Post on 07-May-2015
description
VNA/XDS and their influence on
clinical workflow
Dr. Mohammed Hussein
Healthcare Imaging & UCA Lead - UK
Infrastructure & Cloud Computing - Dell Services
Dell Healthcare & Life Sciences
• 13,000+ healthcare & life sciences professionals
• We support over 10,000 Healthcare providers, health plans, pharmaceutical, biotech, medical device, diagnostic and scientific instrumentation customers worldwide
• Leading Healthcare Information Technology Services provider1
• Dell Healthcare & Life Sciences is with $2.6 billion (FY11) the second largest Healthcare IT company2
• We provide OEM services to 70+ Healthcare and Life Sciences software, medical device and scientific instrument providers
• Our Clinical Archive Cloud manages more than 70 million clinical studies and 4.8 billion diagnostic imaging objects on behalf of more than 800 clinical sites in North America3
1) Source Gartner 2011 [url] 2) Source Healthcare Informatics 2011 [url] 3) See real-time ticker
Services
Transformation of Medicine
Episode
based
Translational
Medicine
Healthcare
Information
Exchange
Systems Efficiency
Non-specific Episode by Episode
Better Organized to Reduce Duplicate Effort
Patient Centric Disease Prevention
Decision Support Systems
Information Correlation
Diagnosis
Services
Clinical and Operational Challenges -Fragmentation
Services
What is the Issue? Currently healthcare IT deals with numerous silos of data found in a number of specialised ‘ology’ silos with
different storage tiers and modalities as well as different care delivery sites, formats and systems (Images,
PDF, Word documents, Excel sheets, etc…)
This results in a multitude of data formats often only accessible through the specific vendor who created it
within the site it was acquired/created at.
These silos require the clinician to go to multiple sources to gather a holistic view of the patient condition.
PAS/EPR
Image / Clinical Documents Silos Systems
Locations
PACS
Labs
Hospital 1 Hospital 2 GP ??
??
Services
Current Sharing Flow (Imaging/Clinical Docs)
CTCR
US
Diagnostic Workstation
PACS
Site A
CTCR
US
Diagnostic Workstation
PACS
Site C
CTCR
US
Diagnostic Workstation
PACS
Site B
Images shared via CDs
With its limitations and issues
Services
Sharing Flow
CTCR
US
Diagnostic Workstation
PACS
Site A
CTCR
US
Diagnostic Workstation
PACS
Site C
CTCR
US
Diagnostic Workstation
PACS
Site B
Viewing WorkstationWeb Viewer
Images shared via Web access
with its limitations and issues
Services
Data Locked in Departmental Silos
Radiology Oncology Cardiology Women’s health Pathology
• Clinical Information Silos
• Expensive and redundant procedures are performed
• Diagnostic collaboration among departments is
inefficient
• EMR systems are incomplete and lack certain critical
patient information
• Painful vendor application migrations
• Expensive and risky data migrations
– Lengthy scope of work negotiations
– Months to prepare, inspect, and migrate
data
• True…for every application silo in
your environment
Services
Unified Clinical
Archive
-Consolidation -Standardisation
Services
Dell Unified Clinical Archive Helping Healthcare providers efficiently store, manage and share medical image data
Radiology Oncology Cardiology Women’s
health Pathology
Medical
Record
Unified Clinical Archive
Dell On-Premise Clinical Archive Object based storage platform
Dell Cloud Clinical Archive Managed Enterprise Archive
Dell Clinical Data Management Data Consolidation and Information Life cycle Management
Dell Clinical Collaboration Portal Cross Enterprise Data Access and Distribution
Unified Clinical Archive
•D
ell
Serv
ices
•D
ell
Security
Services
UCA – Portfolio At a Glance
Unified Clinical Archive Portfolio
Data Virtualization and VNA Software layer
On-Premises Archiving Hardware
- Compellent
- DX6000 Series
- Equalogic
- PowerVault
- Servers & Infrastructure
Cloud based Managed Archival Service - Dell Cloud Clinical Archive
- Dell Cloud Clinical Recovery
Tools for Data Sharing and exchange - Apollo
- Calgary Scientific
- Dell Cloud Clinical WebAccess
- MEDecision
- Aperio*
SERVICES (Migration, Assessment, Deployment, Support)
SECURITY (Encryption, Access Control, Audit Logs, Role based access)
Dell Clinical
Data Management Dell On-Premise
Clinical Archive
Dell Cloud Clinical
Archive Dell Clinical
Collaboration Portal
* Solution available later in 2012
Healthcare and Life Sciences
BridgeHead /Dell Solution
Manage and control clinical and non-
clinical documents, records and
images in a searchable, centralized
repository
• DICOM Storage Class Server
• HL7 interface
• Microsoft® Exchange Storage
Management, Compliance
Journaling and PST Migration
• File System Archiving from
Windows® and Linux
• Direct integration with Microsoft®
SharePoint® Server
• Mixed content and meta-data
index
• Full search and Web portal
access
Services
inFrame differentiators Unrivaled medical imaging distribution/visualization
InDex provides a turnkey infrastructure that is image-enabled empowering the sharing of patient centric information
UCA Clinical Collaboration: Dell Cloud Clinical WebAccess
• Integrated Web-based portal
for viewing medical images
• True Zero-Footprint
• Multi-browser support
• Access to DICOM and HL7
updates
• User/group management
controls
• Accesses documents across
multiple institutions (XDSi)
• Enables image sharing with
referring physicians
Services
Dell UCA Benefits • Infrastructure Simplification
• Application Neutral Enterprise Archive – accessible information and easier sharing.
• Clinical Workflow and Automation overcoming silos and locked up clinical information
• Disaster Recovery and Data Protection
• No more Data Migration
• Easier Data Sharing and Information Exchange
• Business Continuance and Physician Access
• New Capital / Operational acquisition models
Tier 1 Tier 1
Clinical On
Premise Archive Clinical Cloud
Archive
Clinical
Collaboration
Portal
Healthcare and Life Sciences
Dell’s UCA - Market Leadership Leading provider of digital medical image archiving
• Providing digital medical archiving services for 11+ years
• 800 clinical sites generating 60 TB monthly
• Managing over 4.7 billion images and 70 million+ studies and growing daily
• Largest number of concurrent systems integrated into secure cloud based archive delivery model
• Over 28+ PACS and hundreds of modalities, DICOM versions and associated non-imaging data sources
• ISO 13485:2003 certification on quality systems within Dell Data Centers
Multiple configurations and deployment models
• Licensed software with capital / operational business models
• Includes long term storage, disaster recover, and business continuance
• Provides SLAs on access to your data and full support for automated IHE integrated workflow
Tight integration with a large Eco-System of partners, to meet diverse customer
needs
– Mobility and Ease of Access
– Collaboration and Exchange
- Vendor Neutral Archive
- PACS and Workflow management
Services
Cross Enterprise
Document Sharing
(XDS/XDS-I)
-Sharing -Flexibility
17 Confidential Services
IHE (Integrating the Healthcare Enterprise)
• Anatomic Pathology
• Cardiology
• Eye Care
• IT Infrastructure
• Laboratory
• Patient Care Coordination
• Patient Care Devices
• Radiation Oncology
• Radiology
• Consistent Time (CT)
• Audit Trail and Node Authentication (ATNA)
• Request for Information Display (RID)
• Enterprise User Authentication (EUA)
• Patient Identifier Cross Referencing (PIX)
• Patient Synchronized Application (PSA)
• Patient Demographic Query (PDQ)
• Cross Enterprise Document Sharing (XDS)
• Cross Enterprise Document Sharing for Imaging (XDS-I)
• Personnel White Pages (PWP)
• Cross Enterprise Document media Interchange (XDM)
• Cross Enterprise Document reliable Interchange (XDR)
• Cross enterprise sharing of scanned document (XDS-SD)
• Retrieve Form for data capture (RFD)
Domain Profiles
Services
Cross Enterprise Document Sharing (XDS)
Cross-enterprise Document Sharing for Imaging (XDS-I)
Registers and shares electronic health record documents between healthcare enterprises,
ranging from physician/GP offices to clinics to acute care in-patient facilities.
While XDS-I extends XDS to share images, diagnostic reports and related information
across sites.
Ref:
IH
E_IT
I_T
F_R
ev7-0
_V
ol1
_F
T_2010-0
8-1
0.p
df
Services
Enhanced Workflow (Imaging/Clinical Docs)
CTCR
US
Diagnostic Workstation
PACS
Site A
CTCR
US
Diagnostic Workstation
PACS
Site C
CTCR
US
Diagnostic Workstation
PACS
Site B
Repository
Registry
Manifest sent
Manifest sent
Manifest sent
Services
Enhanced Workflow (Imaging/Clinical Docs)
CTCR
US
Diagnostic Workstation
PACS
Site A
CTCR
US
Diagnostic Workstation
PACS
Site C
CTCR
US
Diagnostic Workstation
PACS
Site B
Repository
Registry
Query
Services
Enhanced Workflow (Imaging/Clinical Docs)
CTCR
US
Diagnostic Workstation
PACS
Site A
CTCR
US
Diagnostic Workstation
PACS
Site C
CTCR
US
Diagnostic Workstation
PACS
Site B
Repository
Registry
Manifest Retrieved
with Image location
Services
Enhanced Workflow (Imaging/Clinical Docs)
CTCR
US
Diagnostic Workstation
PACS
Site A
CTCR
US
Diagnostic Workstation
PACS
Site C
CTCR
US
Diagnostic Workstation
PACS
Site B
Image retrieved
Services
Solution • Consolidation of the different silos using a UCA (Unified Clinical Archive) with a web
based viewer.
• Allowing interoperability and seamless sharing using XDS/XDS-I, this facilitates bottom
up approach to building a national patient data sharing infrastructure especially with the
development of ITK and CUI within the NHS.
Outcome • Better clinical workflow and more time spent with patients
• Sharing of information more quickly and effectively across clinicians and enterprise,
especially in emergencies
• The safety, quality, and efficiency of care for the patient is immediately improved
• Reduce cost of care – reduce procedures, cross utilise resources, informed decision
across boundaries
• Improve quality of care, reduce errors/duplication, improve clinical decisions and better
patient satisfaction
• Critical patient information is safe and protected; clinical record is complete and
longitudinal
New standard of future patient care – truly effective, affordable healthcare
Thank you Dr. Mohammed Hussein International Healthcare - Dell Services mohammed_hussein@dell.com