VNA for Enterprise Image Management UnPAC Your Archives

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1 VNA for Enterprise Image Management UnPAC Your Archives 13 April 2015 Trent Conwell, Director of Enterprise Imaging, Sentara Healthcare Eric Rice, CTO, Mach7 Technologies DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2 Conflict of Interest Trent Conwell, Bachelor of Science Has no real or apparent conflicts of interest to report. Eric Rice, Bachelor of Science Salary: Mach7 Technologies Ownership Interest: Mach7 Technologies HIMSS 2015

3 VNA for Enterprise Image Management Ignorance may be bliss, but it is the perfect recipe for absolute failure. Ignorance may be bliss, but it is the perfect recipe for absolute failure. You will only be as successful as the relationships that you build. You will only be as successful as the relationships that you build.

4 Learning Objectives Compare enterprise-level imaging strategies leveraging PACS and VNA systems Compare the IT cost impact of PACS and VNA image management solutions Analyze imaging informatics process and workflow improvements Distinguish image management strategies at the departmental, enterprise and regional/hie levels Evaluate the impact of vendor neutral image management on Health Information Exchanges

5 An Introduction to the Benefits Realized for the Value of Health IT Value STEPS TM Satisfaction S Physician Satisfaction context based viewing across ologies Patient Satisfaction a picture is worth 1000 words Treatment/Clinical T Improved patient care Image Access across the entire continuum of care Electronic Information E Any Image, anywhere, any time - Immediate Context Based Image Access to all images across the Enterprise Patient Education P Enhanced Patient Physician Relationship allowing patients a visual understanding of their care Savings S Centralized Archive Platform ILM Return to the days of owning and managing your images

6 Enterprise Image Management, a journey

7 Imaging IT The past 4+ decades PACS born in the early 1990 s brought enhanced diagnosis, clinical efficiencies, and new challenges Cause Medical Imaging Challenges Today PACS proprietary vendor formats Departmental data silos Lack of storage management capabilities Limited ability to communicate and exchange (HIE) imaging data outside of a single organizational department Effect EMR Image Enabled Disabled Imaging Growth Inhibited Exponential growth + rip and replace Data Integrity it can be a Liability Cost of Migration Not Sustainable M&A Cost High Access & Sharing Challenged: HIE, Image Sharing, MU2+3 Workflow Efficiencies unachievable

8 PACS Imaging IT We have options today Options Option 1 Option 2 Option 3 Traditional PACS Model Challenges Remain PACS PACS Traditional VNA Model Enterprise Imaging Platform PACS PACS PACS PACS PACS PACS Benefits VNA VNA (Archive) Traditional PACS: Status Quo EMR Image Enablement Imaging Growth Enabled Data Integrity Maintained Eliminate Future Migration Costs Reduce and/or Defer M&A Cost HIE, Imaging Sharing, MU2+3 Enabled Workflow Efficiencies Achieved Enterprise Imaging Platform Enterprise Imaging Platform

9 Enterprise Imaging Platform Defined Vendor Neutral Image Management for Archiving + Communication + Exchange Enterprise Imaging Platform Vendor Neutral Archive (VNA) - Standards based storage - Non-DICOM raw format storage - Disaster Recovery - Migration capabilities and target - Storage Management - Imaging Lifecycle Management (ILM) - Change Management Controls Health Information Exchange (HIE) Communication Workflow Engine - DICOM routing and prefetching - Imaging translations & transformation - HL7 listener and sender - Non-DICOM services - XDS source enablement workflow - XDS consumer workflow - Patient identify workflow - HIE Enablement - XDS Source - XDS Repository - XDS Registry A C The A and C in P.A.C.S designed for an enterprise

10 Enterprise Imaging Platform The decomposition of PACS Options Option 3A Enterprise Imaging Platform PACS PACS PACS Option 3B Enterprise Imaging Platform Viewer Viewer Viewer Benefits Enterprise Imaging Platform Enterprise Imaging Platform Deconstructed PACS On average, 60% lower cost to a diagnostic workflow Universal Worklist + Diagnostic Viewer + Archive + Reporting Reduce future migration costs On average, $100,000 for every 500K procedures. 10 years = $1M Reduce storage costs Traditional PACS minimally requires a tier 1 storage cache Best-of-breed approach with specialist flexibility buying decision

11 Enterprise Imaging Platform Business Drivers and Strategies Region Enterprise Department Radiology Cardiology ology ology PACS PACS PACS PACS Adv. Vis Regional Strategies - Connect to State or Private HIE - Provide Regional HIE Infrastructure - Image Sharing - TeleServices Enterprise Imaging Platform Enterprise Strategies - Image Enable EMR - Consolidating Storage and Vendors - Reduce Storage Cost - Provide Access to Referring Physicians and Patients - Reduce Liabilities (data integrity + data retention) Departmental Strategies - Optimize Dataflow - Resolve Data Integrity Issues - Reduce Visualization Switching Costs - Enable TeleServices - Resolve PACS and Modality Limitations

12 Costs Differential The following table highlights cost benefits with moving forward with an Enterprise Imaging Platform. Storage Costs Migration Costs Service Contracts New Revenue Channels Cost to Diagnose Reduce Liabilities Differential Costs - On average compress storage by 2X compared to default compression algorithms - With Image Lifecycle Management (ILM), stabilize/stop storage growth today - Eliminate future migration costs with a VNA - On average 500,000 procedures will cost $100,000 to migrate. Equates to $1M for 10 years of data - Eliminate expensive service contracts on storage and PACS systems. - Standardized to a single Archive and Communication vendor - Host an Archive as a Service, HIE Enablement, PACS as a Service, or with your Enterprise Imaging Platform - On average, a Deconstructed PACS costs 60% less than a traditional PACS - With Image Lifecycle Management (ILM), purge old studies and remove clinical liabilities

13 The Sentara Journey 2002: Implementation of AGFA PACS - Serving 5 Hospitals 2004: 6 th Hospital 2009: 1 st VNA Business Case Failure 2010: 2 nd VNA Business Case Failure 2011: 8 th Hospital - FUJI PACS 2012: 2 AICs - using Carestream & Viztek PACS 2013: 9 th & 10 th Hospitals using GE PACS 2014: 11 th & 12 th Hospital - using Merge & McKesson PACS 2014: Enterprise Imaging Business Case Approved 2015: Sentara Implements Enterprise Imaging Platform 2016: Defined HIE model 2008: 7 th Hospital 2017: PACS Agnostic with multiple ology's implemented

14 The Sentara Journey Setting Objectives Become PACS Agnostic Improve Image Retrieval Response Times Image Migration Plan (Too many PACS systems to support) Business Continuity Model (for imaging systems) Decrease Imaging Storage Costs Flexible M & A Strategy Solution must support other ology's PACS system stabilization

15 The Sentara Journey Organizing Objectives Primary Goals Improve Image Retrieval Response Times PACS system stabilization Decrease Imaging Storage Costs Need for a more robust Clinical Viewer Secondary Goals Solution must support other ology's Flexible M & A Strategy Business Continuity Model (for imaging systems) Image Migration Plan (Too many PACS systems to support) Roadmap Become PACS Agnostic Imaging HIE Strategy

16 The Sentara Journey Creating the Business Case Image Migration 40% Storage 16% Education RFP Development Business Case Development Vendor Selection Process 3% Hardware 8% Enterprise Imaging Platform 31% Implementation 2%

17 The Sentara Journey Generating a Positive ROI 6,000 Storage Growth 5,000 Acquisitions Department Inclusions 4,000 TB 3,000 Technology Advances Increased Business Standard Growth Projected Savings with ILM 2,600 TB Growth with ILM 2,000 1,

18 The Sentara Journey Enterprise Imaging Design Strategy Patient Identity EMR Integration Enterprise Imaging Solution Other Ology s Mobile HIE Strategies

19 Sentara Healthcare PACS to VNA to HIE PACS Generally radiology images within the organizations network VNA Brings in other ology s images and provides: Management, Control & Ownership of the images Greater accessibility to contextually view images Mobile viewing & collaboration capabilities HIE Strategy Waiting for a government solution is not practical Design strategy should incorporate a federated approach Peer to peer integration as a subscription model delivered by the vendor community

20 Sentara Healthcare Museum Mona Lisa, c By: Leonardo da Vinci This painting depicts Lisa del Giocondo whose expression is well-known for the enigmatic aura emanating from it. The Mona Lisa is possibly the most famous painting in the world of all time. American Gothic, 1930 By: Grant Wood American Gothic was inspired by the Dibble House in Iowa. Wood saw its Gothic architectural style and decided to paint the house along with the kind of people he imagined might live in it. The painting depicts a farmer and his daughter, both modeled by his dentist and his sister. Each element of the painting was done separately; the models sat separately and were never at the house. Girl with a Pearl Earring c By: Johannes Vermeer One of Vermeer s masterpieces, this painting utilizes a pearl earring as a focal point. It is sometimes known as the Dutch Mona Lisa or the Mona Lisa of the North. The Starry Night, 1889 By: Vincent van Gogh Considered to be the best and most famous work of Vincent van Gogh, The Starry Night was created from memory and portrays the sight outside the window of his sanitarium room at night.

21 Questions? Trent Conwell Director IT Eric Rice CTO

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