Picture archiving and communications systems revolutionized medical imaging, digitizing examinations that used to be on film and archiving them in the PACS. But now many providers are moving from a PACS archive to an enterprise archive. That brings technical and political challenges as control of images moves from the radiology department to the hospital.

“I’m a radiologist and want to maintain control of our system,” says Alexander Towbin, M.D., a radiologist at Cincinnati Children’s Hospital Medical Center. “But it goes beyond radiology--should the radiology department have control over dermatology issues?” And beyond the hospital level is the delivery system level with technical and political questions of how to exchange images across other hospitals within and outside of a delivery system. For instance, how do you make sure every partner is identifying patients correctly? And whether hospitals want to or not, the electronic health records meaningful use program is pushing them toward accelerated health information exchange, including diagnostic images.

The challenges of moving beyond local archiving are being tackled during three education sessions at SIIM2013, the annual meeting of the Society for Imaging Informatics in Medicine. “There are challenges in local departments, enterprisewide and across a region,” adds Towbin, who will co-present Learning Lab 3, “Future Proofed Archiving,” on June 6. “Sharing images is against their competitive instinct, but a lot of hospitals are realizing it’s the right thing for patients and we need to get over it.”

The sessions also will feature vendors explaining image-enabled HIE and creating efficient workflows, and a town hall discussion with moderators setting up topics with questions and letting the audience debate the answer. For instance, moderators will bring up questions about why a lot of hospitals are very conservative with their data because of HIPAA privacy/security concerns, the level of confidence they have in their vendors and whether cloud-based storage is a viable option today for hospitals and radiologists. Towbin will emphasize the need to start thinking about the cloud now because it is technology coming quick to radiology. Personally, he’s not convinced it is ready for prime time yet.

More information is available at siim2013.org.

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