Healthcare providers who are researching and implementing new digital tools and electronic health records (EHRs) realize that infrastructure costs can increase quickly, especially for large file sets like medical imagery.
Some organizations may find that cloud and colocation may not be cost effective as they still have in-house infrastructure; others may be looking for a disaster recovery solution or new systems or software that must work together with the current Picture Archive and Communication System (PACS) or EHR environment.
By combining existing patient record systems with Vendor Neutral Archiving (VNA) and Enterprise Content Management (ECM) tools hosted with a compliant cloud vendor, providers can enable a central repository of patient information in an economical and powerful manner.
Vendor Neutral Archiving systems work in concert with PACS to serve medical images, like those produced by radiology departments, to other systems without the use of proprietary formats. They can serve from onsite or offsite to multiple different PACS and also allow direct viewing of images.
All VNAs must archive in a standard format with a standard interface in order to be used by any system and remain non-proprietary. DICOM format is the standard and also a prerequisite to be considered a VNA. Some administrative information may be included as well as non-DICOM content, but this varies from vendor to vendor.
When hosted by a worthy provider, they offer high availability and disaster recovery options. Healthcare providers can place the entire PACS and VNA system in the cloud, but the HIPAA Security Rule does require a method of image recovery, so disaster recovery is an ideal use of the cloud for VNA. This is an easy way to cut down on hardware procurement as storage can quickly become expensive and redundant as files are deleted or moved around.
VNA can be set up to store structured or unstructured data (structured is placed in a database, a la an Excel spreadsheet, while unstructured is not as easily scanned or sorted). Structured data is usually much smaller while unstructured is rich media like images and video—AKA the content category that most medical imagery will fall into.
As a data archive, VNAs can be used for live, regularly accessed information or else stored for later reference. In either case, the cloud provider should use strong encryption in transit and at rest.
ECM, or Enterprise Content Management, is another method of storing and organizing the vast amounts of content generated from healthcare procedures and patient records. ECM can enable a single location for EHRs and any other relevant documents or unstructured data, including lab results, radiology reports, notes, EKG measurements, patient consent forms, and insurance information.
Simply because of convenience or different processes in different departments, many hospitals and providers end up with several ECM systems running concurrently. Organizations should strive to deploy a single ECM system for everyone.
Information can be entered into the ECM from a variety of sources and then referenced by the EHR system. Once again, these systems can be ungainly for local networks, servers, and storage systems, making a HIPAA compliant data center an attractive option for running an ECM.
ECM overlaps with some definitions of VNA, specifically those that allow VNAs to include non-DICOM images, as ECM systems often contain scanned images like forms, charts, and handwritten notes. ECM can include additional automation and information controls.
Because cloud and colocation providers specialize in highly available, redundant infrastructure, placing these critical systems in the hands of one that is HIPAA compliant can ensure your health organization always has access to critical patient information.
Existing systems can be used for less vital functions like e-mail, phone systems, security monitoring, etc. If staying in-house, you can extend the VNA, ECM, and EHR systems you have already deployed to a cloud environment for disaster recovery or when you need additional resources, especially storage.