If you think about it, an electronic health record (EHR) is to physicians like what the internet is to netizens.
Both the internet and EHRs hold terabytes of information. Sometimes it takes time bouncing around websites or applications to find the information we need. Needless to say, we’d work much more efficiently if it didn’t.
And this is where health information management has historically fallen behind. While the internet (in theory) gave us the power to access what we want, when we want, instantly, cross-enterprise EHRs were slow to navigate. Yet, the need for instant information isn’t any less urgent in clinical environments where patient needs are at stake. That’s where vendor neutral archives (VNAs) entered the picture—and where they still hold growing potential.
These days, VNAs are overtaking PACS as the standard picture archiving and communication system for radiology, and the healthcare enterprise, enabling better storage and faster sharing of patient data. But what if it could provide even faster access—in part by improving the quality of the data we store?
Before we explain where VNAs are going, let’s take a quick look back at where they started.
How do vendor neutral archives work?
When each care area of a healthcare organization (HCO) stores its own clinical content, things can get click-heavy, obscured, and siloed pretty quickly. Traditionally, if a physician wanted to see their patient’s clinical images, they would go to a separate PACS system, sign in, search, pull up the images, go back to their EHR, and toggle between the two. If you had three different PACS for three different departments? Multiply those steps by three, then imagine having to assemble the complete puzzle of images in your head.
The result was fragmented, sometimes missing or incomplete, patient data and a lot of lost productivity. Not to mention the fact that PACS only supports images in DICOM format. To address these shortfalls and improve data sharing and interoperability, HCOs turned to vendor neutral archives.
With a VNA, you can pull up a patient’s images right from within your workflow application, no matter the source or format. It standardizes and centralizes diagnostic imaging from multiple vendors—no bouncing around, no training on individual PACS—to much more productive effect. UPMC, the top hospital in Pittsburgh, PA, estimated in a recent study that their VNA saved clinicians one to two minutes per instance, adding up to an hour per day better spent on care.1
Little wonder the VNA has fast become a foundation for enterprise imaging. By consolidating all imaging content and data from across the care delivery network into a single ecosystem, it helps drive improved diagnostic confidence, patient satisfaction, and efficient, collaborative care.
But is that the end of the story?
Like every data-driven technology, there is a caveat to vendor neutral archives: you get out of them what you put into them.
Case in point: encounter-based care
VNAs need to work no matter the workflow or situation. How? It’s all in the data.
This is why it works so well in radiology, for example. Radiology operates on order-based workflows, meaning when an order is placed, an accession number is provided to link the report to the images. The radiology workflow is structured, and the data quality is high, so it’s easy to get what you need from the VNA.
But what about in not-so-precise or emergency scenarios like encounter-based care?
In stressful, high-speed cases like these, there’s often no order, let alone an accession number. There might be no time to record studies in the system. If it’s not in the system, it won’t be stored in the VNA. And if it’s not in the VNA, it can’t be found down the care pathway. Lost information isn’t just a risk to HIPAA compliance—it’s bad news for patients.
So there’s the dilemma: The VNA is there to help streamline things, but if we don’t have time for record-keeping, there will be nothing to streamline in the first place. We can’t take advantage of it to improve patient care as it’s designed to.
And while we shouldn’t have to take time away from patients for record-keeping, good record-keeping is key to helping caregivers do what they do best.
How are we solving the VNA challenge?
The good news is, there are ways hospitals can improve data transfer to solve this catch-22. For example, what if we:
1. Use mobile? When clinicians can use a mobile app to take clinical photos or videos, they can more quickly document and connect all the metadata of a patient’s condition on the go, even in emergency situations.
2. Use VNA to evaluate current radiology workflows? It could make them more efficient, prioritizing quality data.
These two emerging enterprise imaging solutions are already in production at UPMC and other top hospitals . As a result, they get more complete patient records and higher-quality data to interface with the EHR. There’s even scope for modern VNAs to provide analytical insights into operational, financial, and clinical processes taking place across the enterprise, to help improve organizational outcomes holistically.
The bottom line: we think of vendor neutral archives as enablers of access to imaging data, but it’s not that simple. VNAs can only do their job when you have time to put into them and quality to get out of them. This is something to think about if you’re considering one for your enterprise.
Of course, there are a few other important considerations involved. You can learn more about them in the new resources we put together on the latest VNA developments, which go into more detail on how modern VNAs are enhancing EHR, improving data quality, and driving actionable insights. Or, experience Virtual HIMSS20 On Demand Now!