By Richie Pfeiffer

The IT staff and scores of specialties are now part of multidisciplinary implementations that move many imaging tests across health system networks. As technology evolves, more health care specialties are finding value in medical imaging. More than 57 different clinical areas exchange data within their local networks and with outside providers, who typically get involved when patients:

• Get CT or MR scans at a stand-alone imaging center.
• Seek second opinions at an outside provider.
• Need to send hospital images to a primary care or specialist provider.
• Secure referrals at specialists outside their usual network.
• Demand better access to their personal health information in the future.



The fact that this is happening means IT leaders and medical imaging departments must partner to create more sophisticated enterprise imaging strategies to accommodate patients’ needs for image sharing across most specialties.

Hospital and health system CIOs are taking notice, as informaticists in the different specialties tap them to organize and implement enterprise-grade image sharing. As these trends become more evident, image sharing technology is more frequently adopted at an enterprise level, driven by the CIO and the CFO with the radiology department influencing, not owning, the decision-making process.

Enterprise architecture: Image exchange built to last

How are CIOs getting involved? By moving imaging beyond storage and addressing clinical workflow pain points. An enterprise imaging strategy comprises the right tools for each “ology” to do its work — interpretation and review of images — with a user interface that gives them the quick access, resolution and perspective, covering the needs of those specialists on a given network. Each hospital and health system has a different network, different clinical needs and are all scaled to their particular patient base. But all successful imaging strategies have the following processes in common:

Cataloging all provider needs: Where are the specialists who need images? Radiology, cardiology and oncology are the usual suspects. Then emergency medicine, intensivists and referring physicians. Each group might not need deep-featured imaging tools, but still need access to images and the interpreting providers’ reports to make real-time clinical care decisions. Make a list to get a handle on the scope of the imaging strategy that facilitates collaboration between physicians — preferably in real time — to let them look at the same image on their respective monitors at the same time, allowing real-time collaboration versus verbal descriptions.

Giving the experts their due: IT staff execute the solutions for clinical problems. Talk to the specialists who are using the imaging systems and tailor an enterprise-wide implementation that solves their specific problems so they can deliver better, efficient care.

Choosing a hybrid network-and-cloud model: One side facilitates sharing within the network firewall, and the cloud component gives providers outside the firewall secure access to needed imaging studies. This enables physician collaboration outside of a network for referrals and second opinion reviews.

Selecting a partner with the most usable tools: Whatever technology vendor your organization selects, carefully choose the standard interface physicians will be using to interpret and review clinical images, and make sure not only that the correct features are built in, but that it’s intuitive to use in all of the clinical workflows. Usability isn’t a “nice to have,” it’s a “got to have.”

Rolling out first to the specialties that need it most: Chances are, if IT staff has not set up a formal imaging workflow for emergency medicine and the stroke neurologists, those specialists probably have devised an ad hoc workflow to share images. Clinicians for which treatment time is crucial will benefit the most.

Radiology remains a key entry point for images on a network. Understanding this dynamic is a crucial facet of the enterprise imaging strategy. It’s incumbent upon IT to support medical imaging’s needs. But there is a shift where there are more specialties whose imaging access and use need to be addressed. Once all of the back-end technical issues of an implementation are addressed, imaging repositories become an open system with a common viewer, integrated with the electronic medical record.

While building enterprise imaging strategies now falls on enterprise-wide decision-makers in a health system — because such strategies span specialties far beyond medical imaging (radiology, cardiology, oncology and others using PET scans, etc.) — medical imaging leaders should sit on planning committees for developing enterprise imaging strategies. After all, they were the earliest adopters of imaging among the specialties, and they have the most institutional knowledge of how the technologies and workflows dovetail to create positive patient outcomes.

About the author: Richie Pfeiffer is vice president, product management, at lifeIMAGE.