“It’s Everyone Working Together”: Experts Share the Keys to a Successful Enterprise Imaging Strategy

As healthcare organizations delve further into digital transformation — and subsequently, more data is created — it’s becoming increasingly vital to ensure providers have the right information at the right time, and in the right format.

And that includes imaging.

In fact, the ability to access images isn’t merely advantageous. “It changes my ability to make a diagnosis,” said Alex Towbin, MD, Associate CMIO at Cincinnati Children’s. “We need to take care of our patients in a way that’s as safe and effective as possible.”

Implementing and maintaining a solid enterprise imaging management system, he noted, is a key step in achieving that goal.

During a recent webinar, Towbin spoke with co-panelists Joseph Marion (Principal, Healthcare Integration Strategies) and Lenny Reznik (IT Business Unit VP, Commercial Product Leader, North America, AGFA HealthCare) about the rising value of enterprise imaging — particularly as it relates to patient care, and offered best practices based on their experiences.

Although there are more detailed definitions of what exactly enterprise imaging entails, Towbin summed it up as “getting all of the pictures taken in the hospital into one spot and making them easy to capture, distribute, view, and eventually exchange,” he said. It’s certainly a departure from the traditional method in which images are housed and managed by the radiology department.

“Better care”

The old siloed approach, according to Marion, can make it extremely difficult to integrate clinical information. “The traditional environment has been very compartmentalized. That’s not conducive to long-term patient care.”

Reznik agreed, adding that when data — including images — reside in disparate systems, “clinical care teams don’t have access to the information they need to make the best diagnosis,” he noted. It also “doesn’t facilitate communication among providers and patients.”

For Towbin, that was a critical element when he made the case for enterprise imaging at Cincinnati Children’s. “I want to take better care of my patients, and I believe having images from other specialties helped me to do that,” he said. “I also want to help my colleagues to do their jobs in a more efficient manner and to help gain insight from their data.”

What’s not efficient is having to print out PDFs and scan them into the EHR, which is often the case. Even if images are stored in an archive and referenced into the medical record, it can cause challenges for users, Towbin said. On the other hand, with an enterprise imaging approach, users can store images in an archive, “be able to apply metadata labels to them, allow others to see the images and, within the viewer, put in protocols that allow users to evaluable all of the data more historically.”

It’s particularly critical in wound care, for example, where images play a key role in guiding diagnosis and treatment. Attaching a photo to a clinical note — which was the approach often used — doesn’t do much good, as the note can only be viewed by certain members of the care team, said Reznik. “That’s the fundamental difference that not everyone can appreciate. It’s why enterprise imaging becomes so important to address some of the issues we have today around patient expectations.”

Not to be ignored are the added security risks that come with having disparate imaging systems. “It’s a lot harder to secure all of those than one system,” he added. “You have to have database backups for every one of those systems. You have to have servers and security policies.” Consolidating systems can mean “less liability from a security point of view.”

Although that’s certainly a critical selling point, the primary driver with enterprise imaging is to “make sure the right information is in front of the right caregiver at the right time,” Reznik stated. “That’s ultimately what we’re trying to do.”

Best practices

However, as with any major initiative, it has to be approached thoughtfully, according to the panelists. Below are some of the best practices they shared for rolling out an effective enterprise imaging strategy.

• Do your homework. The first step, according to Reznik, is to get educated, whether it’s by reaching out to colleagues who have been through the process or leveraging vendor-neutral resources like the HIMSS-SIIM Enterprise Imaging Community. “There’s a lot of information out there,” he said.
• Lock down support. “You need executive buy-in from the beginning, because there is a cost outlay, and you need some agreement that this is the strategy going forward,” Towbin said. “There are a lot of turf battles that come up and a lot of differences of opinion.” Having solid leadership in place, therefore, is a must.
• Establish goals. One of the keys to success, Marion has learned during his long tenure in consulting, is to identify specific objectives. “What are you trying to accomplish? What are your requirements?” Failing to do so is like, “building a house without a plan,” he noted.
• Talk to users. The best way to pinpoint those goals, according to Marion, is by getting out and speaking with those on the frontlines. “If you talk with clinicians, you’ll find that it’s not the radiology or CT images that they’re necessarily interested in,” he said. “It’s the high-demand images that might be as simple as a chest X-ray.” For leaders, the challenge is in “getting all of the entities involved and getting them to at least agree on some common objectives.”
• Appoint a champion. An initiative as complex as enterprise imaging doesn’t stand much of a chance without a champion, said Towbin. That may include someone who sits atop the entire program and helps prioritize and set strategic decisions, as well as local champions. What’s important is having a domain expert who is actively engaged in the project; preferably someone who “knows imaging informatics and understands workflow steps and design.”
• Committees work. Of course, workflows aren’t universal across a health system, which is why it’s important to have a committee with representation from various departments. “You can’t force a radiology workflow, for example, into dermatology — it’ll never work,” said Reznik. “That’s why you set up an enterprise imaging committee to help make those decisions.” And when new workflows are introduced, there needs to be a strong focus to “help reduce steps for them and cut down on clicks and keystrokes as much as possible,” he added. “People just want it to be easy. They want it to work for them.”
• Build a bridge. Not to be overlooked is the criticality of ensuring IT and clinicians are collaborating closely, Reznik noted. “That’s the number one thing. This is not just a radiology program. It’s not just radiology or ophthalmology. It’s everyone working together.” His advice? Leverage the same model EMR implementations have adopted by prioritizing governance. “Ultimately, there needs to be a group of people working together to solve this. That’s what makes a successful enterprise imaging program. That’s what will get the most results.”

Finally, enterprise imaging is a process, Reznik emphasized. “It isn’t just software you install. It changes over time; what works for a dermatologist today may not work a year from now.” Therefore, it requires constant maintenance and optimization. “You can’t go live on day one and get all the benefits. It takes time.”

That could mean bringing up a department every week or month, depending on the organization’s needs and resources. “You don’t want to do a full bang and rip out radiology, cardiology and all these other departments at once,” he said. “It’s a journey. And those who view it that way will be more successful.”

To view the archive of this webinar — Harnessing the Potential of True Enterprise Imaging (Sponsored by AGFA HealthCare) — please click here.