Carestream VNA, an Oxymoron?

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Presented at UKRC 2013, this presentation discusses healthcare needs, what vendor neutral archives are, and how to choose the right VNA supplier.

For more information on Carestream's Vue for VNA, visit http://carestream.com/vna

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  • EMR management:As moredepartments seek access to PACS, the proper identification of patients and exams becomes anissue. Often, each department will have its own patient and exam requisition system, AccessionNumbers may or may not be used for identification, and patient and exam IDs may be assigned by
  • EMR management:As moredepartments seek access to PACS, the proper identification of patients and exams becomes anissue. Often, each department will have its own patient and exam requisition system, AccessionNumbers may or may not be used for identification, and patient and exam IDs may be assigned by
  • Carestream VNA, an Oxymoron?

    1. 1. Carestream VNAAn Oxymoron ?Presented at UKRC 2013Ignace WautierHealthcare IT Business Development Manager11 June, 2013Public© Carestream Health, 2013
    2. 2. AgendaHealthcare needsRequirements for UK market.What is a Vendor Neutral Archive?How to chose the right VNA Supplier?Public© Carestream Health, 2013
    3. 3. What is Vendor Neutral Archiving? What is an Oxymoron?An Oxymoron is defined as:“A figure of speech that combines contradictory terms. The plural isOxymora.”Oxymora usually reveal a paradox, especially when applied toVendor Neutral Archiving.If it’s Vendor Neutral, who do you buy it from? Nobody? Anybody?Everybody? What makes it Vendor Neutral?What is Vendor Neutral Archive?Public© Carestream Health, 2013
    4. 4. Healthcare TrendsDepartment Silos archives replaced byunique archiveCross site secured data sharingBenefits to the overall enterprise ratherthan one specific department.Consolidate Patient Centric Data RepositoryPublic© Carestream Health, 2013SingleVendor NeutralArchive
    5. 5. Public© Carestream Health, 2013Consolidate data in a cost effective way, without the need toreplace the existing infrastructure in one single stepEasily integrate with legacy systems, expanding production andreplace existing systems when neededArchive and share data that are not necessary DICOM compliant.Keep control/ownership of data produced when replacing clinicalapplications. Cost control. Be vendor independentConstant increase in performance & speed of data transferHealthcare organisations needs in UK
    6. 6. VNA appear to be a solutionPublic© Carestream Health, 2013What is theideal VNA?Who’s the right Partnerto provide your VNA?Is there a standarddefinition for VNA?Is it answeringall the needs?
    7. 7. VNA Market definition2009, Herman Oosterwijk, President, OTech Incp.7Public© Carestream Health, 2013“A Vendor Neutral Archive (VNA) is a medical device that providesscalable image and information and life cycle management so thatimages and related information can be queried, stored, and retrieved ina manner that is defined by open standards at multiple department,enterprise, and regional level while maintaining patient privacy andsecurity.Characteristic for a VNA is that it provides a patient-centric approach thattranscends upgrades and changes of the different viewing, acquisition,and workflow management components as they should beinterchangeable without having to migrate, convert, or change the dataformats or interface of the VNA”.
    8. 8. VNA Market definitionInMedica – Industry Report 2012p.8DICOM, HL7 and other Standards-based communicationSupport for multiple PACSNon-DICOM data sharing Clinical lifecycle managementSecurity, long-term archiveand disaster recoveryOptionally: XDS registry andrepository, storage virtualization,web-based access & zero-clientviewerPublic© Carestream Health, 2013A vendor-neutral architecture (VNA) for medical data is a platform that provideslong-term, disaster recovery, lifecycle management and the ability to easily sharemedical by communicating with different PACS. It serves as a central repository formedical images and other patient data based on an open architecture for multipledepartment, or multiple hospitals. It should also accept data irrespective of theoriginating PACS or other viewing, acquisition and workflow management system,making these originating sources changeable without having to change the dataformats or interface of the archive. Outside the sharing of information based onsecure access and authorization, it offers resilience against network interruptions,long-term archive, and disaster recovery services.
    9. 9. VNA – More Than a Buzzwordp.9VNA attempts to solve three main problems:Public© Carestream Health, 2013Consolidate data archiving fromdifferent PACS within anorganisation, region, country, …Cost reduction, foundation fordata sharing, …Provide repository for otherdepartments beyond radiology.This is true for single or multi-siteenvironments.PACS replacement has provento be costly & lengthy.Important information stored inPACS such as imageannotations, Key Images, andchanges to studies aresometimes lost.
    10. 10. Typical Requirementsp.10Public© Carestream Health, 2013
    11. 11. The Ideal VNA: Design•Specialised EMR modules drive the viewer of each“ology” taking care of departmental workflow•Image/data transfer protocol is standard & efficient•All departmental application servers are independent& replaceable without affecting the rest of theorganisation•Data is accurate with all modifications•VNA is replaceable (no data migration)– Works like USB•Any enterprise viewer can access ANY data in the VNA,a patient-centric view.p.11Vendor Neutral ArchiveWorkflowRadiologyViewerCardiology OtherEMRRISCIS (non unified)WorkflowViewerWorkflowViewerEnterprise ViewerDICOM//XDSApplicationServersStandard Storage FormatTransfer protocolEMRRISCIS (non unified)Public© Carestream Health, 2013
    12. 12. The Ideal VNA: ChallengesThis Ideal VNA may introduces challenges•Lack of "hyper speed" transfer protocols.Current standard communication protocols are slowand limited (DICOM)•Vendors optimise their solutions to provide enhancedfunctionality and features through proprietarymechanisms.•Customers expect more benefit out of the centralisedarchive (e.g. enterprise viewer, patient portals, etc),May require non standard components.•Customer are not willing to compromise onperformance.•Master Patient Index management! Who isresponsible? EMR driven MPI or VNA vendor?p.12Vendor Neutral ArchiveWorkflowRadiologyViewerCardiology OtherEMRRISCIS (non unified)WorkflowViewerWorkflowViewerEnterprise ViewerDICOM//XDSApplicationServersStandard Storage Format (DICOM Part 10 ???)Transfer protocolEMRRISCIS (non unified)Public© Carestream Health, 2013
    13. 13. The Practical VNA:•Each department has its own workflow and displayneeds. Departmental systems include an additionalCache + DB layer to address performance issues.•There is continuous traffic between departmentalsystems and the VNA– to ensure data integrity. Requires overhead monitoring.– Supporting the prefetch mechanisms required forperformance to access the complete patient record•Some VNA’s are implemented with local database &proprietary file formats to maintain adequateperformance against the departmental systems•VNA’s vendors provide exit strategies to support theVendor Neutral conceptp.13Vendor Neutral ArchiveWorkflowRadiologyViewerCardiology OtherEMRRISCIS (non unified)WorkflowViewerWorkflowViewerEnterprise ViewerDICOM//XDSApplicationServersProprietary Storage FormatDICOM/XDSEMRRISCIS (non unified)Cache & DB Cache & DB Cache & DBCache & DBDatabase / InterfacePublic© Carestream Health, 2013
    14. 14. p.14VNA is also non-Dicom SupportPublic© Carestream Health, 2013Vue Archive (VNA)Tiered StorageLifecycle ManagementXDS RepositoryAPIDICOMHL7XDSRegistryRadiology:DICOM /HL7Laboratory:“Other”dataOther Clinical:“Other” data,XDSCardiology:DICOM / HL7 /“Other “dataAdditional IHE ProfilesXDS, XCA, BPPC, MPI, …
    15. 15. XDS Actorsp.15DocumentRegistryDocumentConsumerDocumentRepositoryDocumentSourceProvide & RegisterDocument SetQuery RegistryRegisterDocument SetRetrieve DocumentPatient IdentitySourcePatient Identity FeedPatient Identity Feed HL7v3VendorNeutralArchiveXDS ConsumerModality :Workstation /Clinical applicationPublic© Carestream Health, 2013
    16. 16. p.17BPPC – Basic Patient Privacy ConsentUnder which condition?Medical documents are labeled with a Confidentiality CodeWhich functional rolemay access which document?What aredisclosure rules?
    17. 17. XDS Consumerp.18 Zero foot print client List of Medical datastored Launch a webviewer/browser todisplay data Support BPPC profile toguaranty patient privacy
    18. 18. BPPC & XDS Consumerp.19 Confidentiality codedefines documentaccess In of emergencyuser can “brake theglass”. Action will be tracedin the Audit Logrepository followingthe ATNA profile
    19. 19. VNA is the foundation for data sharingp.20Public© Carestream Health, 2013
    20. 20. Can A PACS Vendor be a Vendor Neutral for Archive?p.21Public© Carestream Health, 2013One of the biggest misconceived notion isthat a PACS vendor cannot provide a VNAIf it’s Vendor Neutral, who do you buy it from?Nobody? Anybody? Everybody?While some legacy solutions would fall under that category,Carestream strives to provide an enterprise clinical data repositorythat fits the description above and addresses the needs of the healthcareEntire portfolio has been articulate aroundCentral VNA solution called “Vue Archive”
    21. 21. At Carestream we believe …p.22RepositoryVue Archive - VNAConsolidated clinical archive: interoperable, standardsbased for longevityEnterprise ManagementEnterprise ManagementPatient data aggregationData sharingRIS PACS CardioClinical Departmental SolutionsAdvanced clinical toolsets: single workspace forproductivity from image review to reportPhysicianCollaborationPatientAccessUniversal ViewersAccess to Patient Medical records regardless of clinicalsystem: secure, device neutral, mobilePublic© Carestream Health, 2013A complete portfolio articulated around Vue Archive
    22. 22. p.232004First Nonradiologicaldepartmentconnected toNeutralArchive2003First NeutralClinical Archiveinstalled201010 CloudInfrastructuresmanaging 80Mstudies“Trendsetter” someone who starts a new style or helps to make it popularSmart Innovations2011FlexibleenterpriseaccessPatientImagingportal20122008IntroductionOf CloudArchive Services2009Single patientworklist connectsmultiple PACSXDS onVueArchiveVNA onVue ArchivePublic© Carestream Health, 2013
    23. 23. p.24RuralClinicVue ArchiveVNAUniversityHospitalDICOMHL7IHE XDS-iRegionalHospitalHL7Public© Carestream Health, 2013One Software fit all needsDICOMDICOMHL7“Other” DataXDSReadingCenterTeleradiologyCARESTREAMVue ArchiveXDSSecured “Patient Centric” archiving solution.Endless number of data sourcesUnlimited storage volumeVendor Neutrality: Data format, platform, PACS vendorIngensts data from disparate clinical vendors via:DICOM, HL7, IHE XDS, XDS-I, OtherAll data types managed through one centralized system
    24. 24. p.25A “PACS” Vendor can also provide you additional layersPublic© Carestream Health, 2013Universal ViewerVue MotionA Vendor Neutral Portal for physiciansZero foot-printNo installationPure WebHTML 5Zero TrainingIntuitive User InterfaceEnableRemote collaboration
    25. 25. And what about the Patient?p.26Public© Carestream Health, 2013Pure Web HTML 5Patient PortalEasy to accessEasy to useAbility to sharewith referringPatient definessharing rulesPatient keep controlof his medical dataMy VueA Secured Vendor Neutral Portal for patient
    26. 26. p.27RuralClinicVue ArchiveVNAUniversityHospitalDICOMHL7IHE XDS-iRegionalHospitalHL7Public© Carestream Health, 2013A complete solutionDICOMDICOMHL7“Other” DataXDSReadingCenterTeleradiologyCARESTREAMVue ArchivePhysician’sOfficePatient PortalClinical PortalXDS
    27. 27. Smooth migration from your legacy archivep.28Public© Carestream Health, 2013Public© Carestream Health, 2013LegacyArchiveMeta-data Take-overIntelligent Data MigrationQueryData RetrieveVue Archive VNARetrieve CommandData Retrieve
    28. 28. p.29Fully Owned CapitalInvestmentCarestream Vue CloudServicesPurchasing Options
    29. 29. p.30Imagine an Enterprise Health IT Strategy with a CompletePatient Medical Records Platform that can…Manage patients not pixels. Easily provide global patientmedical records, shifting the reporting workflow paradigm.Collaborate and share. Enable on-demand access to criticalclinical insight regardless of system or geography.Infinitely scalable. Seamlessly manage and archive all imagingsource and document formats beyond traditional radiology or cardiologydepartments, throughout the entire medical data lifecycle.Public© Carestream Health, 2013
    30. 30. Thank you

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