How a Barn Raising Can Help Build an Effective Enterprise Imaging Strategy

An 18th-century building process may seem worlds away from a 21st-century healthcare implementation. Yet an Amish barn-raising provides critical lessons that transfer to constructing an effective enterprise imaging strategy. Certain elements must be in place before the execution of the project can begin, and coordination of teams and tools is vital for a predictable outcome.

What is an enterprise imaging strategy?

If you work in any proximity to the healthcare sector, you are probably familiar with medical imaging. And in this context, "enterprise" refers to the business, including the network of physician offices, hospitals, health centers, imaging departments, and administrative operations that are part of the organization. A strategy is, of course, a plan of action to achieve a goal.

The Cleveland Clinic explained enterprise imaging strategy as "(it) addresses the overarching enterprise need for standardization of clinical image acquisition, management, storage, and access."1 An effective enterprise imaging strategy essentially puts the archiving and communication pieces into VNA (vendor-neutral archive), providing efficient access to DICOM and NON-DICOM images across the care continuum.

Borrowing from the “plain people”

Anabaptist sects may live simply, but their blueprint for construction is anything but plain.2 The Amish apply time-tested principles that can be borrowed in the building of an effective enterprise imaging strategy.

Everyone shows up at the same time

Driving a modern vehicle is a violation of Ordnung, a set of rules followed by some orders. Instead, they may hire a driver to transport all workers to the construction site. Though some individuals may not be needed immediately, their presence avoids delays, and their tactical input can be invaluable.


While there are common elements to every enterprise imaging strategy, an effective program is fine-tuned to the needs of the organization and those who will use the system. It cannot be pre-packaged or designed in a void. Strategy development requires the presence of hospital administrators, IT personnel, and clinicians at the outset.

Prep work is completed in advance

A time-compressed video of an Amish barn-raising is an impressive display of teamwork.3 It also shows the importance of advance preparation. Roof trusses and framing sections, which can be done by just a few individuals, are built and ready before assembly crews arrive.

In structuring an enterprise imaging strategy, the essential preparation is selecting the right partner. The vendor you choose should have a proven track record of deployment on a scale similar to your organization.

The solution provider should offer expertise in the areas of:

  • Assessment of current systems
  • Process review
  • IT applications and other necessary resources
  • Redesign of workflows
  • Regulatory compliance
  • Migration of data
  • Data analytics
  • Implementation and adoption

This level of guidance allows your internal team to focus on how they want the system to perform, and on change management.

Materials are on site

Amish builders aim to show up at first light and get right to work.2 Supplies have already been delivered, and equipment is on hand.

Vendor-neutral archive" (VNA) describes the storage of images and documents with a standardized format and interface.4 It makes diagnostic viewing accessible across the enterprise. The VNA prevents your organization's information from being held hostage by restrictions of a proprietary vendor.

Meaningful use" outlines standards for the exchange of patient data through the use of electronic health records. According to TechTarget, "The general intent of meaningful use was to improve the collaboration between clinical and public healthcare, improve patient-centric preventative care and support the continued development of robust, standardized data exchanges."5

Starting in 2019, all hospitals eligible under Medicare and Medicaid Promoting Interoperability Programs (the now official name for meaningful use) are required to use current versions of these measures, and it is now part of the Merit-Based Incentive Payment System (MIPS).

If integrating a compliant VNA and meaningful use sounds complicated, that’s because it is. However, they are two cornerstones – materials for your project – that must be in place before your enterprise imaging strategy can be coordinated. The guidance of a seasoned solution provider can be instrumental.

Quality matters

You won't find pneumatic hoses and nail guns at an Amish barn raising. Trusses are secured with hammers and nails. Builders feel that, because this allows them to use longer, better quality nails, the outcome will be more substantial.2 The structure performs as it should and will not likely need to be rebuilt anytime soon.

Smoothly integrated enterprise imaging solutions have vast benefits, including:

  • Optimization of clinical operations for organizational cost efficiencies
  • Improvement in workflows and processes (which drive productivity and job satisfaction)
  • Reduced wait times for patients
  • Overall improvement in the quality of service6

However, the implementation process is intense. It is not an exercise most organizations want to repeat frequently. Plus, it represents a significant investment in time and dollars. Selecting a solution provider is critical, and an organization needs to feel good about their choice. That means a decision based solely on cost may not be advantageous in the long term.

Experience is a primary component of success

According to, at a barn raising, "An experienced Amish carpenter/contractor is in charge, and workers are assigned to various areas of work."7 Their culture has great reverence for the knowledge of elders.

Experience is also essential in constructing an enterprise management strategy. Look for a partner who will help you avoid costly pitfalls, develop a system that aligns with your organization’s goals, and empowers your workforce to ensure continuity of patient care.


  1. Understanding the Enterprise Imaging Strategy. Imaging Technology News. October 31, 2019.
  2. Amish builders do what they have to do to get the job done. Construction Magazine Network. October 31, 2019.
  3. Ohio Amish Barn Raising - May 13th, 2014 in 3 Minutes and 30 seconds. YouTube. October 31, 2019.
  4. How to Choose a Vendor Neutral Archive for Medical Imaging. Xtelligent Healthcare Media. October 31, 2019.
  5. Meaningful Use. TechTarget. October 31, 2019.
  6. Enterprise Imaging: Embracing the enterprise. Applied Radiology. October 31, 2019.
  7. Amish People and Amish Culture. October 31, 2019.