VNA now a strategic necessity: Timing is the only question

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 - William Lacy
William Lacy, Division Vice President, Informatics Marketing and Enterprise Sales, FUJIFILM Medical Systems U.S.A., Inc, Stamford, Conn.

Hospital CIOs now recognize that it’s no longer a question of whether vendor neutral archive (VNA) is a technology they should consider, but rather when is the right time to introduce VNA to their IT organization.

More and more areas of today’s health systems are producing patient imaging content, in both DICOM and non-DICOM formats, and image file sizes continue to grow larger. Disparate storage silos are everywhere, organizational security and backup policies for imaging not controlled centrally by IT is near impossible, and the EHR is mandated by meaningful use to display more and more of the patient imaging record.

Some images live in discrete IT systems with their own storage, such as radiology and cardiology PACS. DICOM residing in its own silo often is not sharable across departments or facilities in a healthcare enterprise.

Non-DICOM images can reside on the acquisition devices, shared drives, in desk drawers and even on personal mobile devices. How secure are these imaging records, who is controlling access, are they backed up, and how long are they being kept? These are all questions healthcare IT needs to wrap their arms around.

CIOs have many projects competing for their attention, but VNA is now a necessary part of their strategic future. Their organizations are growing, they need to centralize and have a singular platform for data center storage expansion, business continuance and data backup. They need a socket into which they can quickly plug new departmental imaging areas as a result of mergers and expansions. With the first phase of EHR deployment completed, they are now looking to expand the use and value of their EHR investment and manage the security of patient records, all while operating more efficiently. 

FUJIFILM Medical Systems, Stamford, Conn., convened a panel of ten CIOs on April 14 in Chicago during the annual meeting of the College of Healthcare Information Management Executives (CHIME) to address the maturity and potential of VNA technology to eliminate storage silos, and help address the challenges and opportunities of creating a complete patient imaging record for EHR. While most CIOs have not yet deployed this new and emerging technology, all agreed it’s needed and were eager to discuss potential benefits of VNA to their own health systems

VNA drivers

A VNA is a vendor neutral image/content storage archive.  The technology has been around for more than 10 years, but the adoption of VNA has exploded in the last 12 to 24 months.  The term itself is a bit of a misnomer:  You have got to buy it from one of us, so it's not really vendor neutral—let’s say application, or content, neutral. 

Several drivers are accelerating the adoption rate of VNA, beginning with the adoption of the electronic health record (EHR), meaningful use imaging requirements and physician demand for image access. Our CHIME panelists confirmed that physicians are pushing for access to more imaging beyond the traditional radiology or cardiology DICOM silos, and they want a single, consistent place in which to access and view patient images.

At the same time, CIOs are concerned with the exploding number of images being generated in radiology and cardiology. It is significantly more expensive to scale multiple silos of storage than one scalable storage hardware platform. The VNA enables CIOs to retire expensive disparate storage silos, and often in IDN environments remove storage from individual sites entirely. The benefit to growing a centralized VNA is unending. It’s just a matter of getting started.

Migration expense

CIO panelists discussed the expense of migrations resulting from departmental application replacement. Considering many hospitals and departments are on their second or third PACS for radiology or cardiology, an important question was raised: How many times have hospitals paid to migrate the same data?

There are many returns-on-investment factors that make VNA an easy decision, but the fact that future application vendor replacements will not require a costly migration will yield the largest savings. A fringe benefit of that is the departmental freedom of being able to make application vendor changes in the future without worrying about the cost or complexity of a data migration.

One CIO counted the number of image sources across the enterprise to be at least 50, some of which reside on a disk in the machine that takes the image. Other sources include data that is illustrated in graphs (echocardiographs,