Doctors using electronic medical records especially expect easy access to patients' heart, dermatology, and pathology images, he says. The challenge for providers is how to provide that access easily and securely, he says.
Some healthcare providers are using different approaches for different departments' imaging needs, says Ben Brown, general manager of imaging informatics at research firm KLAS. Short term images--less than 6 months to a year old--will generally be stored on disk devices for quick access, but for longer-term storage, images are archived on tape or optical. Older images need to be requested in advance of seeing a patient so they can be retrieved from storage, he says.
Other providers are standardizing on one PACS to take advantage of economies of scale and so they can consolidate and virtualize storage. Hospitals are also turning to outside companies for offsite storage, archiving, and management of images. In those cases, healthcare providers pay per use of a image study, by month, by volume, or some other calculation, Brown says.
Poudre Valley Health System standardized its imaging platform and outsourced digital image storage and management to an outside provider. Three years ago, the nonprofit with four medical centers and hospitals in Colorado, Wyoming, and Nebraska, was preparing to upgrade its PACS, when it discovered its imaging storage needs "were exploding--there was no way we'd be able to pay for it," says Russ Branzell, CIO at Poudre.
In addition to the growing storage needs, Poudre Valley's doctors wanted access to images from multiple locations, not just while in the radiology offices. This meant expanding network bandwidth to enable multiple clinicians to be able to simultaneously access huge diagnostic-quality medical images.
To address these challenges, Poudre Valley decided to move its imaging system to an ASP model. It moved to a system where it now owns the imaging testing equipment as well as the images, but uses Philips to electronically send and store images.
Poudre Valley pays per click to access to an image, with each click representing access to a full medical imaging study that could include hundreds or thousands of slices depending on the exam, Branzell says.
The transfer of images to the new platform took 18 months, working 24 by 7, he says, and all the images needed to be available to the doctors during the transition.
Had Poudre Valley not moved to the ASP model, it would have had to double its imaging staff from four to eight to manage the systems. Instead, its staff now spends more time working with the clinicians, rather than tending the backend needs of the systems. Branzell estimates the ASP model is saving the company $1 million to $2 million a year.
"All our images are managed by one system, there's no longer a need for doctors to use different systems side by side," he says. In addition, all imaging reports feed into a patient's EMR, so doctors also have easy and secure access to those records while viewing images, he says.
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