VistA Imaging Usage and Growth FY04 – FY12
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VistA Imaging Usage and Growth FY04 – FY12 February 2012 – Part 1
Transcript of VistA Imaging Usage and Growth FY04 – FY12
VistA Imaging Usage and Growth
FY04 – FY12
February 2012 – Part 1
ContentsVistA Imaging Overview– General Usage Graphs
– VistA Imaging Summary Facts
VistARad– VistARad Usage Graphs
Clinical Display and Capture– Clinical Display/Capture Usage Graphs
TeleReader– TeleReader Usage Graphs
VistA Imaging Overview
In the early 1980’s, the Department of Veterans Affairs (VA) developed an automated information system for use in its medical facilities. This system is now known as the Veterans Health Information Systems and Technology Architecture (VistA).
VistA is a large suite of applications that includes clinical, fiscal, quality management and administrative software.
VistA is implemented in all facilities in the VA medical system.
– The VA medical system is organized into 21 geographic networks known as VISNs (Veterans Integrated Service Networks).
– Each VISN contains two or more VAHCSs (VA Health Care Systems) as well as outpatient clinics.
VistA Imaging Overview
VistA Imaging (VI) is part of VistA. The VistA Imaging System captures clinical images, scanned documents, motion video, and other non-textual data files and makes them part of the patient's electronic health record.
VistA Imaging facilitates medical decision-making by delivering the multimedia component of the patient record to the clinician’s desktop in an integrated, timely and accurate manner.
VistA Imaging’s architecture lets clinicians access images and text data at all times anywhere in the hospital.
VistA Imaging’s Remote Image Views component enables image sharing between VA hospitals and facilities. A patient’s images can be accessed by VA caregivers from any place in the VA enterprise.
VistA Imaging Overview
VistA Imaging handles high quality image data from many specialties, including cardiology, pulmonary and gastrointestinal medicine, pathology, radiology, surgery, dermatology, ophthalmology, hematology, radiotherapy, nuclear medicine, and others.
VistA Imaging can also process textual reports from the hospital information system, scanned documents and electrocardiograms.
VistA Imaging provides a framework for image file storage, management, and retrieval from magnetic and optical disk servers and supports data capture, storage, and retrieval over local and wide area networks.
VistA Imaging Overview
VistA Imaging facilitates interoperability between VistA and commercial PACS systems using HL7 (Health Level Seven) and DICOM (Digital Imaging and Communication in Medicine) standards and the IHE (Integrating the Healthcare Enterprise) technical framework.
VistA Imaging operates using a set of standard index terms to facilitate grouping, sorting, filtering and retrieval of images (e.g. specialty, event, procedure, document type).
VistA Imaging Timeline1988 - 2012
2011 – 2012Storing All DICOM Objects in DICOM
Q/R Enhancements - Multiple Modality Service - IAN Capture & Display Update - ROI - Importer II
LSRP - Annotations - TelePathology VA/DoD Sharing of Images & Artifacts
Improved IHS support - Updating AWIV
1993 - 1995 1st VI PACS Interface, DICOM Development 1990 VI Operational at Washington DC
2007 TeleReader & IHS Using VI
1988-90 VistA Imaging (VI) Prototype for VA
2003 Index Terms 2005 Remote Image Views – Clinical Display
1996 - 1997 VI GUI , VI 2.0 with VistARad
2006 VistARad Redesign
2001 VI 2.5, FDA Clearance
2010 VA/DoD Importer. Teledermatology. Remote Image Views – VistARad
1998 – 1999 CPRS GUI - Gigabit Ethernet , VRad - TeleRadiology
2002 VI 3.0 Mandate, Document Scanning
VistA Imaging
General VistA Imaging Facts
VistA Imaging FactsFY12
Images captured & available online: 2,293 billion.New Images expected to be captured in FY12: 449 million.New Images captured so far in FY12: 187 million.Images captured this month: 44 million.Unique Patients served every month: 1.45 million.Used online RAID storage: 2,036 terabytes.Total online RAID storage: 3.5 petabytes (free and used storage).
VistA Imaging FactsFY12
VistARadOver 48.7 million studies viewed.Studies viewed per month: 420,000- 506,000.Studies interpreted per month: 120,000–153,000.More than 100,000-150,000 patients have their studies interpreted using VistARad each month.Studies viewed remotely per month: 40,000-57,000.
VistA Imaging FactsFY12
Clinical Capture and Display1 – 1.6 million images captured every monthBy Feb 2012, 82 million images captured9 – 15 million images viewed monthlyMore than 1.1 million scanned documents captured every month
TeleReader (Diabetic Retinopathy Screening)680,530 studies completed (more than 5.9 million images)In Feb 2012: 17,996 studies were completed
VistA Imaging FactsContingency Tool
VistA Imaging can serve as a backup/ contingency system at no extra cost to the VA.
5.4 million images were recovered after Hurricane Katrina, New Orleans, 2006 (99.996% recovery)Images could be remotely viewed from any VA site 13.08 million images were recovered in Tennessee, after a computer room flood in 2008
Sites that choose not to store their images in VistA Imaging do not have this capability
VistA Imaging
General VistA Imaging Usage
VistA Imaging Sites Reporting Data
Number of VistA Imaging site that reported data for each month.
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VI New Images (Captured & Stored) FY04-FY12
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New Images Captured using DICOM GatewayFY04-FY12
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New Images Viewed by Clinical DisplayFY04-FY12
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New Images Captured by Clinical CaptureFY04-FY12
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VistARad Viewed StudiesFY04-FY12
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VistARad Interpreted StudiesFY04-FY012
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Cumulative Images Captured FY04-FY12Images Captured per Month FY04-FY12Images Captured per Month FY04-FY12 (cumulative)New DICOM Captures by VISN for current monthAverage Monthly New Images per SiteUnique Patients Served per Month FY04-FY12New Clinical Captures by VISN for current monthVistARad Views by VISN for current month
VistA Imaging Usage
VistA ImagingCumulative Images Captured – FY04 – FY12
As of Jan, 2012: 2,293 million images have been captured, stored and available online using VistA Imaging Software.
FY08 – 255 million new images.FY09 – 334 million new Images.FY10 – 392 million new Images.FY11 – 437 million new Images.FY12 – 449 million new images expected
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VistA ImagingImages Captured per Month FY04 – FY12
Images captured every month in FY04: about 5 million.Images captured every month in FY12: more than 29 million.
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VistA ImagingImages Captured per Month FY04-FY12
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VistA ImagingNew DICOM Captures by VISN – Feb 2012
VISNs 8 and 6 captured the most DICOM images this month.VISNs 3, 11, and 21 capture the fewest DICOM images.DICOM captures are mostly (about 90%) radiology images, and are processed by VistA Imaging DICOM Gateways.
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VistA ImagingAverage Monthly New Images per Site FY04-FY12
The values in this graph are calculated by averaging the number of images across the VA sites that provide monthly imaging statistics.Average new captured images per site in FY2003: about 50,000 images per month.Average new captured images per site in FY2012: about 300,000 images per month.
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VistA ImagingUnique Patients Served per Month FY04-FY12
The patients served include the total number of individual patients that had images displayed or capturedUnique patients served in Oct 2003: about 210,000.Unique patients served in Feb 2012: 1,450,212.
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VistA ImagingNew Clinical Captures by VISN – Feb 2012
Clinical captures are images from devices such digital cameras, document scanners, endoscopes, ultrasound scanners, video cameras (including those connected to microscopes or ophthalmoscopes) and x-ray film digitizers.
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VistA ImagingVistARad Views by VISN – Feb 2012
This graph shows the total number of studies viewed using VistARad by VISN.
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VIX OverviewThe VistA Imaging Exchange (VIX) service is responsible for managing inter-site and interagency requests for images. The VIX runs on VistA Imaging’s image storage cluster as a high availability windows service.
– Used by VistA Imaging Clinical Display and VistARad to request images from remote VA sites and from the DOD using the Bidirectional Health Information Exchange (BHIE) framework.
– Used by the BHIE framework to request radiology images from VA sites on behalf of DoD clinicians.
The VIX optimizes the exchange of images by compressing images before transmission and caching images to satisfy subsequent requests. Image conversion is performed as needed.
Based on the VistA Imaging Services Architecture (VISA) , the VIX implements an extensible standards based solution for data sharing.
VIX Deployment Map
= VIX Deployed
AcknowledgementsThis report reflects efforts of all members of
VistA Imaging team.Data for this report is derived from
MagEnterprise software, developed by Richard Price.
Please address any questions or comments to:
Dan Carozza: [email protected]
