From the January/February 2022 issue of HealthCare Business News magazine
As new web-based APIs, such as HL7 FHIR and FHIRcast, become mature and adopted by industry, the creation of the new form of multimedia report becomes more feasible.
Challenges remain, however.
Persistence and distribution of Radiology reports in a form other than plain-text HL7 ORU messages is technically possible. But interface, EMR, and other application teams are not always ready to adopt them. The tried-and-true (yet limited) method of a v2.x HL7 interface for results distribution remains common.
Another challenge is standardizing the values within the structured fields. Structure without standardized terminology or coded values prevents data analysis at scale, such as what is required for disease-specific surveillance and public health.
State of PACS
This is a big topic, so I will break it down into several areas.
Vendor strategies for solution scope - Industry builds solutions based on their prediction (or observation, if they are reactive to market trends) of where customer needs will develop or appear to be headed.
Vendors will invest R&D developing different modules of a solution — such as a reading worklist, reporting module, or image sharing solution — if they believe customers will want to source those functions from them.
One area that has received lots of attention over the past few years is enterprise imaging, including imaging data from phones, scopes, and dedicated ancillary department equipment in service lines such as wound care, dermatology, and pathology. Some vendors have made significant investments in functions to capture and manage non-diagnostic, non-DICOM data within the PACS. Other vendors have invested less, resulting in a wide variation of capability across solutions in this area.
When health systems make buying choices, they are often confronted with a choice between the preferred solution for Radiology and the preferred solution of those looking to use the new system to manage all the enterprise’s medical imaging data.
Each enterprise will make their own choices based on their strategy and the decision-making roles involved, but choosing a solution that is not preferred (or even accepted) by Radiology is a risky option.
Cloud - Vendors also vary widely on their adoption of cloud-based hosting of the PACS. Popular solutions range from on-premises, an option for either on-premises or cloud-based deployments, a hybrid with some parts being installed on-premises and some in the cloud, and some that are only available in the cloud.
