Please could you stop spamming the various PACS forums with these advertisements - the three identical messages posted here this evening, combined with your phonecalls this afternoon and then the subsequent direct emails are just a little too eager!
Apologies Alexander, I am new to the community, website and its functionality. However I would certainly like to think it's not spam. This is the perfect event for anyone procuring or thinking of procuring a VNA, those thinking about pacs data repatriation and those interested in the enhancement of patient records (including cross document sharing). I'll withdraw to the quiet step for a while.
Thanks and apologies, Gary
posted on Wednesday, February 27, 2013 - 07:55 am
It is important that Trusts do not buy a simple DICOM archive as a VNA.
Enterprise VNA features: 1. Image standards--DICOM 2. Medical documents--CDA (pdf wrapped CDA is entry level CDA) 3. Indexing standards for enterprise wide sharing-XDS 4. Sharing standards--XDR & XDR-I
Make sure there is a contractually defined exit strategy so that VNA vendor does not have absolute control over your data.
posted on Thursday, February 28, 2013 - 10:01 am
I agree with Neelam's comments that the true VNA is more like an enterprise content management or ECM. Which SHOULD include all the items listed in her last note.
Dr Dugar wrote: Enterprise VNA features: 1. Image standards--DICOM 2. Medical documents--CDA (pdf wrapped CDA is entry level CDA) 3. Indexing standards for enterprise wide sharing-XDS 4. Sharing standards--XDR & XDR-I And others. Breaking the link between the imaging requirements PACS and patient information brings a whole new world of possibilities when looking at overall patient management when using an extended VNA solution and NOT just DICOM images!!!! This is where the roadmap of any current VNA provider MUST provide the future requirements of ECM and these contracts will be for a longer term that just 5 to 7 years!! See Wikipedia on ECM or our web site for more info: www.pfcl.co.uk
posted on Thursday, February 28, 2013 - 03:02 pm
Enterprise Content Management is a good term Chris. However, I would still advice Trusts to have 7-10 contracts as a maximum even for ECM. Technology changes & it is important Trusts look at what is the right direction to travel in 2023. Data stored must be "fluid" and easily transferable to another vendor --which is why standards are important. As a customer it is important that vendors dont lock us into their solutions forever.
With our RIS replacement with Rogan -it will act as an XDS document source for radiology reports & scanned/electronic requests to the Enterprise Vendor Neutral Archive. PACS viewer will act as an XDS consumer and display both images & documents.
Couldn't agree more with the comments above. Our solution for VNA is ECM lead. Our platform is built on EMC Documentum, the leading Enterprise Content Management solution globally for the last 20 years.
In addition to the healthcare standards mentioned (i.e. DICOM / HL7 / XDS.b / XDS-I.b etc.), a true VNA solution should also offer an open-standards-based and neutral architecture. This means that : 1. the underlying ECM platform should have logical storage endpoints so that Information Lifecycle Management (Storage Tiers) and Retention Policies are not dependent on any specific storage vendor or hardware. 2. the underlying ECM platform should also adhere to the CMIS API standard to allow open access to the content for any future system integrations or migrations. the underlying ECM platform should run on a variety of architectures so that Trusts are not tied to a specific hardware/OS/database vendor
posted on Saturday, March 02, 2013 - 11:55 am
The main issue with using a VNA/ECM profile is to ensure that it comes from the medical direction and that it adopts all the DICOM/IHE profiles and history. The problem I see with using Documentum is that it comes from the document business arena and not from an imaging background and adapted for this purpose. Modern VNAs now moving to ECM have this medical foundation from the start and are not just a series of bolt on's from other vendors. As stated previously by Dr Dugar - Industry standards are the key.
As Chris suggests it is beneficial when the ECM has its foundations as a Clinical Solution from the outset. Agfa are now offering to UK customers the ICIS VNA solution that combines two Agfa fully IHE enabled products integrated seamlessly with each other and external solutions to enable users to directly access content both Dicom and none Dicom from a single secure web client. Importantly the Agfa solution uses an established module called Hydmedia that is now in its 5th revision as a mature medical ECM. In addition to its IHE compliance it is equally at home integrating to many of the legacy systems via API interaction and acting as an IHE proxy for legacy systems. Another benefit is that the Agfa solution allows mobile users to add content from mobile devices making for example tracking of wound care using images from a tablet straight forward. The mobile app allows the metadata to be created in real time by the clinician and the data added immediately to the ECM. Hydmedia coupled with the Impax Data Centre module provides a one stop shop for clinical content. It has document scanning, auto indexing and OCR based search capability and is used extensively in the DACH market for several years as a stand alone solution or a slave to EPR systems.
As demonstrated in many annual connectathons, IHE conformance statements and successful implementations, the EMC Documentum VNA solution has adopted all the DICOM/IHE profiles and history. In fact in many areas such as XDS Repositories and Registries are ahead of the competition. The storage and management of DICOM is very much a content management issue, the Documentum platform has featured scalability, performance, sophisticated retention management and information lifecycle management for many years. PACS vendors have a long way to go in this area and are completely lacking in non-DICOM let alone non-clinical. There are huge advantages as proven in all other market sectors who have deployed ECM solutions in a platform approach to unstructured content management. Implementing a VNA that doesn't share a common platform with non-DICOM and non-clinical content is perpetuating a silo'd information management architecture which in our experience Trusts are trying to move away from.
When choosing a Enterprise VNA solution customers must be explicit in their regarding their requirements: 1. VNA must allow life cycle management. i.e local policy based data culling 2. VNA must have a "customer enabled migration engine" which will allow migration of all data--DICOM & non-DICOM along with the metadata at the end of contract. 3. VNA must comply with XDS registry & repository actors of XDS profile 4. VNA must store & index both DICOM and non -DICOM context. 5. VNA must allow any display software from any vendor to display the VNA content--XDS consumer
VNA content display by XDS comsumer: Displaying non-DICOM content within a VNA can be tricky. Customers need to be aware of this. There are some good XDS consumer viewers coming into the market--it is important to evaluate this. They support DICOM, jpeg, pdf & CDA. Most PACS displays today will not support non-DICOM content display.
Another thing to be aware of is the need for some access control mechanisms. For example we would like to give access to ECGs to ECG technicians within VNA but perhaps they should not be allowed access to rest of patient record in the VNA. Again the access control lies within the XDS consumer display viewer.
So in essence Enterprise VNA future proofs PACS replacements with ability to store both DICOM content but be aware of needs to display the VNA content via an XDS consumer--which I would call a "Enterprise Clinical Portal".
We will be discussing Enterprise VNA, Clinical Portal & Access control issue at UKRC 2013--session called "PACS is reborn". These very issues will be discussed.