In this Q&A, SearchHealthIT caught up with Joe Marion, principal at Healthcare Integration Strategies, LLC, which provides imaging strategy and implementation services, to discuss the role vendor neutral archives play in population health. Marion discussed how to integrate these two technologies, what barriers stand in the way and what the future holds for vendor neutral archives and population health.
How do you see vendor neutral archives and population health coming together from a technology standpoint?
Joe Marion: Well, I think that the IHE [integrating the healthcare enterprise] profiles and the XDS [cross-document sharing] standard are going to play a major role. There's also another additional standard that's an extension of the HL7 … the FHIR standard, I think, also will weigh heavily in that, not necessarily for imaging data, but for related information. So, if you take the case of cardiology, besides collecting images, they collect a lot of all the information, such as waveforms and pressures and other measurements that are made during, say, a cardiac catheterization. So, in that context, having standards, such as FHIR, that can easily communicate those data elements is going to be important as well. And I think that using the XDS standard, having the ability across enterprises or entities, is going to be valuable in the context of being able to aggregate that information for population health purposes.
From a technology standpoint, what are the challenges or barriers to achieving this?
Marion: Well, there are a couple of critical ones. One is, in the context, the fact that most organizations have separately grown their document management environments and, again, the whole notion of cross-document sharing or XDS is intended to try to bring all of that information together so that people refer to something as clinical content management. So, instead of just worrying about or managing images, having a common environment that can handle images and associated other data or documents is going to be important.
The other aspect of that is being able to use standards to do that. There are some companies out there that have tried to stick to proprietary image formats. And early on in the industry, there were some advantages to doing so because maybe network speeds weren't as high. Internet bandwidth wasn't as high, so it took longer to transmit that information. So, some of these proprietary schemes were initiated to enhance the movement of information around, either internal to the organization or external to the organization.
But with the bandwidth speeds of today's networks, and just the industry standard information, there's plenty of efficiency in moving that information using the standards.
What tips do you have for successfully integrating vendor neutral archives with population health management technology?
Marion: Well, I think you know this is a very emerging area. I'm not sure that a lot of that is clear, but again, [it should be] in standardized formats and readily accessible through standards, such as the XDS, where you can be a repository, but maybe participate in multiple registries, so that data can be accessed across different entities. I think those are going to be the factors to allow the access to that information.
And I think if you look at companies like IBM with their Watson Health initiative, you're going to see more and more of that activity in the context that ... I don't think, perhaps in our lifetime, we'll see the point where machines do the interpretation and people trust it. But they may participate in that process, so I think that's probably a huge opportunity and is going to be a growing case in the sense that people are going to have to find ways to bring that information into more standardized solutions so that it is accessible by these tools, such as IBM Watson.
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