Vendor Neutral Archive and the Electronic Health Record
As follow-up to a recent blog post around Vendor Neutral Archive (VNA) and Analytics, I think it's worth pointing out that the intent of VNA is to provide an archive that is standards based and can operate independent of any given Picture Archiving and Communications System (PACS) provider. The objective is to store all of the data in non-proprietary interchange formats along with context management to facilitate a seamless transfer between different PACS.
Consider the gravitas of this objective and match it to some of the hype evident in the market around VNA today. It is important to qualify the degree of understanding and knowledge your vendor and implementation partner has on the subject so that history doesn't repeat itself - the last thing you want is to move from PACS solutions with unique DICOM interpretations to a VNA solution with it's own nuances. Let's look at a summary list of core qualifications for VNA:
A storage platform and repository that stores Digital Imaging and Communications in Medicing (DICOM) content as it is presented, in it's original form with all tags, proprietary and optional, associated with the content.
The ability to morph DICOM header information and tags to provide standardization.
A common database that can be shared and queried by different PACS platforms.
Keeping all DICOM Service Object Pair (SOP) classes available and providing the ability to import and export in DICOM format.
Moreover, VNA should facilitate a consolidation of imaging centers across departments and facilities.
The reality is that healthcare institutions need to knock down proprietary silos of data, manage a broad portfolio of image assets that are integrated with electronic patient records so they can deliver increasingly effective and accountable care efficiently. Doing so requires truly open standards, metadata management and transparency.
VNA is one element of the healthcare provider informatics ecosystem. Keep in mind that imaging accounts for roughly 20% of patient information yet consumes roughly 60% of the storage with the remainder coming from other sources. This ratio will continue to skew as imaging becomes more sophisticated.
The image on the right is a computer tomography (CT) Scan of a sinus which was compiled by Kai-hung Fung, a radiologist at the Pamela Youde Nethersole Eastern Hospital in Hong Kong.
The dimensional effect comes from stacking together 182 thin CT “slices” to create a 3D image.
This is more of the 'art of what is possible' but modeling of this type is becoming more common place where it delivers value - the technology is available today to rapidly capture, synthesize and display but the context needs to be as rich and meaningful.
Healthcare providers need to look beyond the medical imaging component and ensure that they are making infrastructure and integration decisions that support an Electronic Health Record incorporating all aspects of the hospital, not just medical imaging.