Beyond the Software: Creating the Optimal Enterprise Imaging Environment

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A familiar face on exhibit floors from Chicago to Vienna and in hospital radiology departments around the world, Robert Cooke, has participated in the commercial development of PACS from its very early days. Currently vice president and general manager, network business, FUJIFILM Medical Systems, Stamford, Connecticut, Cooke has spent the past seven years working on the development of Synapse TM PACS®. He shares his thoughts on the people and processes that distinguish a successful imaging environment from others, as well as his insight into the source of the next paradigm changes for imaging informatics.

“One of the things I’ve learned through the years is that people are everything. They are the only assets you have to drive success. Certainly, people need to be motivated, to have clear understanding of what their roles need to be, and to have the ability not only to drive change, but to embrace change." -Robert Cooke, vice president and general manager, network business, FUJIFILM

imageRobert Cooke We know that two different organizations can implement the same software and hardware with vastly different levels of success. What are the key questions that a facility should consider before tackling the implementation of a true enterprise imaging environment?

Cooke: The basic issues are these: One, define what that enterprise really is; two, identify the clinical stakeholders who need to be communicated with; and three, identify the external systems that need to be integrated. Those really are the key questions that a facility needs to consider before tackling the implementation of an enterprise imaging environment.

In any health care institution, about 80% of the data come from radiology and the cardiovascular domain. These imaging areas are the most mature in terms of standards, compliance, and the ability to generate a meaningful linkage between the image and the patient data. Other imaging areas are, of course, coming along, but the level of implementation and the integration of a full digital environment clearly are not as mature.

Here’s the other side of the coin: The main purpose of an enterprise imaging environment remains to facilitate better care decisions, so the information must be presented in the right way to the clinical stakeholders. Whatever solution gets implemented should, of course, have the ability at least to aggregate the variety of data coming from the most mature imaging areas, in terms of digitization, as well the ability to distribute and share those data with the various clinical stakeholders.

Realistically, any facility should take some time to define the scope of the imaging enterprise and how that scope will evolve. Ideally, the solution it picks might include the key aspects of the enterprise that are in scope now and then be capable of evolving along the lines of changing needs. Understanding these aspects can dramatically change a number of possible solutions to the problem. What are the common factors that you see for facilities that have been successful at implementing an enterprise imaging environment? What are some of the challenges?

Cooke: In any project, the most important success factor is having a plan. The attributes of a plan should include having clear, assigned, and accountable parties on the vendor and the client sides. Beyond that, there must be established clinical IT leadership, and it is very important to understand the project goals and the environmental factors, such as external systems and workflows in terms of remote reading. Those goals have to be defined clearly in advance of starting the project.

Some of the challenges that we’ve seen customers face relate to a mismatch between the goals of IT (for lack of a better description) and the goals of those within the clinical domain. The most important factor, in that case, is to remember that these are health care solutions first, and IT is the enabling force. In an enterprise context, you are bridging all of the communications across clinical areas, and episodes of patient care are perhaps the critical aspect of any successful project because that should be the goal. How important are the people? What role do human resources play in the success of an enterprise imaging informatics implementation, both before and after implementation?

Cooke: One of the things I’ve learned through the years is that people are everything. They are the only assets you