Cheryl Petersilge, MD, MBA, with the department of regional radiology at the Cleveland Clinic, examined enterprise imaging—and how radiologists must integrate and collaborate with other departments. Her clinical perspective clinical perspective was published online in the October issue of the American Journal of Roentgenology.
“Radiology has been at the forefront of most advances in the infrastructures and workflows for imaging management,” Petersilge wrote. “Radiology can remain at that forefront by embracing the new world of enterprise imaging through carefully selected purchases and through engagement with other image producers in their institution.”
The paper examines the value of enterprise imaging, experiences from Petersilge’s time at the Cleveland Clinic and obstacles faced by the industry in increasing implementation and efficiency.
Inside & Out
Petersilge comments that a complete enterprise imaging program must incorporate images produced internally with those from outside a healthcare system. Distribution of images can be shared within a healthcare group, though radiology departments are often best suiting to handle images.
“Many of the other imaging-producing departments are in their infancy and are not equipped to handle these challenges,” Petersilge wrote. “These departments are often smaller and do not have the experience to support these activities. Radiology departments should step in to fill these voids, lending their expertise and increasing their value to the healthcare system.”
Healthcare has faced difficulties in streamlining interoperability and health information exchanges. Radiology departments can take a lead in efficiency sharing and archiving images.
Open, Easy Access
Images need to be shared—and they need to be shared immediately in some cases. Petersilge points to the case of a pregnant woman undergoing a pelvic ultrasound. Instant access to previous ultrasounds allow an emergency department to best interpret new images.
Similarly, patients who present at different providers can be problematic, because a second provider is at a disadvantage without access to earlier images. Providers can also be more able to share images with patients.
“This sharing of images makes the disease process easier to understand and converts the computer from a barrier to a supporting tool during the visit,” Petersilge wrote. Many radiology departments have already begun making significant progress in sharing images with patients.”
Cleveland’s Case Study
The Cleveland Clinic developed an enterprising imaging program that incorporated all producers into the archive, which is connected to electronic medical records (EMR).
“Images from 11 different healthcare service lines, in addition to images from the radiology service, have been incorporated into the clinical image library,” Petersilge wrote. “A total of 440 different image-generating devices that reside outside of the radiology service have been integrated into the library. For the end of 2016, the anticipated volume of integrated images was more than 320,000, in addition to more than two million studies from the Imaging Institute.”
The enterprise imaging team also handles PACS, while developing workflows for various services linked to the library.
Challenges are plentiful in improving enterprising imaging. A few things that need to be answered include:
- Should data be stored in a DICOM format?
- Is a PACSbased strategy better than a VNA-based one?
- How can providers meet the varying needs of image producers?
- How can systems overcome resistance among clinicians?
- Can radiologists be trained to work closely with nonradiologist image producers?
- What steps must be taken to reduce redundant imaging across a system?
- What security threats face radiologists and how can they be prepared to respond?
As the industry begins to formulate answers to these questions, it’s clear enterprise imaging will remain a focal point for radiology departments—which will include time, money and effort to be successful.
“Enterprise imaging is on the horizon for every institution,” she wrote. “Such a program comes with a significant capital cost, and in these times of economic constraints in the healthcare industry, investments must be wisely chosen.”