Despite the importance of developing an enterprise medical imaging approach, the strategy requires the easy exchange of images, and achieving that interoperability is a major challenge, according to results of a recent survey.

Still, more than half of 100 surveyed IT leaders in healthcare organizations say their facility has an enterprise imaging strategy—a major component supporting the move to interoperability—and 54 percent say specialists at their facility can electronically exchange images with patients, providers and referring sites.

The College of Healthcare Information Management Executives, which represents IT leaders, recently surveyed 100 executives overseeing IT departments, with 76 percent of respondents using Epic, Cerner or Meditech electronic health records.

In a report, CHIME notes that C-suite executives increasingly are concerned with improved interoperability, both within and outside of their organizations,. While, a shared PACS or virtual private network aggregates images from across an enterprise. “there’s only one problem: Patients often don’t receive care from only one network in a given region,” the report for the survey noted.

Survey results resonate quite well with what Mach7 Technologies, a vendor offering an enterprise imaging platform, is seeing in the market, says Eric Rice, its chief technology officer. “When we talk to customers, it’s not about archiving anymore, but about exchanging,” Rice says.

That’s where the need for better interoperability across disparate technology systems and corporate entities becomes apparent, in order to permit access to a complete medical imaging history, according to CHIME.

But challenges abound, Rice notes. Because organizations’ level of interoperability varies, much image exchange still involves using compact discs and DVDs that hold images to be imported into a reading station. In addition, the industry also lacks a standardized dictionary of clinical terms or descriptions across the various disciplines of imaging.

Further, current DICOM and HL7 interoperability standards fall short of enabling the exchange of the clinical terms that accompany the details of the data, Rice adds. “The next evolution will be to normalize the data and bring it into the reader.” That could be done through national, local or proprietary standards.

Solid patient identification also remains elusive for now, according to Rice. His full name is John Eric Rice, but he goes by Eric Rice, and a provider’s electronic health record may not know that, demonstrating the need for patient-matching tools.

More exchange of imaging studies can reduce the 20 percent to 30 percent of the time an original image is not available, or the referring physician does not know the same exam was conducted elsewhere, or discrepancies in the interpretation of an exam compels the need for more imaging.

Current radiology processes encourage overutilization, as medical imaging has become a major source of revenue and profit for providers; the financial effect of attempting to reduce the number of imaging studies could hurt facilities as accountable and value-based care comes into play.

In the CHIME survey, sponsored by lifeImage, 58 percent of respondents say their hospital has implemented an enterprise imaging strategy, with another 23 percent indicating the task is in progress.

Still, there often remains no single department responsible for enterprise imaging. Some 48 percent of respondents say imaging responsibilities are shared by IT and radiology; 38 percent by IT; 7 percent by radiology; and 7 percent by another department. Optimally, Rice believes, radiology should be the driver in overseeing diagnostic imaging, but have a close relationship with the IT department.

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