Contenu connexe Similaire à Carestream VNA, an Oxymoron? (20) Carestream VNA, an Oxymoron?1. Carestream VNA
An Oxymoron ?
Presented at UKRC 2013
Ignace Wautier
Healthcare IT Business Development Manager
11 June, 2013
Public
© Carestream Health, 2013
3. What is Vendor Neutral Archiving? What is an Oxymoron?
An Oxymoron is defined as:
“A figure of speech that combines contradictory terms. The plural is
Oxymora.”
Oxymora usually reveal a paradox, especially when applied to
Vendor Neutral Archiving.
If it’s Vendor Neutral, who do you buy it from? Nobody? Anybody?
Everybody? What makes it Vendor Neutral?
What is Vendor Neutral Archive?
Public
© Carestream Health, 2013
4. Healthcare Trends
Department Silos archives replaced by
unique archive
Cross site secured data sharing
Benefits to the overall enterprise rather
than one specific department.
Consolidate Patient Centric Data Repository
Public
© Carestream Health, 2013
Single
Vendor Neutral
Archive
5. Public
© Carestream Health, 2013
Consolidate data in a cost effective way, without the need to
replace the existing infrastructure in one single step
Easily integrate with legacy systems, expanding production and
replace existing systems when needed
Archive and share data that are not necessary DICOM compliant.
Keep control/ownership of data produced when replacing clinical
applications. Cost control. Be vendor independent
Constant increase in performance & speed of data transfer
Healthcare organisations needs in UK
6. VNA appear to be a solution
Public
© Carestream Health, 2013
What is the
ideal VNA?
Who’s the right Partner
to provide your VNA?
Is there a standard
definition for VNA?
Is it answering
all the needs?
7. VNA Market definition
2009, Herman Oosterwijk, President, OTech Inc
p.7
Public
© Carestream Health, 2013
“A Vendor Neutral Archive (VNA) is a medical device that provides
scalable image and information and life cycle management so that
images and related information can be queried, stored, and retrieved in
a manner that is defined by open standards at multiple department,
enterprise, and regional level while maintaining patient privacy and
security.
Characteristic for a VNA is that it provides a patient-centric approach that
transcends upgrades and changes of the different viewing, acquisition,
and workflow management components as they should be
interchangeable without having to migrate, convert, or change the data
formats or interface of the VNA”.
8. VNA Market definition
InMedica – Industry Report 2012
p.8
DICOM, HL7 and other Standards-
based communication
Support for multiple PACS
Non-DICOM data sharing Clinical lifecycle management
Security, long-term archive
and disaster recovery
Optionally: XDS registry and
repository, storage virtualization,
web-based access & zero-client
viewerPublic
© Carestream Health, 2013
A vendor-neutral architecture (VNA) for medical data is a platform that provides
long-term, disaster recovery, lifecycle management and the ability to easily share
medical by communicating with different PACS. It serves as a central repository for
medical images and other patient data based on an open architecture for multiple
department, or multiple hospitals. It should also accept data irrespective of the
originating PACS or other viewing, acquisition and workflow management system,
making these originating sources changeable without having to change the data
formats or interface of the archive. Outside the sharing of information based on
secure access and authorization, it offers resilience against network interruptions,
long-term archive, and disaster recovery services.
9. VNA – More Than a Buzzword
p.9
VNA attempts to solve three main problems:
Public
© Carestream Health, 2013
Consolidate data archiving from
different PACS within an
organisation, region, country, …
Cost reduction, foundation for
data sharing, …
Provide repository for other
departments beyond radiology.
This is true for single or multi-site
environments.
PACS replacement has proven
to be costly & lengthy.
Important information stored in
PACS such as image
annotations, Key Images, and
changes to studies are
sometimes lost.
11. The Ideal VNA: Design
•Specialised EMR modules drive the viewer of each
“ology” taking care of departmental workflow
•Image/data transfer protocol is standard & efficient
•All departmental application servers are independent
& replaceable without affecting the rest of the
organisation
•Data is accurate with all modifications
•VNA is replaceable (no data migration)
– Works like USB
•Any enterprise viewer can access ANY data in the VNA,
a patient-centric view.
p.11
Vendor Neutral Archive
Workflow
Radiology
Viewer
Cardiology Other
EMRRISCIS (non unified)
Workflow
Viewer
Workflow
Viewer
Enterprise Viewer
DICOM//XDS
ApplicationServers
Standard Storage Format
Transfer protocol
EMRRISCIS (non unified)
Public
© Carestream Health, 2013
12. The Ideal VNA: Challenges
This Ideal VNA may introduces challenges
•Lack of "hyper speed" transfer protocols.
Current standard communication protocols are slow
and limited (DICOM)
•Vendors optimise their solutions to provide enhanced
functionality and features through proprietary
mechanisms.
•Customers expect more benefit out of the centralised
archive (e.g. enterprise viewer, patient portals, etc),
May require non standard components.
•Customer are not willing to compromise on
performance.
•Master Patient Index management! Who is
responsible? EMR driven MPI or VNA vendor?
p.12
Vendor Neutral Archive
Workflow
Radiology
Viewer
Cardiology Other
EMRRISCIS (non unified)
Workflow
Viewer
Workflow
Viewer
Enterprise Viewer
DICOM//XDS
ApplicationServers
Standard Storage Format (DICOM Part 10 ???)
Transfer protocol
EMRRISCIS (non unified)
Public
© Carestream Health, 2013
13. The Practical VNA:
•Each department has its own workflow and display
needs. Departmental systems include an additional
Cache + DB layer to address performance issues.
•There is continuous traffic between departmental
systems and the VNA
– to ensure data integrity. Requires overhead monitoring.
– Supporting the prefetch mechanisms required for
performance to access the complete patient record
•Some VNA’s are implemented with local database &
proprietary file formats to maintain adequate
performance against the departmental systems
•VNA’s vendors provide exit strategies to support the
Vendor Neutral concept
p.13
Vendor Neutral Archive
Workflow
Radiology
Viewer
Cardiology Other
EMRRISCIS (non unified)
Workflow
Viewer
Workflow
Viewer
Enterprise Viewer
DICOM//XDS
ApplicationServers
Proprietary Storage Format
DICOM/XDS
EMRRISCIS (non unified)
Cache & DB Cache & DB Cache & DB
Cache & DB
Database / Interface
Public
© Carestream Health, 2013
14. p.14
VNA is also non-Dicom Support
Public
© Carestream Health, 2013
Vue Archive (VNA)
Tiered Storage
Lifecycle Management
XDS Repository
API
DICOM
HL7
XDSRegistry
Radiology:
DICOM /
HL7
Laboratory:
“Other”
data
Other Clinical:
“Other” data,
XDS
Cardiology:
DICOM / HL7 /
“Other “data
Additional IHE Profiles
XDS, XCA, BPPC, MPI, …
16. p.17
BPPC – Basic Patient Privacy Consent
Under which condition?
Medical documents are labeled with a Confidentiality Code
Which functional role
may access which document?
What are
disclosure rules?
17. XDS Consumer
p.18
Zero foot print client
List of Medical data
stored
Launch a web
viewer/browser to
display data
Support BPPC profile to
guaranty patient privacy
18. BPPC & XDS Consumer
p.19
Confidentiality code
defines document
access
In of emergency
user can “brake the
glass”.
Action will be traced
in the Audit Log
repository following
the ATNA profile
19. VNA is the foundation for data sharing
p.20
Public
© Carestream Health, 2013
20. Can A PACS Vendor be a Vendor Neutral for Archive?
p.21
Public
© Carestream Health, 2013
One of the biggest misconceived notion is
that a PACS vendor cannot provide a VNA
If it’s Vendor Neutral, who do you buy it from?
Nobody? Anybody? Everybody?
While some legacy solutions would fall under that category,
Carestream strives to provide an enterprise clinical data repository
that fits the description above and addresses the needs of the healthcare
Entire portfolio has been articulate around
Central VNA solution called “Vue Archive”
21. At Carestream we believe …
p.22
Repository
Vue Archive - VNA
Consolidated clinical archive: interoperable, standards
based for longevity
Enterprise Management
Enterprise Management
Patient data aggregation
Data sharing
RIS PACS Cardio
Clinical Departmental Solutions
Advanced clinical toolsets: single workspace for
productivity from image review to report
Physician
Collaboration
Patient
Access
Universal Viewers
Access to Patient Medical records regardless of clinical
system: secure, device neutral, mobile
Public
© Carestream Health, 2013
A complete portfolio articulated around Vue Archive
22. p.23
2004
First Non
radiological
department
connected to
Neutral
Archive
2003
First Neutral
Clinical Archive
installed
2010
10 Cloud
Infrastructures
managing 80M
studies
“Trendsetter” someone who starts a new style or helps to make it popular
Smart Innovations
2011
Flexible
enterprise
access
Patient
Imaging
portal
20122008
Introduction
Of Cloud
Archive Services
2009
Single patient
worklist connects
multiple PACS
XDS on
Vue
Archive
VNA on
Vue Archive
Public
© Carestream Health, 2013
23. p.24
Rural
Clinic
Vue Archive
VNA
University
Hospital
DICOM
HL7
IHE XDS-i
Regional
Hospital
HL7
Public
© Carestream Health, 2013
One Software fit all needs
DICOM
DICOM
HL7
“Other” Data
XDS
Reading
Center
Teleradiology
CARESTREAM
Vue Archive
XDS
Secured “Patient Centric” archiving solution.
Endless number of data sources
Unlimited storage volume
Vendor Neutrality: Data format, platform, PACS vendor
Ingensts data from disparate clinical vendors via:
DICOM, HL7, IHE XDS, XDS-I, Other
All data types managed through one centralized system
24. p.25
A “PACS” Vendor can also provide you additional layers
Public
© Carestream Health, 2013
Universal Viewer
Vue Motion
A Vendor Neutral Portal for physicians
Zero foot-print
No installation
Pure Web
HTML 5
Zero Training
Intuitive User Interface
Enable
Remote collaboration
25. And what about the Patient?
p.26
Public
© Carestream Health, 2013
Pure Web HTML 5
Patient Portal
Easy to access
Easy to use
Ability to share
with referring
Patient defines
sharing rules
Patient keep control
of his medical data
My Vue
A Secured Vendor Neutral Portal for patient
27. Smooth migration from your legacy archive
p.28
Public
© Carestream Health, 2013
Public
© Carestream Health, 2013
Legacy
Archive
Meta-data Take-over
Intelligent Data Migration
Query
Data Retrieve
Vue Archive VNA
Retrieve Command
Data Retrieve
29. p.30
Imagine an Enterprise Health IT Strategy with a Complete
Patient Medical Records Platform that can…
Manage patients not pixels. Easily provide global patient
medical records, shifting the reporting workflow paradigm.
Collaborate and share. Enable on-demand access to critical
clinical insight regardless of system or geography.
Infinitely scalable. Seamlessly manage and archive all imaging
source and document formats beyond traditional radiology or cardiology
departments, throughout the entire medical data lifecycle.
Public
© Carestream Health, 2013
Notes de l'éditeur EMR management:As moredepartments seek access to PACS, the proper identification of patients and exams becomes anissue. Often, each department will have its own patient and exam requisition system, AccessionNumbers may or may not be used for identification, and patient and exam IDs may be assigned by EMR management:As moredepartments seek access to PACS, the proper identification of patients and exams becomes anissue. Often, each department will have its own patient and exam requisition system, AccessionNumbers may or may not be used for identification, and patient and exam IDs may be assigned by