable

between disparate systems and entities. The barriers to adoption in fi guring out what to include or not include for data elements that were not manda- tory resulted in widespread variations in how systemic models could be implemented. While IHE attempts to address this with their integration profi les, the historic implementations, there are an enormous number of older system software revisions in the fi eld. This sets precedence for general fi nancial barriers in upgrading these systems that will continue to provide barriers to imaging informatics.

Despite this, confusion seems to exist around cross- entity and cross-vendor communications. Providers should not presume that it is overly complex or costly to link PACS systems from various vendors to one another, or to bridge PACS and EMR systems. Some vendors have made great strides in driving down costs and complexity.

Interoperability in imaging is going through a second phase of growth as providers consolidate. Legislation is encouraging more effective exchange of information. There is continued focus on reducing radiation expo- sure and avoiding unnecessary exams. A key challenge in this area is the cost associated with retrofi tting legacy systems. Technology has advanced, however, to a point where organizations can justify the expense – either to retrofi t existing systems or to start with an entirely new system. Reaching beyond pure technical aspects of this ques- tion are continued concerns about the misalignment of economic and political incentives across providers, payers and even patients. This challenge may result in further delays in the move toward more effective interoperability of disparate imaging informatics systems.

IMAGE: Philips Hybrid OR Suite

A derived goal of imaging informatics is to bring value to the delivery of imaging services to users by integrat- ing the process of diagnosis and the results delivery for patient care. These users who are external to imaging services bring new work fl ows, information systems and business issues to bear on the art of imaging informatics. As RSNA launches the RSNA clearinghouse at this year’s RSNA 2010 conference, giving patients control of their imaging information and the market for “CD elimina- tion” begins to take hold, bringing new focus on image sharing and creating new challenges to informatics. Now the information exchange challenge is no longer between technical systems but between solutions envisioned to simplify this information exchange.

Paul Merrild, senior vice p


D t

president, marketing and business d

development, Merge Healthcare Many believe that imaging has been at the forefront of interoperability. In using DICOM, HL7 and IHE, most would agree that imaging departments have a solid u

understanding of interoperability, and

that many imaging systems have a solid base to “play” with other systems.

12 November 2010

Matt Long, vice president, healthcare informatics, Philips Healthcare When radiology PACS systems were first developed, they were designed primarily for radiologists. What we, as an industry, learned over time was that for a PACS system to be truly successful the system needed to also meet the needs of referring physicians as well as IT. Over the past few years, as most vendors have been able to provide a solution that man- ages radiology images effectively, the focus for PACS has expanded from managing the movement of images to providing a platform for managing communications among users and to consolidate images from many dif- ferent clinical specialties: radiology, cardiology, pathology, dermatology, etc. As the role of PACS has evolved from a departmental imaging solution to an enterprise imaging solution and communication platform, the needs for integration have become more important. PACS systems regularly inter- face with RIS systems and more, and more often they in- terface with the EMR. Radiologists are frequently asking to have access to information traditionally stored within the EMR/HIS (biopsy results, pathology results, etc.) to facilitate the diagnostic reporting process. Ultimately, the bi-directional requirement with multiple information systems is the biggest challenge facing the industry as we move forward.


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