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Make Your Sectra PACS into a VNA

Make Your Sectra PACS into a VNA. Anders Osterholm Vice President, Sales Operations. Make Your Sectra PACS into a VNA. Overview of the session . Why is this topic important? Overview of VNA and EIM Overview of Sectra Open Archive Strategies for leveraging Sectra PACS for VNA

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Make Your Sectra PACS into a VNA

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  1. Make Your Sectra PACS into a VNA Anders Osterholm Vice President, Sales Operations
  2. Make Your Sectra PACS into a VNA Overview of the session Why is this topic important? Overview of VNA and EIM Overview of Sectra Open Archive Strategies for leveraging Sectra PACS for VNA Questions and Answers
  3. Reality Check
  4. Healthcare costs increase by age
  5. Challenge: Health spending as % of GDP
  6. How to overcome the challenge?
  7. Improve quality of care and productivity Typical hospital care structure Strong departmental focus Cumbersome, uncoordinated and slow between departments
  8. Shift towards Clinical Pathways Shift away from department focus Shift towards Patient Centric care The rise of the EMR Meaningful Use Accountable Care Organizations
  9. IT systems to support the clinical pathways Primary Care Radiology Cardiology Oncology Orthopaedics Pathology Laboratory Surgery
  10. Consolidation of Imaging IT SINGLE PATIENT VIEW Pathology Cytology ... Dermatology Opthalmology Endoscopy .... Radiology Cardiology Pathology Cardiology
  11. HIPAA – Patient Privacy Patient information needs to be secure and auditable Patients have the right to know ‘who, when, why’ Many do not have these controls in place – especially for smaller departments
  12. Enterprise Image Management Patient privacy …This reporter has personally spoken with doctors who share X-rays and charts with colleagues via Dropbox….. And data breach after a doctor's laptop was stolen from an unsecured area of the hospital. In violation of Beth Israel and HIPAA protocol, the doctor's computer contained an unencrypted Excel spreadsheet with names and diagnoses for more than 4,000 patients. …The oral surgeon read Evas obstetric journal ...included information such as physician’s name, patients’ date of birth, diagnosis descriptions, summaries of treatments provided, medical histories and medical record numbers.... had exposed 32,000 patients’ data across 48 states. “People have the right to expect that their personal health information is protected,” says Ken Croken, Vice President,“And sadly, in this instance, it was not.” ... When the Swedish Minister of foreign Affairs was murdered, her journal was accessed by unauthorized personel at the Hospital- and later convicted for the crime ... 686 breaches of patient privacy have been reported at hospitals statewide and substantiated by investigators at the California Department of Public Health, including four by healthcare workers Six people were fired from a Los Angeles hospital after “inappropriately accessing” patient health records days after reality television star Kim Kardashian gave birth at the facility June 15. Angela Rose, a director of HIM practice excellence at AHIMA, said that whenever a celebrity or VIP is admitted to a facility there’s going to be heightened interest in their health information. To prevent breaches, Rose said it comes down to having a policy, process, and procedure in place for tracking and monitoring the access of all medical records.
  13. What do CIOs think?
  14. Sectra’s own survey Cost reduction and Flexibility are the two general values that CIOs want to fulfill with a VNA CIOs see PACS as a commodity even if proprietary solutions still exists Lack of a dominant design and compatibility between different vendors on the PACS market is the reason for the emergence of VNA
  15. Sectra’s own survey
  16. Enterprise Image Management Reality check Recognize the challenges? Multimedia used more in healthcare Collaboration & enterprise access Different systems/silos Patient Privacy/HIPAA Where is the data? Data growth
  17. So what is EIM/VNA?
  18. What is a VNA? Acuo
  19. What is a VNA? Teramedica
  20. What is a VNA? GE
  21. Wikipedia What is a VNA?
  22. VNA definition (Oosterwijk, Otech Inc) “A Vendor Neutral Archive (VNA) is a medical device that provides scalable image and information and life cycle management so that images and related information can be queried, stored, and retrieved in a manner that is defined by open standards at multiple department, enterprise, and regional level while maintaining patient privacy and security. Characteristic for a VNA is that it provides a patient-centric approach that transcends upgrades and changes of the different viewing, acquisition, and workflow management components as they should be interchangeable without having to migrate, convert, or change the data formats or interface of the VNA”.
  23. VNA definition (InMedica 2012) A vendor-neutral architecture (VNA) for medical data is a platform that provides long-term, disaster recovery, lifecycle management and the ability to easily share medical by communicating with different PACS. It serves as a central repository for medical images and other patient data based on an open architecture for multiple department, or multiple hospitals. It should also accept data irrespective of the originating PACS or other viewing, acquisition and workflow management system, making these originating sources changeable without having to change the data formats or interface of the archive. Outside the sharing of information based on secure access and authorization, it offers resilience against network interruptions, long-term archive, and disaster recovery services.
  24. Key Concepts - Simplified An EIM strategy enables Store & Exchange Capture Consume & Distribute of any image, anywhere, DICOM or non-DICOM
  25. Healthcare Trends – EIM provides a solution Prioritize Patient centric over individual departments Enable sharing of patient image records EMR, Meaningful Use patient portal Push to consolidate department silos with unified archive Manage storage better (redundancy, availability) Information Life Cycle management – secure the data Data growth Access and audits (HIPAA)
  26. Enterprise Image Management Cardiology The basic principle of a VNA Diagnostic Workflow Diagnostic Workflow Diagnostic Workflow Other hospitals Orthopedics Endoscopy Ophthalmology GynecologyDermatology SurgeryENT Radiology & Nuclear Medicine Capture Store Access Exchange Capture Store Access Exchange Capture Store Access Exchange Capture Store Access Exchange Proprietary storage Any storage Proprietary storage Proprietary storage
  27. Enterprise Image Management The basic principle of a VNA Any PACS Any PACS Any PACS Vendor Neutral Archive Any Storage
  28. Enterprise Image Management Accessibility within the enterprise Any PACS Any PACS Any PACS EPR Vendor Neutral Archive Viewer Any Storage
  29. Enterprise Image Management Accessibility beyond the enterprise Any PACS Any PACS Any PACS EPR XDS Vendor Neutral Archive Viewer Any Storage
  30. Sectra Open Archive
  31. Enterprise Image Management Capture, store, access & exchange Capture non-DICOM images, videos and documents and associate with metadata with efficiency Any PACS Any PACS Any PACS EPR HL7, DICOM Store & Q/R XDS Sectra Open Archive Viewer(s) Any Storage Storage neutral with CIFS support & DICOM part 10
  32. Make Your Sectra PACS into a VNA Capture and Store - Neutrality Application Neutrality through standards based interfaces (DICOM, HL-7, ....) Storage Neutrality through standards (CIFS, SAN, NAS, ....)
  33. Enterprise Image Management Capture any DICOM objects EPR Sectra Open Archive Modality Univiewer HL7 ORM DICOM worklist HL7 content notification DICOM Store
  34. Enterprise Image Management Capture non-DICOM images & videos EPR Sectra Image Cental Camera Sectra Open Archive Univiewer Patient demographics JPEG HL7 content notification DICOM Store
  35. Enterprise Image Management Capture video streams EPR Sectra Open Archive Frame grabber Video device Univiewer HL7 ORM DICOM worklist Stream HL7 content notification DICOM Store
  36. Enterprise Image Management Capture documents EPR Sectra Image Cental Document Sectra Open Archive Univiewer HL7 ORM DICOM worklist Import HL7 content notification DICOM Store
  37. Enterprise Image Management Capture, store, access & exchange Tight integration with EPR system XDS-I for images, XDS repository for documents (third party Forcare) Any PACS Any PACS Any PACS EPR XDS Sectra Open Archive Viewer(s) Any Storage ClickOnce/Citrix(IDS7) Zero footprint (LiteView) Published CDA documents can be viewed in IDS7
  38. Information at their fingertips What do your users need? Information from the EMR Information from the PACS At the same time Widespread needs: GPs Radiologists Surgeons Orthopedics Oncologists Pathologists Medical Imaging EMR & Specialties informatics
  39. Make Your Sectra PACS into a VNA Access and Exchange - Neutrality Neutrality through standards based interfaces (DICOM Q/R, XDS-i, WADO, APIs, ...) Tight univiewer integration to the EMR – ideally seamless
  40. Enterprise Image Management Beyond the standards Clinical workflow Exit strategy Maximum performance Patient privacy Maximum consolidation
  41. Enterprise Image Management Business continuity Any PACS Any PACS Any PACS EPR XDS Sectra Open Archive Viewer(s) Any Storage Proven stability, Redundant platform with no SPOF, VMware support Offsite, storage vendor neutral archive mirror
  42. Enterprise Image Management Information Lifecycle Management (ILM) Cascade changes to VNA by DICOM re-send or HL7 update Any PACS Any PACS Any PACS EPR XDS Sectra Open Archive Viewer(s) Any Storage Clinical ILM, i.e. storage tiering based on clinical context
  43. Enterprise Image Management Viewing performance PACS prefetch to temporary cache Any PACS Any PACS Any PACS EPR XDS Sectra Open Archive Viewer(s) Any Storage
  44. Enterprise Image Management What history is clinically relevant?
  45. Enterprise Image Management Direct Archive Access Archived Archived RapidConnectTM Sectra PACS PACS Sectra Open Archive VNA Sectra VNA Standard VNA
  46. Enterprise Image Management Maximum speed & consolidation IDS7 Any PACS EPR IDS7 Sectra PACS Sectra PACS Servers & storage Servers & storage XDS Sectra Open Archive Viewer(s) Any Storage
  47. Enterprise Image Management Maximum speed & consolidation Maximum speed & maximum consolidation for majority of departments. Freedom of choice for special cases, e.g. cardiac US Any PACS EPR IDS7 IDS7 XDS Sectra Open Archive Viewer(s) Any Storage
  48. Enterprise Image Management Business analytics Any PACS EPR IDS7 IDS7 XDS Sectra Open Archive Viewer(s) Any Storage Data warehouse solution with advanced statistical analysis toolkit
  49. Enterprise Image Management Patient privacy Advanced access control, audit & patient consent management in both IDS7 and Sectra LiteView No widespread use of standards (e.g. IHE XUA, BPPC, sup-99 QR). Filter on QR available. Any PACS EPR IDS7 IDS7 XDS Sectra Open Archive Viewer(s) Any Storage
  50. High Level Design
  51. Leveraging Sectra PACS for VNA
  52. Enterprise Image ManagementThe Desired End Result
  53. Make Your Sectra PACS into a VNA Strategy #1 – extend current PACS The PACS already has a large amount of data Leverage Image Central and normal DICOM imports to serve as an archive for other departments Grow what you have – minimal effort
  54. Extend current PACS Cardiology Others Radiology, Mammography & Orthopedics Sectra PACS Scalable storage platform
  55. Make Your Sectra PACS into a VNA Strategy #1 – extend current PACS Pros: Low effort Low cost Cons: All images in radiology workflow solution Creates a hospital wide dependency on a departmental solution
  56. Make Your Sectra PACS into a VNA Strategy #2 – Split current PACS Radiology produces approximately 75% of all image volume in a hospital Data migration to a separate VNA can take years and be very costly (and error prone...) Application neutrality can be achieved by realigning the current architecture – separating the archive from the workflow solution
  57. Enterprise Image Management
  58. Today PACS Workflow Online Storage Archive Management Archive Storage
  59. Step #1 PACS Open Archive/EIM Workflow Archive Management Online Storage Archive Storage
  60. Step #2 PACS Workflow Online Storage Open Archive/EIM Archive Management Archive Storage
  61. Step #3 PACS Other Ologies Workflow Workflow Online Storage Online Storage Open Archive/EIM Archive Management Archive Storage
  62. Step #4 EMR PACS Other Ologies Workflow Workflow Online Storage Online Storage Open Archive/EIM View Archive Management Archive Storage
  63. Make Your Sectra PACS into a VNA Strategy #2 – Split current PACS Pros: Creates hospital wide infrastructure component No dependencies on a specific department – usually managed by IT Lower cost than buying a separate VNA Very quick migration of radiology data Cons: More expensive than extending current PACS

  64. Sectra PACS Migration Services – Sectra Open Archive Exit StrategiesTransition to a different VNA vendor

    Scenario: Exit from Sectra Open Archive (VNA)
  65. Three alternative exit strategies a.) DICOM Q/R New vendor responsible for migration b.) DICOM Push A migration service from Sectra c.) Bulk Migration To replica on external file system Different Scenarios – Different Needs If you ever would like to exit from Sectra Open Archive, three transparent approaches exists.
  66. The DICOM Q/R approach a.) DICOM Q/R New vendor responsible for migration b.) DICOM push A migration service from Sectra c.) Bulk Migration To replica on external file system Data made easily accessible Sectra configures multiple DICOM Q/R SCPs Data is accessible on non proprietary format for new vendorto fetch using DICOM Q/R New vendor responsible for controlling the migration process, validation and consistency check
  67. The DICOM push approach a.) DICOM Q/R New vendor responsible for migration b.) DICOM Push A migration service from Sectra c.) Bulk Migration To replica on external file system A Sectra service, performed with Sectra’s migration tools Advanced functionality for controlling the migration process Migrate in reversed chronological order Migrate based on modality type, e.g. CT images first Etc Support for parallel DICOM C-MOVE operations Automatic resending of failed images
  68. The bulk migration approach a.) DICOM Q/R New vendor responsible for migration b.) DICOM Push A migration service from Sectra c.) Bulk Migration To replica on external file system A file system export Sectra provides tools for updating all DICOM files with info from the database, then exporting all image files on a open DICOM part 10 format to one or more external file systems The new vendor attaches the file system and imports all image files from the file system
  69. Questions?
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