There is most likely an explosion of medical imaging raining down throughout your health system today. We are creating more, and more varied, images than ever, but many of them are not being managed consistently. This not only invites possible regulatory compliance risk, but denies your institution the potential value of those many images in meeting its operational and clinical goals.

1. Complete the EHR: Without images, electronic health records (EHRs) don’t fulfill their promise to share the whole patient story. Like most CIOs, you are probably looking to leverage your EHR investment and resource allocation to support your newest strategic initiatives for population health management, value-based care, and risk sharing. Contextual, intelligent indexing of medical image and document data from each episode of care leverages their clinical value across the enterprise – providing powerful, proven support of clinical productivity and patient satisfaction. Look to optimize the EHR with robust imaging information, not simply archive data.
    
2. Consolidated Technology Platform, Modular Services: Consolidation reduces cost, complexity and the resource-draining need for multiple integrations. Look for a purpose-built platform consisting of modules to leverage your EHR investment incrementally as part of your organization’s strategic plan, not the vendor’s.
    
3. Standards, Protocols, and Frameworks: Interoperability is a priority for lasting IT value. Insist on a deep commitment to industry standards to support your technology investments today and in the long term.
    
4. Massive and Incremental Scalability: Anticipate the IT needs for interoperability due to merger and acquisitions (M&As), accountable care organizations (ACOs), and other regional collaborative initiatives. Look for a solution that can grow and connect as needed.
    
5. Advanced Care Coordination through Seamless Access to Shared Information: Assure your institution gains a network-aware platform to drive collaborative care both within the hospital walls and with affiliates. Easy access to patient images helps foster an environment of collaborative and informed patient management, supporting today’s model of shared decision making and value-based care across multiple points of care, regardless of specialty. Format should become a non-issue — the long-term solution should house studies from virtually any device, from virtually any format, DICOM, DICOM SR, and, importantly, non-DICOM images such as MPEG, AVI, WMV, MP3, JPEG, TIFF, BMP, CINE, WMA, PDF and more.
   Unfettered information sharing – online, in the cloud and with a single-click url – puts the patient first and helps reduce unnecessary imaging exams and fragmented care. This is the clinical apex of Enterprise Imaging and why I place it as the center consideration in this list.
6. Risk Mitigation: Enterprise imaging enables accurate attribution of metadata to episodes of care, providing actionable information and a trail for future documentation, if needed. Look for a solution that enables a controlled environment for managing and sharing images, including a secure Single Sign On framework that provides context controlled and audited access to data. By consolidating the number of systems to manage, the long-term enterprise imaging platform helps to limit the total number of potential points of data breach by replacing “rogue media” such as thumb drives or personal email attachments with a controlled, audited enterprisewide multimedia platform.
    
7. Encourage Secure Communication and Engagement among Stakeholders: Advances in easy-to-use mobile applications allow both patients and clinicians to review sophisticated information on demand yet securely. Expect efficient use of patient and system time with universal, zero-footprint applications that enable engagement such as “medical selfies” or mobile viewer access to images to help speed discharge by busy physicians.
    
8. Support Multiple Imaging Departments’ Productivity with Standardization: Task-based workflows provide consistency and efficiency. Demand task-based standardization to bring one learning curve application across multiple service lines, with enough flexibility to support unique actors and workflows. Non-radiology departments such as Ophthalmology, Wound Care, Dermatology, Cardiology or Surgery cannot thrive with Radiology workflows and so require their own flexible processes. Business Intelligence reports should be available to help identify inefficiencies.
    
9. Information Lifecycle Management: Work with vendors to identify organizational objectives and records management policies and create solutions to the challenges of information lifecycle management (ILM). Among the issues: How should a data retention policy guide read/write access to medical image metadata? By what criteria should your organization decide how and when to delete or dispose of medical images?
    
10. Comprehensive Platform, Comprehensive Strategic Team: Demand a team to work with you toward ROI across clinical, operational and fiscal measures. Commitment to a platform approach informs both technology and services to support your goals of quality outcomes and cost containment. Work with a vendor that can provide a technology roadmap and vision for a standards-based modern platform. Look for a team that seeks to understand your multiple clinical workflows and challenges in order to develop adoptable processes and support your institution’s change management.

The visionary solution provider should help your care organization establish their own enterprise imaging vision and help realize a governance model. Long-term success benefits from a right beginning, and your vendor should bring to the project experience in governance best practices. Source a team with a proven record in helping institutions build a governance framework, including a cross-departmental strategic decision-making body, implementation processes and agreed-upon critical metrics definitions.  And let me know how you’re doing.

By Miriam Ladin, Director, Marketing and Communications – North America, AGFA HealthCare