In today's healthcare environment, there's no question that the need to connect silos of data, whether department or enterprise wide, has become an increasing demand placed on IT infrastructures. To meet that demand, you need rapid and secure access to clinical data across the continuum of care, along with the flexibility to select components. Today, in the U.S., you can connect disparate hospital and department data by leveraging industry standards such as DICOM, HL7 and XDS, through an optimized vendor neutral archive.

1. THE OPTIMIZED VENDOR NEUTRAL ARCHIVE:
SUCCESS STORIES SPONSORED BY:
FOR CLINICAL USERS
Presenter Presenter Moderator
Scott Charlton Thomas Hough Mary Tierney
Solutions Architect President and Founder Chief Content Officer,
London Health Sciences Centre True North Consulting & Associates TriMed Media Group
London, Ontario, Canada Mississauga, Ontario, Canada Providence, RI, USA

2. LEGAL DISCLAIMER
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The information in this presentation represents the views of the specific authors and presenters. The content
and materials for this presentation have not been screened, approved or reviewed by GE Healthcare.
*GE, the GE Monogram, Centricity and imagination at work are trademarks of General Electric Company.
General Electric Company, by and through its GE Healthcare division.
Presenter and Event 6/26/12
2

3. SOUTHWEST ONTARIO
VENDOR NEUTRAL ARCHIVE (VNA)
Scott Charlton
Solutions Architect
London Health Sciences Centre
London, Ontario, Canada
3

4. SOUTHWEST
Yukon
Northwest
Nunavut ONTARIO (SWO)
Territories
One of 4 VNA projects
storing all hospital
British
Columbia
Alberta
Manitoba Quebec diagnostic images in
Ontario
New PEI Canada’s largest province
Brunswick
Nova (15 million people )
Scotia
London

5. SOUTHWEST ONTARIO (SWO)
The Southwestern Ontario Diagnostic Imaging Network
(SWODIN) connects radiologists, referring physicians and
specialists at hospitals across southwestern Ontario,
allowing them to instantly access,
Project Details Benefits Sought
• 62 hospital locations across the region • Care provider
• 19 hubs with separate RIS and PACS productivity
• 3.2 million exams/year • Centralized patient
records to improving care
• 1600+ system users
• Reduce patient transfers
• Hardware redundancy and disaster
recovery • Reduce duplicate exams
• High Availability with dual data centers • Storage infrastructure
cost savings
5

6. SWODIN VNA
INFRASTRUCTURE
GE Healthcare’s comprehensive VNA1
Department or Facility
1Based on Centricity*
Enterprise Archive
6

7. CENTRICITY ENTERPRISE
ARCHIVE TECHNOLOGY
Key Architectural Components Application Requirements:
HL-7 DICOM • 1 x Intel 2.66GHz
WADO
Engine Engine (+IHE) Hexa-core or better
IHE PIX Load Bal HiAV • 6 GB RAM
• 8 x 300 GB in a Raid5
Virtualization (& Federation) + eBroadview
configuration
ILM • Dual fans and power supply
• Microsoft® Windows 2008
XDS/XDS-I.b Repository
Standard Edition R2
Scripting Engine • Microsoft® SQL Server
2008R2 Standard or
VM WS/SQL 2008 Enterprise Edition
CIFS (& APIs to CAS) • VMware ESXi 4.0
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8. IMAGE SHARING
BENEFITS:
THE SWODIN
EXPERIENCE
8

9. CLINICAL SCENARIO #1:
CONSULT OF A REFERRED PATIENT
A patient is referred by clinician at Windsor Regional Hospital (WRH) to
an oncologist at London Health Sciences Centre (LHSC). The patient had
a prior CT study at the WRH and is now with the oncologist at LHSC. A
review of the patient’s prior CT study is needed by the oncologist for the
purpose of radiation and treatment planning.
Benefits of the VNA/Image Exchange:
• Provides faster treatment because specialists can access prior
diagnostic tests directly, without needing to request hard copy.
• Provides the treating physicians with the complete picture of the
patient's history no matter where imaging was performed.
• LHSC administration staff do not have to request guest imaging CD
from Windsor Regional Hospital, nor does Windsor admin staff need
to be involved to generate the guest imaging CD.
• No cost borne in creation of the guest imaging CD and
CD transport from Windsor Regional Hospital to LHSC
(either by courier or patient personal travel for pickup).
• Eliminates challenges with different image viewers on
guest CDs coming from different sites.
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10. CLINICAL SCENARIO #2: TRAUMA
TRANSFER FROM COMMUNITY HOSPITAL
A trauma patient is admitted to a small hospital in Goderich, where diagnostic
imaging is performed. A clinical decision is made to transport the patient to
London’s large referral center. The intake specialist (ortho, plastics, surgeon,
etc.) needs to review the images from the sending facility to plan for patient
treatment prior to the patient arriving at the referral center.
Benefits of the VNA/Image Exchange:
• Reduces the need to repeat tests already performed at other
centres because they are now easily viewable.
• Specialist has access to images performed at other centres and
can plan treatment even before the patient arrives
(no need to wait for CD arriving with patient).
• Guest imaging CDs do not need to be created.
• In some cases, a decision can be made not to transfer the
patient, avoiding unnecessary movement and patient disruption,
as well as saving the cost of the transport.
10

11. ECONOMIC BENEFITS ACHIEVED
FROM VENDOR NEUTRAL ARCHIVES
Thomas Hough
President and Founder
True North Consulting & Associates
Mississauga, Ontario, Canada
11

12. VNA ECONOMIC BENEFITS
Canada Health Infoway
• Mandate – the Pan-Canadian
Electronic Health Record
• Vendor Neutral Archives ~ 22 DI-r across Canada
• Inter-connection of DI-r’s to facilitate sharing of
patient records for health and economic benefits
• Commissioned Economic Studies
– To understand where benefits can be achieved
– To confirm were the benefits realized
12

13. VNA ECONOMIC BENEFITS
Infoway Commissioned Two Economic Studies
• 2005 Commissioned Courtyard and True North
Consulting & Assoc. Inc.
– Projection of economic benefits
• 2008 Commissioned Videre and True North
Consulting & Assoc. Inc.
– Validate the economic benefits were achieved
13

14. VNA ECONOMIC BENEFITS
Areas benefits found: Productivity Dimension
• Technologists
• Referring Physician Productivity
• Turn Around Time • Radiologist Productivity
• Patient Transfers • Duplicate Exam
• Film Cost
Access Dimension
14

15. VNA ECONOMIC BENEFITS
Source of Content
• Diagnostic Imaging Benefits Evaluation Full Report
https://www.infoway-inforoute.ca/index.php/resources/video-gallery/doc_download/339-diagnostic-imaging-benefits-
evaluation-report-full
• Canadian Healthcare Manager – Hospitals of Distinction “ENITS
improves access to care for head trauma patients”
• e-health Remote Consultation System has saved Taxpayers $50 Million
Since 2009
http://www.ehealthontario.on.ca/News/2011/March3_2011.asp
Permission Granted from CHI
E-Health Ontario
General Electric Med Systems
15

16. VNA ECONOMIC BENEFITS
Canada Health Infoway Reports:
• PACS is referenced through out documents
• Definition of PACS can be considered Image
Capture, Image Display, Report Generation,
Networking and Diagnostic Imaging Repository
AKA the Vendor Neutral Archive
• Realization of a number of the Economic Benefits
are directly related to the Vendor Neutral Archive
16

24. VNA ECONOMIC BENEFITS

25. VNA ECONOMIC BENEFITS
Required Infrastructure to Achieve Identified
Economic Benefits
• Vendor Neutral Archive
• XDS/XDSi.b Repository
• MPI across all sites
• IHE Standards – Integration Profiles
• Web Access to images and reports
25

26. CANADA HEALTH
INFOWAY AGENCY
Benefits Analysis of Regional Results and Workflow Sharing
• GE Shared infrastructure at SWODIN
• Common repository (3.2 M exams/year) for 30 hospitals
• Heterogeneous RIS/PACS systems (GE, AGFA, McKesson, Philips,
Carestream, Ramsoft, Sectra)
• IHE standards + MPI across all locations
• Web access to images and reports
Improve workload sharing 25% – 30% improved productivity for radiologists and clinicians
Improve report turn around time 30% – 40% improvement in examinations turn around time
Informed clinical decision making Efficiency improved by 50–60mins per week
Avoid patient transfers 10,000 – 17,000 patient transfers avoided
Reduce duplicate exams 2 – 3% reduction in unnecessary duplicate exams (60K – 90K)
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27. VNA ECONOMIC BENEFITS
Measured VNA Economic Benefits
• SWO – 3.2 Million exams annually
• 62 hospital referral area – 1600+ users
• Trauma Neuro-patients transfers avoided
– Since Jan 2009 - 1558 Neuro-patient transfers have been avoided
– Savings = $ 50 Million or ~ $22 Million annually
• Exam Duplication Eliminated
– 2–3% of exam eliminated – 60,000 – 90,000 reduction annually
– At $35.00 per exam savings are $2.1 Million – 4.5 Million annually
• VNA’s will provide a positive business case for
implementation
27

28. VNA ECONOMIC BENEFITS
Other Vendor Neutral Archive Benefits:
• Centralized Storage Management costs greatly
reduced over distributed local archives
– Cost per TB to manage is much lower
• Elimination of CD transfers and Admin Overhead
– Cost is not media – Cost is the management
• Disaster Recovery – Throughput – Better Access
– Duplicate data centers
– Local storage infrastructure budget limit DR, Business Continuity
– VNA permits this cost avoidance at local sites
28

29. THE OPTIMIZED VENDOR NEUTRAL ARCHIVE:
SUCCESS STORIES SPONSORED BY:
FOR CLINICAL USERS
Presenter Presenter Moderator
Scott Charlton Thomas Hough Mary Tierney
Solutions Architect President and Founder Chief Content Officer,
London Health Sciences Centre True North Consulting & Associates TriMed Media Group
London, Ontario, Canada Mississauga, Ontario, Canada Providence, RI, USA