For the vendor-neutral archive (VNA), James M. Conyers says, making the A stand for archive no longer adequately describes the technology’s true capabilities. Conyers, national director of Enterprise Architecture Solutions for FUJIFILM Medical Systems, explains, “It’s more of an architecture than an archive. An archive is just one component of what the VNA actually does.” As a 10-year veteran of Fujifilm, Conyers has had the chance to expand the architecture of the modern VNA, using it to take the output of multiple specialties and put it into a unified storage-management solution. From there, radiology providers can give access to patient information to any appropriate person, whether within or outside a given organization. When done correctly, this amounts to an imperative for radiology department heads who wish to take an enterprise solution and create economies of scale. The alternative is to buy multiple storage solutions and technologies to manage all clinical content and data—quite costly, for any organization. The end result is a unified solution (or architecture) that dramatically reduces costs. “Once you are in a VNA, the cost of adapting new solutions and software applications is drastically reduced,” Conyers explains, after diving deeply, with Fujifilm, into VNA waters about five years ago. He says, “That is because you don’t have to migrate from one proprietary front-end application storage infrastructure to another continuously if you decide to change application vendors.” Dreaded data migrations are no joke, sometimes costing millions of dollars. Conyers points out that, for large institutions, migration can cost $2 million just for the radiology data. He says, “Then, you have cardiology data, which can be another million (or for midsized organizations, hundreds of thousands of dollars)—and those are just two of 26 different specialties.” With a state-of-the-art VNA, however, organizations migrate data once, and they are done forever. By many estimates, migrating into the VNA is relatively inexpensive. Conyers predicts that a free-flowing information health-care exchange, prevalent in Europe, will increasingly be seen in the United States. The ability to exchange information might start regionally, but it will inevitably expand nationally (and even globally). “For example, the states of Iowa and Ohio want to create a VNA in which all the facilities and hospitals can store all their information in a VNA cloud,” Conyers reports. “To do that, we must have a neutral platform that can serve up information in a native format, regardless of the application you are using to view, manipulate, and manage the data.” The concept is utopia for some, but others are hesitant to embrace the VNA workflow. “Health-care information and data have been in silos,” Conyers explains. “The individuals who manage those environments may start to feel as if they are losing control, because it becomes more enterprise based rather than department based.” Conyers says that those who are hesitant might ultimately realize that (far from losing control) they actually have more flexibility and control over data, particularly when they realize that the VNA is not just an archive. “VNA is such a bad term,” Conyers reiterates, “because a VNA is a layer for managing the transition of data to an enterprise archive.” The Native Advantage A VNA solution is composed of both hardware and software. The hardware includes the servers and storage media standard in any archive, as well as a couple of servers that run the VNA software (or management layer). “The facility may also already have the storage; if so, the VNA will be attached to existing storage—in the physical or virtual environment—as an appliance,” Conyers explains. “It is storage agnostic.” The software orchestrates the management of the data, including how long they are kept, how the are presented, and where they are stored. The flexibility, or neutral aspect of the solution, derives from its reliance on standards (rather than proprietary code) and the solution’s ability to store clinical data in their native formats. When it comes to DICOM and non–DICOM images, Conyers says, VNA flexibility can really come in handy. “If I’m going to store DICOM information, it will be in a DICOM format,” he explains, “but with non–DICOM information, the formats are similar to what we use every day, such as TIFFs, QuickTime movies, and MP3s.” A true VNA has the ability to store the non–DICOM data in their native formats, without having to wrap the images in a standard such as DICOM (adding an extra step to the process). Today, many VNA vendors wrap non–DICOM data in a DICOM shell. They are not storing non–DICOM images in their native formats. “If you have a solution that can store data in their native formats and then present that information to any application in its native format, that is a significant advantage to a VNA,” Conyers continues. “That is because you increase performance and reduce the cost of the system. When you wrap non–DICOM data, it makes the data twice as big, so now, your storage cost goes up; the Synapse VNA stores everything in its native format.” Greg Thompson is a contributing writer for Radinformatics.com.