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Unfortunately, this approach is not effi cient or effective.

Patients often forget to bring the CD to their next medical encounter. Or the data on the CD is incompatible with the technology at the receiving physician’s offi ce, thus it is un- able to be loaded and viewed. Even the most capable imaging departments report success rates of less than 90 percent when attempting to view CD

Michael Warthen is responsible for corporate strategy at Merge Healthcare. For more information on Merge Healthcare solutions:

images. This inability to view the image often results in treat- ment delays or additional (redundant) tests being ordered. If the CD being transferred is part of a trauma case, the impact can be signifi cant to the patient.

What can address this challenge? An intelligent DICOM

gateway, which serves two purposes: it eliminates the need for a CD to be created, and it enables successful uploading when a CD arrives with the patient.

The optimal scenario is to avoid the creation of a CD in

the fi rst place. The gateway would be used to receive an elec- tronic copy of the study via secure Internet (HTTPS). Once received, the gateway would perform appropriate DICOM tag morphing. This would enable the study to be viewed in the

native PACS of the receiving site. Additionally, the gateway would send text messages or e-mails to receiving physicians to inform them that studies were available for review. After review, the study would be saved to the VNA. Because this repository would store images from all departments and also be able to import images from outside sources, it would provide a true patient-centric view of medical images. With a VNA and a DICOM gateway in place, an organiza- tion is well on its way to the implementation of a compre- hensive enterprise imaging strategy. The third leg of the stool is the implementation of a zero-download, browser-based DICOM referral viewer. This viewer would be able to provide access to diagnostic images from a PC, an iPad or a smart- phone, thus giving near-ubiquitous access to any DICOM image as clinicians and patients move between environments – medical offi ce locations, hospital and home. Great value can be derived from the implementation of a VNA for image storage, along with a DICOM gateway and optimized viewing. This technology and model are used widely in other industries. The deployment of an enterprise imaging management solution is achievable. The question then presents itself: Is it time to go back to the future, to leverage technology and achieve the reality of this vision?


According to the U.S. Bureau of Labor and Statistics, the health care industry is growing faster than any other—with a projected 3.2 million new jobs by 2018. Be prepared with a Master of Science degree from University of Maryland University College (UMUC). Our health care administration and health administration informatics degree programs can help you meet the challenges of management, improve industry outcomes and build a thriving career.

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