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IT Matters - Image access strategies

February 20, 2016
From the January/February issue of HealthCare Business News magazine

PACS consolidation and a VNA
While consolidation on a common PACS platform (the same type but perhaps multiple server clusters) or instance (the same server cluster) provides several benefits, sometimes it is impractical or time-consuming to complete the data migration and system replacement required. Also, where organizational autonomy prevents consolidation, a shared VNA connected to each PACS can provide a longitudinal patient imaging record, even with different PACS. If an enterprise is very large, PACS consolidation may occur regionally (within common patient referral patterns)
and still be connected nationally through a VNA. Finally, even with a shared Radiology PACS, a VNA may be necessary to provide a shared repository for a longitudinal patient imaging record across clinical domains, such as cardiology, dermatology, and other enterprise image-generating departments.

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What to look for in a system
In addition to meeting the needs of the radiologists, the consolidating PACS should have features to support multi-facility workflows, different patient identities (MRNs) along with a Master Patient Index (MPI) value, support for different procedure information originating from a variety of facilities’ RIS, and a shared long-term archive (within the PACS, or a connected VNA).

If the PACS can discover patient and study information on demand from external image sources, such as a VNA, without requiring a data migration, the PACS can provide its users a longitudinal record for the patient, allowing comparison of any of their studies, regardless of acquiring facility. It should also offer multiple deployment options (for example, on-site or central servers and storage, or a combination), and demonstrate the ability to scale to very large transactional volumes with performance. Providers should consider user role and permission management and the ability to set different configurations (such as DICOM attribute mappings, display protocols, and so on) to accommodate different group or facility needs.

The ability to allow staff from each site to perform quality control functions on data acquired locally is often desirable. A system that provides High Availability (HA) and Disaster Recovery (DR), along with real-time system monitoring with alerts, is even more important when supporting many facilities. Getting clinical, system admin, and IT infrastructure staff to work together, reach consensus on workflows, and accept a shared PACS is not a simple task. To get buy-in, leadership should be sure to be able to explain not only the operational benefits, but also the clinical ones.

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