Given today’s broad healthcare challenges, it’s hard to be neutral about Vendor Neutral Archiving (VNA). Given its ability to translate data to a standardized format and enable communication across disparate IT systems, hospital departments, and enterprises, the VNA addresses today’s most crucial healthcare issues – enabling patient data communication across the continuum of care, creating a more complete patient record, and supporting Meaningful Use. Moreover, after years of little control over PACS and other important data, a VNA puts providers back in the driver’s seat and relegates vendors a secondary position. By Greg Strowig, COO, TeraMedica, Inc.
By Greg Strowig, COO, TeraMedica, Inc.
Given today’s broad healthcare challenges, it’s hard to be neutral about Vendor Neutral Archiving (VNA). Given its ability to translate data to a standardized format and enable communication across disparate IT systems, hospital departments, and enterprises, the VNA addresses today’s most crucial healthcare issues – enabling patient data communication across the continuum of care, creating a more complete patient record, and supporting Meaningful Use. Moreover, after years of little control over PACS and other important data, a VNA puts providers back in the driver’s seat and relegates vendors a secondary position.
VNA technology can create medical records spanning a full range of medical specialties, support electronic medical records (EMRs) enhanced with radiology images and reports, and allow users to switch on a new PACS or other major IT application in minutes. Moreover, treatment location becomes irrelevant as patient information becomes accessible to any authorized physician anywhere.
By the year 2016, VNAs are predicted to store 31 percent of all new imaging studies worldwide, according to a recent report by InMedica, the leading independent provider of market research and consultancy to the global medical electronics industry.
While specific definitions of the technology may vary, most experts agree that its key benefits include allowing sites complete control of their own data, interoperability among IT systems, information sharing as desired, and analysis and use of this information in ways never before possible. In short, it enables imaging sites’ data to be independent from the proprietary IT systems that so often restrict the usage and value of important medical information.
Key Attributes of a Vendor Neutral Archive
- open standards
- patient-centric storage
- support for query, storage, and retrieval
- management of images and related information
- support for multiple departments, enterprise, and regional architectures
- maintenance of patient privacy and security though audit trails
- compatible with PACS upgrades and implementation of new PACS solutions
- elimination of future data migration and/or conversion of data formats
- hardware agnostic
- IHE compliant and certified
Offering a Better Way to Archive
A VNA uses an approach to storage and data formats that neutralizes healthcare information by complying with shared standards independent of the vendor application that created it, in contrast to the approach of most PACS and other healthcare IT systems. Additionally, with a VNA, IT applications are no longer committed to physically addressed storage and communication with other systems through proprietary integration.
Underlying all of the benefits of a VNA is its consistent metadata format, which enables identification of all data for each patient, regardless of where the information entered the IT system.
This patient-centric data format eliminates today’s hodge podge of expensive, unwieldy IT interfaces and home grown workarounds that today attempt to fill in the gap among systems. Applications using the archive require only a single point of integration to a standardized service for access.
VNAs commonly include data from HIS, RIS, PACS, and EMR as well from many specialty departmental systems.
Capitalizing on a Full Range of Healthcare IT Standards
A VNA works with standards developed by the widely recognized Integrating the Healthcare Enterprise (IHE) initiative, including DICOM, XDS and XDS1, HL7, and others. Using this common data formatting, the VNA provides an all-inclusive archive as the single point of information access for all the healthcare IT applications connected to it.
Any current non-standard data needs to be transitioned to this standardized formatting as part of the VNA migration process – but many VNAs actually provide this data conversion for users. Medical sites weary of the ongoing cycles of data translation that accompany a move to a new IT application will be relieved knowing that this is the last data migration they will ever have to perform. And the process can be handled efficiently and cost-effectively by many VNA vendors.
Image-enabling of EMRs and other IT systems becomes far less challenging than with an isolated PACS archive since the VNA contains diagnostic images. The ability to provide this patient-centric storage and information sharing will put facilities on the road to Meaningful Use.
Getting a Started with a VNA
A VNA is a solution you will live with for a long time – probably through multiple PACS applications. And it will serve the needs of multiple departments. Therefore, articulating a VNA vision and creating a roadmap for success will help move the project along more successfully and rapidly when the time comes to transition to a VNA.
Examine Your Priorities. Providers implement a VNA to meet a wide variety of needs. These might include image integration in an EMR, archiving images beyond DICOM (such as endoscopy), enabling data mining for tracking enterprise trends and predicting needs, or integrating a Health Information Exchange. Many of these goals will make specific technology demands on a VNA and may involve trade-offs and added costs. Understanding the goals and priorities for a project across the hospital will support sound decision-making and satisfaction with the results.
Educate Yourself. With your priorities in mind, educate yourself about the specific technologies that will best meet your needs. Talk with other VNA users about the pros and cons of their approach to the VNA and their specific system choices. And, of course, it’s never too early to launch your search for suitable vendors.
Understand Retention Policies. A VNA can automate information lifecycle management. Yet many sites implement a VNA without a clear idea of policies for information retention across the hospital. Survey the different departments involved in the project to begin plan development. Currently, some departments may never delete a single file, making archiving costs add up quickly and, perhaps surprising, putting them at increased legal risk. Policies may require review. Information about retention can help predict initial storage hardware requirements.
Anticipate Integration Issues. Investigate the systems that will need to integrate with your VNA. PACS and EMR are obvious choices – but typically there are others. Speak to your vendors and industry consultants about any potential integration issues to give yourself an advanced start on project implementation.
Assess Your Referrers’ Needs. How will referrers want to interact with the VNA? For example, will they want to view diagnostic-quality images with advanced tools and formatting options, or will lightweight images suffice? The varied preferences of referring physicians will often involve added costs and tradeoffs. Knowing this in advance will help with planning and avoid user disappointment.
About the author
Gregory Strowig has over 25 years of professional services, software development, and implementation experience, primarily in the health payer and provider markets. He has been with TeraMedica since its inception in 2001 and is currently the COO of the company. In this role, he is responsible for most of the company's global operations. Prior to becoming COO, Mr. Strowig was the VP of Client Services for TeraMedica, where he led the efforts to implement and support the company's products and services. Before joining TeraMedica, he was a partner with the global professional services firm, marchFIRST, and a senior manager with the global consultancy, Accenture.