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 Link to this message Neelam Dugar  posted on Sunday, September 03, 2017 - 07:36 pm Edit Post Delete Post Print Post
Enterprise Imaging and Clinical Portals are the new buzzwords:
I do think this is a step in the right direction. Adoption of FHIR and XDS standards are key to the success of Safe Paperless hospitals.
1. Can PACS vendors support development of displays that are compliant with Clinical Portal requirements and XDS consumer requirement. I think PACS vendors are very well positioned to do so, but need to support XDS and FHIR as standards.
2. VNA vendors are well positioned to the enterprise image and document repository with standards based XDS registry and repository
Here is a presentation I am due to give. I would welcome any comments--clinical users and vendors please.
application/pdfClinical Portal
Clinical Portal2.pdf (912.0 k)
 Link to this message John Parker  posted on Wednesday, September 13, 2017 - 05:10 pm Edit Post Delete Post Print Post
HI Neelam,

3. areas you might want to consider adding:

1. Primary care data- seamless links between primary and secondary care
2. patient access
3 patient control of access

I suspect we will end up regretting the move to portal type access to systems. users are moving to them, not because they are the right strategic solution, but they are (seen to be) easier to achieve. If we are ever going to solve the dilemma of appropriate targeted access to a patients longitudinal record, we need to define the format of the patient record.

The data is, and always has been the big prize in the move to digital records.

In the long run, we should be heading this way:

 Link to this message Neelam Dugar  posted on Wednesday, September 13, 2017 - 09:05 pm Edit Post Delete Post Print Post
Hi John,
Primary Care data can be aggregated by "clinical portals" in the same way as 2ndary care data from departmental systems provided they are held in FHIR compatible databases in primary care-
FHIR adoption will allow data aggregation from multiple IT systems to create a longitudinal patient record.
Clinical Portal is identical to a patient Portal as such.
 Link to this message Robin Breslin  posted on Wednesday, September 13, 2017 - 09:45 pm Edit Post Delete Post Print Post
So, I would like to introduce to the discussion the difference between aggregation and federation of information.

My view is that you cannot have "one VNA to serve them all". You are going to need a way to federate information across multiple storage devices (silos, VNAs ..).

This is the purpose of a Healthcare Information Exchange (a HIE).

And this delivers a traversal patient-centric view. It does not, however answer all healthcare needs (secondary use for example).
 Link to this message Neelam Dugar  posted on Wednesday, September 13, 2017 - 10:13 pm Edit Post Delete Post Print Post
I agree Robin.
Health data stored will be federated in many many systems both within primary and secondary care.
However, by standards adoption by vendors --particularly FHIR for structured data and XDS for documents & images, viewers/portals from ANY vendor will be able to "aggregate" the data across the various federated databases and document/image archives.
FHIR and XDS really complement each other.
 Link to this message Robin Breslin  posted on Wednesday, September 13, 2017 - 10:58 pm Edit Post Delete Post Print Post
.. Also, XDS already extends to encompass or use FHIR.

I am sure there will be a convergence of these standards over time.

I am equally sure that vendors will move to use these standards over time. They are natural structures within information with respect to healthcare.
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