Agfa Healthcare

The complete video of “The Big Picture Made Tangible: Realizing the Value of Enterprise Imaging IT” is available online. Watch it today to learn enterprise imaging best practices from leading clinical innovators.

We need to maintain secure custody of medical images within the enterprise and leverage them as strategic assets of the entire organization

Explore how to successfully transform individual departments’ medical imaging into powerful enterprise-wide assets that benefit the clinical, operation and financial health of your care system.

According to KLAS, up to 50% of IT implementation projects fail, here's 5 tips to make yours a success.

New imaging techniques are helping radiologists, cardiologists, oncologists and other diagnosticians with greater anatomical and clinical details, highlighting the need for fast access to imaging reports and results and collaborative workflows. Augmented Intelligence can ease the workload on health imaging experts and simultaneously improve their performance. AGFA HealthCare reached out to senior radiologists, surgeons and clinical leaders around the world, and has included their responses in the following perspectives. Task-based workflow optimization AI will not replace radiologists or other physicians, but in fact enhance their workflow, helping them to make collaborative and intelligent decisions. Enterprise imaging, powered by AI, will help improve radiology even further with task-based workflow optimization. Physicians will obtain faster access to critical results, helping to reduce wait times and improve referral services for cases that require urgent patient care coordination. In a recent survey, our respondents emphasized the need for exploring the capabilities of machine learning and AI in addressing certain mistakes and errors that could alert radiographers and radiologists, and automate certain nonessential tasks to ease workload. “We should free our experts to undertake expert work by removing as many nonessential tasks for them as possible,” noted Angie Craig, assistant director of operations and performance, Leeds Teaching Hospitals Trust, National Health Service, United Kingdom. “That’s where artificial intelligence comes in.” Disseminate DL intelligence with AI As we break down silos of imaging workflows and enable multidisciplinary consolidation and collaboration, the power of a consolidated platform results in the creation of a vast data lake, ready for analysis by radiologists, diagnosticians, researchers and academics to help improve quality of care by better understanding disease and population health data. This helps care organizations progress from descriptive to predictive analytics models to improve early detection of diseases, and introduce care plan models that help enforce and improve patient engagement and compliance. During discussions with senior radiologists and diagnosticians, we witnessed a consensus regarding the clinical application of AI to help address screening challenges associated with pressing healthcare problems that include cancers, chronic chest diseases, musculoskeletal conditions, neurological disorders and cardiac conditions as well as the detection of various other clinical conditions. When it comes to oncology, our respondents discussed the significance of AI not only for initial diagnosis but also for follow-up after the treatment in helping track the potential recurrence. “In my group, we’ve already demonstrated that an AI system for chest X-ray triaging and prioritization can lead to much faster reporting turnaround time,” said Giovanni Montana, professor of data science at the University of Warwick, U.K. “We’ve also shown potential diagnostic benefits in early detection of lung cancer.” Personalized medicine and smart applications Care organizations and health authorities across the globe are faced with pressing population health challenges. Whether it comes to detecting cancers or chronic diseases, machine learning and advanced analytics will help radiologists and diagnosticians to focus less on manual repetitive tasks, and more on improving care pathways. “I think one of the biggest contributions deep learning/artificial intelligence will realistically make to me as a radiologist in the near future is not directly helping with image interpretation, but in bringing the relevant information out of the electronic medical record and presenting it to me in a meaningful way to better inform my clinical judgment,” said Bill Anderson, MD, Edmonton zone medical director for diagnostic imaging at Alberta Health Services. “Incorporating this directly into the report will be how we can really add value as radiologists using deep learning. It not only will streamline my workflow but also will be a major step towards more personalized medicine in radiology.” As the healthcare IT industry drives the progress of augmented intelligence, new imaging techniques will personalize and streamline workflow, improve multidisciplinary collaboration and increase predictive analytics across the continuum of care. Building an ecosystem of augmented intelligence powered by machine learning, cognitive reasoning and a task-based rules engine will help enable innovative solutions to meet the need for rapid and accurate care delivery. About the Author: Anjum M. Ahmed, global director of imaging information systems, AGFA HealthCare

Here are some key tips for successful image management.

Healthcare organizations across the globe are under pressure to deliver quality, outcomes-based care while reducing unnecessary costs.

Here are some key tips for successful image management.

Enterprise Imaging provides structure for successful image management.

One of the most important discussions in healthcare today centers around the shift from fee-for-service care to value-based care. The goal is to improve the quality of care for the patient by changing how healthcare systems are reimbursed for their services. In the traditional fee-for-service model, volume was the name of the game. More patients, more admissions, more tests, more examinations all equaled more money. But this volume-focused approach didn’t necessarily mean patients were receiving the best quality of care or receiving better outcomes. Today, the Affordable Care Act, together with the Medicare Access and CHIP Reauthorization Act (MACRA), carries a new mandate – a shift from volume- to value-based care. The new model is strictly focused on improving healthcare in three core areas: quality, cost and outcome. The results will be closely measured and monitored, and healthcare systems will be compensated accordingly, with penalties imposed for healthcare acquired conditions, recurring readmissions, and never events. The ultimate goal: To provide better patient outcomes at lower, more manageable costs. In the quest to fulfill this goal, new techniques and technologies have emerged that can improve both the quality and cost of patient care, including advancements in electronic health records (EHRs), an increased use of patient imaging, telehealth, and more. But these changes have also exposed challenges facing IT healthcare professionals including barriers imposed by inaccessible and siloed images that need to be overcome to provide the kind of collaborative care that is most beneficial for the patient as well as the healthcare provider’s bottom line. The EHR’s Critical Challenge To simultaneously improve the quality and outcome of care while reducing costs clearly requires a new system of collecting and sharing information about patients among multiple caregivers, a directive that EHRs were intended to address. While establishing EHRs did provide a way to collect, access, and share data about a patient in a more expedient and organized manner, there has been one critical flaw: EHRs typically don’t present the whole patient story. Important information such as patient images, documents and other clinical multimedia files are not always married to the EHR in consistent and relevant ways that allow these elements to be viewed in the proper context by providers both inside and outside of the patient’s primary healthcare system. As a result, access to medical images and other multimedia data is fragmented, and doctors are left to make care decisions often without a comprehensive patient record to contribute to their decision-making process. Even when medical images are accessible within the EHR, it is often challenging for the provider to locate them as they may be scattered in encounter notes or accessible only by a link buried deep within test result records. While many organizations include access to radiology images from within the patient’s EHR, images and documents produced in other image-centric departments like cardiology, ophthalmology, wound care and dermatology typically remain siloed and out of the care team’s reach. And while advances in the functionality of select EHRs now allow some level of digital photography management, it is rarely possible to see a patient’s complete longitudinal imaging history all in one place, regardless of image type, as has been the norm for years with patient laboratory result histories. There is a Better Way Enterprise imaging offers a remedy, yet its role is often misunderstood. One of the biggest misconceptions among healthcare CIOs today is that enterprise imaging is strictly about moving the storage of patient images from today’s Picture Archive and Communication System (PACS) to vendor-neutral archives (VNAs). While PACS have long provided the means to acquire, store and view Digital Imaging and Communications in Medicine (DICOM) images, those images were relegated to silos housing only those produced within image-intensive practices such as radiology, cardiology and ophthalmology. While this approach was adequate in the traditional fee-for-service model, it makes a real-time multidisciplinary approach to sharing these images nearly impossible. As value-based care becomes more widely understood, however, it is becoming clear that the ability to share multidisciplinary images among the wide array of providers in any care continuum is a significant benefit to both patients and providers alike. Among other outcomes, the lack of visual images in the continuum of care can contribute to unnecessary readmissions, the very antithesis of value-based care.  Enterprise imaging solutions are purpose-built imaging engines that give healthcare systems a modular, phased approach to managing images as well as the ability to deliver real-time collaboration among caregivers, all on a single platform. And, because it’s a pervasive solution, enterprise imaging offers healthcare providers a clear and cost-effective detour around the roadblocks currently standing in the way of true value-based, patient-centric care and the financial rewards associated with delivering it. If a picture is worth a thousand words, then a patient’s EHR is clearly incomplete without the myriad images produced on a daily basis. And if repeating studies delays care, increases costs and decreases patient satisfaction and possibly outcomes, then enterprise imaging, which provides a modular multidisciplinary workflow, may just be the interoperable image and information network needed to complete a successful value-based care strategy – and the key to an optimized EHR and a maximized return on investment for the healthcare provider. Let’s examine a few use cases where Enterprise Imaging provides this missing link to value and quality care. Increasing Efficiency of Care To be successful in a value-based model – and to fulfill the requirements for better quality, cost and outcome – it’s imperative for clinicians to have relevant patient information available on demand. Providing a platform for a variety of disciplines to acquire and retain images and to subsequently make that information universally available at a variety of care locations is what platform-based enterprise imaging is all about. Consider the patient examined by a general practitioner who orders images to be taken; later, the patient needs to see a specialist. If that specialist doesn’t share the same EHR as the facility that acquired prior radiology studies, the patient is inserted into the clinical information delivery process. To avoid costly and time-consuming repetition of scans, patients have become personally responsible for moving their images from one physician to another. When possible, patients can request electronic transmission of the images, a process often hampered by a lack of homogenous technology between the sender and receiver. When electronic transmission is not possible, this means the patient must take the images to the specialist on a CD, a practice which leaves the specialist focused on getting the technology to work in order to view the images rather than focused on the patient during their encounter. Enabling the provision of existing images and related documentation to a specialist before the patient arrives, however, gives the specialist time to review the scans and determine a potential treatment plan before seeing the patient in person rather than delaying care, and engendering frustration, while waiting to successfully review existing images or take new ones. Shortening Time to Care When a patient is ill – and worried about being ill – every minute and medical encounter counts. By making previously acquired images accessible to all points of care along the way, time won’t be wasted repeating the same images or waiting for physicians to have collaborative conversations with each other; the information and images will be available for each practitioner to see where and when they need them to make the most informed diagnosis and treatment plan possible. If a family physician thinks, for example, that a patient may have an enlarged thyroid gland, the physician looks at bloodwork, feels the patient’s neck and refers the patient to an endocrinologist. The endocrinologist meets with the patient, performs a brief examination, then orders a radiology ultrasound for the patient. The patient takes off work again to have the ultrasound study, then another time to go back to the endocrinologist to discuss the results. The physician reports that radiology finds an enlarged node that requires a biopsy. The patient is scheduled for another radiology appointment and a needle biopsy is performed, then the patient is scheduled yet again to meet with the physician for the results – more time off work, more waiting, more anxiety building at each step along the way. Today, however, most medical schools are teaching students to perform ultrasound exams. Therefore, many physicians are now capable of performing simple ultrasound studies on their own. In this example, the endocrinologist could have performed the initial ultrasound, reducing costs and saving valuable time and stress for the patient. But, now our healthcare information systems need to catch up with this broadened clinician technical capability. Until recently, physicians had no effective way to capture and meaningfully store patient demographics with images from point of care ultrasounds, which meant the tests were performed, but the images were not accessible for future reference or billing documentation. In most cases, before the ultrasound was performed, the physician typed in the patient’s last name and allowed the machine to assign random numbers as an identifier. No demographics, no key words attached, and the images were not archived or married to the patient’s EHR. When the ultrasound unit ran out of storage space, the images were simply erased. Now, what happens if the endocrinologist in our example says a biopsy isn’t presently indicated and suggests the patient be checked again in six months? There’s no record of the previous ultrasound available for comparison. Even the most simplistic use cases speak to the increased quality of care patients can receive when physicians are empowered to use ultrasound technology – and to store the images in a meaningful and accessible way via an enterprise imaging platform. Using ultrasound guidance to help with needle and line placement, for example, helps assure that the first stick is the right stick during the procedure, and it also allows, in most ambulatory encounters, for the physician to be reimbursed for the use of ultrasound guidance after it is performed. Under the value-based model, reimbursement for services such as these can occur only when clinicians can provide documentation of the ultrasound images.  The most innovative enterprise imaging vendors have recognized these problems and have done something about it by creating solutions that both facilitate provider efficiency and assures the retrievability, and thus, continued use, of medical images. A powerful Enterprise Imaging platform allows the provider to easily select a patient’s name from a work list and acquire the images. The rest is left to technology. In the background, patient demographics are assigned to the images, the image set is routed to the Enterprise Imaging VNA and subsequently made available within the patient’s EHR. Now, in the case of the endocrinology patient, the ultrasound study is readily available for use as a prior comparison when the patient returns for a follow-up visit. And for the clinician who used ultrasound guidance during the ambulatory procedure, reimbursement is virtually guaranteed. Of note is a patient-centric, interactive timeline made available by the leading solutions. This functionality offers a big leap forward in understanding the patient’s story, with its thumbnail-enabled, study-by-study, unified view of the patient’s images. By leveraging the investments made in capturing medical images, this a formidable example of information technology advancing value-based care. A Word About Workflows A common mistake that healthcare organizations often make is to assume that a radiology workflow will enable the successful acquisition of images in a non-radiology environment. It is important to keep in mind that image acquisition is the business of radiology, and as such, the existing radiology information systems that enable a radiology workflow are designed specifically for a radiology environment staffed with many different roles from scheduling to the technologist to the radiologist. This type of system, and its required workflow, is not at all suited for non-radiology physicians using other image capture systems, such as ultrasound, in the delivery of care to their patients. Therefore, organizations that follow this path find it necessary to create workarounds and complex rules to support the needed agility of a non-radiology practice, and many times, the clinicians are unhappy with the result. Alternatively, with a mature Enterprise Imaging platform, the technology takes care of the demographic documentation, marrying the image to the patient’s EHR in the background. And because Enterprise Imaging offers the ability to create practice-specific workflows, there is no need for rogue workarounds or costly overhead to manage special rules. Part II continues the coverage of how accessible images enable stronger outcomes, which helps healthcare organizations support their value-based care goals. About the Author  Kim Garriott is the Principal Consultant, Healthcare Strategies, Logicalis Healthcare Solutions