ECM + VNA = A CLINICAL CONTENT STRATEGY THAT WORKS

OnBase | Healthcare | VNA | 2

CHALLENGE, MEET OPPORTUNITY.Clinical content isn’t easy to wrangle. With structured and unstructured information stored in disconnected data repositories across multiple departments, clinical content often creates “islands of information.”

Between the sheer volume and variety of clinical information and the increasing demand for mobile access to it, the task of aggregating all of the relevant data seems nothing short of herculean.

Yet, it’s on healthcare information technology (HIT) to make it happen.

Good news: Adopting a clinical content strategy that utilises a data management solution to manage and provide access to clinical information housed in a secure, centralised repository turns challenge into opportunity.

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The biggest problem is the lack of a single enterprise data repository that would simplify searches for all this structured and unstructured data. What we want is one system that combines those two systems.

-Michael Gray, principal of Gray Consulting

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THINK BEYOND THE EMR Electronic medical records (EMR) manage discrete data, but they simply cannot capture and manage the vast size and the volume of data flowing in and out of an enterprise. They also cannot natively display medical images. As a result, clinicians conduct individual searches to view DICOM and non-DICOM content on multiple viewing applications risking patient context errors and lacking a clinically relevant lens into the content.

Today, at best, imaging studies stored in a picture archiving and communication system (PACS) might be accessible from the EMR via a link in a report.

However, before those reports are available, studies must be interpreted, creating a built-in delay to treatment. Another downside? Many PACS and enterprise viewers only support PCs making it challenging to view studies on mobile devices.

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Many more specialties than just radiology generate and store DICOM and non-DICOM data. These images are usually not available across the enterprise unless there’s a vendor neutral archive (VNA) and enterprise viewer installed.

Associating a universal viewer with the EMR simplifies clinical workflow by supporting a single point of access for image and content viewing.

The viewer retrieves the desired content and end-users view all relevant images side-by-side. Although traditional VNAs manage medical images from PACS departments, non-PACS and mobile devices, this information remains separate from all of the related data residing in other systems, or in hard copy.

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VNA and enterprise content management (ECM) capabilities are converging as the healthcare enterprise evolves.

-Source: Gartner Market Guide for Vendor-Neutral Archives, Barry Runyon, August 18, 2015

“The VNA will come to be viewed less as a passive archive and more as an active participant in care delivery.”

–Source: Gartner Market Guide for Vendor-Neutral Archives, Barry Runyon, August 18, 2015

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Figure 1. VNA Market Segmentation

Source: Gartner (August 2015)

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ONE DATA MANAGEMENT SOLUTION TO RULE THEM ALL an EMR solution to drive the life cycle of patient content has proven to be a failed strategy resulting in poor user adoption.

Optimising your existing technology - specifically, integrating all systems and applications into a single software solution, connecting standalone imaging modalities, image share solutions, document scanning, storage solutions and the universal viewing application - boosts user adoption of your system of record.

It also allows for customised workflows to be applied to the data, facilitating cohesive processes related to providing patient care unlike anything we have seen previously in healthcare.

To support a more robust exchange of health information across multiple systems and care settings, HIT must embrace future-state technology: A single data management solution built on a single platform that stores all content in its native format in a single archive.

This single point of access for clinical content ensures that the right provider has the right information, at the right time and in the right context to help support the right decisions.

After all, the EMR is only as good as the data that’s in it - and database models simply can’t store every piece of clinical and non-clinical content. Relying only on

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The next-generation VNA will have more comprehensive workflow, information access, and sharing and viewing capabilities.

-Source: Gartner Market Guide for Vendor-Neutral Archives, Barry Runyon, August 18, 2015

Capture content

Deploy ECM first to organise the data that the EMR doesn’t natively manage. This includes the pathology images, images captured with mobile devices and endoscopic studies typically stored on separate systems. Doing so also prepares you for the second step: fully image-enabling your existing EMR to enable users to view content.

View content

Implement a universal viewer to allow clinicians to access images either directly from the universal viewer or, alternatively, in complete patient context through the EMR. The universal viewer essentially serves as the “search and display” subsystem for all structured image data. However, its storage capacity supports only a limited amount of data.

Store contentThe third step in designing this ideal state of technology is deploying a VNA, which at an entry level provides DICOM storage within the ECM. Once completely configured, the VNA’s remaining features, functions and interfaces for plug-in applications round out the solution.

STEP THREE:

STEP TWO:

STEP ONE:

FUTURE-PROOFING YOUR EXISTING HITCombining the functionality of ECM and VNA and creating a single enterprise data management solution drives greater patient and provider satisfaction by providing access to complete patient medical records.

And, by breaking the process down into more manageable steps, the task no longer seems herculean at all:

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