Enterprise imaging is becoming mainstream in healthcare

Here's Monique Rasband's response to the perennial question of whether VNAs are taking over from PACS.

"Not really," the KLAS research director said in an interview just after HIMSS 2017 wrapped up in Orlando.

Monique Rasband

The real divide, Rasband said, is not so much as between VNAs and PACS but between old-school departmental, mostly radiology-based imaging and the fast-growing wave of enterprise imaging that distributes access to images across all key departments in a healthcare system.

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Among the most common imaging-intensive specialties being brought into enterprise imaging frameworks are cardiology, dermatology and pathology.

Some big providers are taking parts of their existing PACS, in what Rasband called a sort of "PACS a la carte" strategy, and plugging them into image storage, retrieval, workflow and analytics systems that might revolve around a VNA and universal viewer, she said.

Or providers are adding a VNA instead of buying a new PACS, but keeping their traditional PACS and linking them to the VNA to form an enterprise imaging system.

"What the more innovative providers are either doing now in early phases, or looking to do, is bring together all of these service lines, all of the 'ologies,' into the VNA," Rasband said. "Their strategy is to get everything into the VNA."

Providers are starting to look at their enterprise imaging systems as an "EHR for images," she said. "It's having everything in one place so physicians have the information."

What struck Rasband most about HIMSS 2017, she said, was the dramatic upsurge in interest this year in medical imaging; in particular, enterprise imaging, at a show that has traditionally not had much imaging presence.

That boosted role for imaging means it has entered the mainstream of health IT, with CIOs and CMIOs now getting much more involved in purchasing imaging systems, she said.

"Before, that was just not a focus for them," Rasband added.

The larger organization is realizing the importance of imaging. We’re seeing a lot of purchasing going on right now. A lot of people are getting deep into enterprise imaging.

Rasband said she was struck by the standing room-only crowd that showed up at a joint HIMSS-Society for Imaging Informatics in Medicine focus group meeting on imaging.

And most of the 80 or so people who attended the HIMSS-SIIM event were from provider organizations, she said, along with a few vendors.

"The larger organization is realizing the importance of imaging," Rasband said. "We're seeing a lot of purchasing going on right now. A lot of people are getting deep into enterprise imaging."

A key driver behind the move to enterprise imaging is the gradual changeover to value-based care. A cross-departmental imaging architecture that includes an image trail can help clinicians cut down on duplicative and unnecessary scans, and can also help providers determine more accurate costs of individual procedures, Rasband noted.

As for image retrieval, Rasband said VNAs aren't necessarily faster than departmental PACS, "it's just that you have it all in one spot."

"It's not so much speed in getting it as speed in knowing where it is," she said.

Up until the advent of VNAs, a physician might be looking for images in three or four different PACS or in a specialized cardiology image repository. Or, let's say a doctor is looking for an image for wound care.

"Where is my stuff for wound care? Is it on a bunch of cell phones and the physician doesn't even know whether it exists and there's no way to access it," Rasband said.

There is still a place for PACS, Rasband said.

She acknowledged that VNAs are on the upswing, "but I don't know of any provider I've talked to in the last five years that doesn't have a PACS."

In other words, providers are still using their PACS, but they're doing so increasingly in concert with VNAs in enterprise imaging setups.