The Era of VNA: How to Decide on the Right Solution

The concept of a unified storage management system to index and manage data across an organization, including data in public cloud services, company servers and employee devices is something that is commonplace, even taken for granted by employees in corporate environments, but in hospital systems, the adoption of vendor neutral archiving (VNA) systems is in its infancy, as healthcare works to catch up to the technological standard of corporate America. Kevin Collins, vice president of product management at Sectra, and Anders Osterholm, vice president of sales operations at Sectra offer their perspectives on the coming of age of vendor neutral archiving systems; their benefits and important considerations in selecting a VNA solution.


Drawing Parallels and Identifying Needs

“A VNA is an enterprise solution, similar to an email infrastructure, or telephone system,” offers Osterholm. “The primary purpose of a VNA is to provide a universal infrastructure to capture, hold and archive images. The enterprise resource database is then able to be fully accessed by authorized personnel and communicated and exchanged between departments, he adds. “Asking one department to select an image archiving solution for the entire enterprise would be like asking them to select an email provider, or a telephone system that would be used universally across the hospital system.”

Though it may come as a surprise to some, there are still hospital departments running less than up-to-date processes for archiving patient image files, and, there have been some recent instances where data storage components have been lost, leading to financial penalties and patient lack-of-trust in the hospital system.

“The most important and first question to ask in selecting a VNA for a hospital or health system is ‘Why do we need a VNA? What problem(s) are we looking to solve with a VNA?’” adds Collins.


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Enabling Connections

There may be several reasons that a VNA would be helpful in a hospital system, not the least of which is connecting image records to patient records in an EHR.

“A VNA steps in as a way to image-enable your EHR,” says Osterholm. EHR adoption has been driving VNA along, and it goes hand in hand to be able to communicate and exchange the data, as well as connect it to the patient record.”

With HIPAA constraints and data access and security concerns, a VNA solution offers a way to safely archive and store images as well as control authorized access to the data. A VNA solution should be an important consideration in data management strategy for a hospital system, according to Osterholm.

With the number of hospital system consolidations on the rise in the market, a VNA solution can also be used to bridge the transition when a system acquires new facilities using disparate image management systems.

“If your system is considering expanding or acquiring another facility, implementing a VNA provides a way to secure all the data first, so that you have one place to store, communicate and share image data. There’s no reason to say, ‘We’re going to take away your PACS’ at the onset of a merger. Smart business tells you to consider the investment in each PACS system, and the life left on each contract; so you can continue providing services as usual, using a universal archive, and address PACS efficiencies down the road, “ counsels Osterholm.

The Sectra team commented that there have been instances where they’ve come in to provide Sectra’s VNA solution when two facilities using disparate PACS were consolidating.

“It’s our advice to them,” says Osterholm, “get your infrastructure in place first—then start standardizing your PACS platform.”

Taking the “A” Out of PACS

The truth is, there’s always going to be a vendor, but let’s take the A over to VNA. Vendor-based solutions have their benefits, according to Collins, and there’s no shortage of vendors that are providing VNA products. So is PACS a thing of the past? Not really. PACS systems are department based communication systems that provide extreme value in terms of workflow and communication. But VNA solutions take storage, archiving and security to the next level, providing a universal, enterprise-wide archiving solution.

What’s the best VNA solution? The answer—it depends. It’s important to evaluate the different features of each VNA you are considering to meet the needs of your particular facility, says Collins. It’s important to consider what the problem is you are trying to solve, and most of the time, he says, those problems fall outside of radiology. Radiology is usually the most advanced in terms of PACS.

Most VNA solutions offer standard archiving and query functions to be used across the enterprise, as well as the ability to access and audit the data. Many of the differences come in to play in terms of the details, but the details can carry varying significance and priority from facility to facility and across state lines. Collins counsels to understand first the needs of your facility and then begin to look at the features of each VNA system to arrive at the most informed decision for your institution.

For example, data management such as the ability to purge files is important. The length of time required to archive image files varies.

“There are different regulations in different states,” says Osterholm. “And it’s also going to vary by procedure. Mammography scans should be kept longer for comparisons, and pediatric images should be kept until the patient reaches the age of 18, or longer,” he says.

Another important consideration to keep in mind is the ability to consolidate multiple department files. While radiology is very advanced in terms of universal image formats such as DICOM and HL7, there are still departments that may use jpeg files for cosmetic before and after procedures, for example, and will have different formats of images to share across the VNA.

The other important consideration is the ability to manage master patient indexes (MPI) over time. The ability to store image files according to a single patient file is not always easy if the patient moves, or changes their last name for example. Data analysis for recognition would help to keep files in a single patient record.