Is governance at the core of your EMI strategy?

enterprise medical imaging

At the recent Society for Imaging Informatics in Medicine (SIIM) 2018 Annual Meeting, I had the opportunity to attend a presentation on whether or not enterprise imaging should be a high-level strategy within a healthcare delivery organization (HDO). The deployment of medical imaging technology on an enterprise basis continues to be a struggle within some HDOs due to the competition for resources. A central focus of the discussion was on the importance of governance and the role it plays in generating internal support for an imaging initiative.

Much of the discussion explored the existing relationships between traditional radiology and IT departments. In some HDOs, this relationship is strained because there is a mutual lack of understanding of the needs of the other department. On more than one occasion, I heard attendees say that the IT department doesn’t understand medical imaging and couldn’t be trusted to provide the adequate support required for the enterprise imaging needs of the HDO.

Another common challenge and point of contention is that EMR deployments continue to consume a large amount of the HDO’s IT resources and have left little time for addressing the imaging needs of the enterprise.

This lack of collaboration is concerning and reinforces how important a solid governance strategy really is. Without a governance strategy that clearly outlines how traditional imaging departments should work together with IT, your enterprise imaging initiative could be compromised at the outset.

5 tips to establishing governance in enterprise imaging

Governance is the key to driving enterprise-wide transformation and change. The following are a few tips to establishing a strong governance structure for enterprise imaging:

1. Ensure your governing body is appropriately diverse

Radiology and cardiology stakeholders should be well represented in a governing body for enterprise imaging, but you also need to realize that imaging today has expanded to incorporate other image-intensive specialty departments including dermatology, ophthalmology, gastroenterology, pathology, wound care and more. Stakeholders from each of these departments should be part of your enterprise imaging governing body and you should view each of these departments as key internal customers by IT.

Furthermore, maintaining an ongoing list of the image types generated by each of these departments (as well as their current storage locations) should be a central part of your governance strategy.

2. Don’t ignore clinical workflows 

Many HDOs attempt to push enterprise imaging from the top down, citing financial or security considerations as primary drivers. While it’s important to secure executive buy-in and have C-level stakeholders present on the governing body, an enterprise imaging strategy that fails to consider departmental changes in clinical workflows will suffer slow or limited adoption.

Your governance strategy must clearly articulate how each department will approach and manage the transformative changes that will occur.

3. Think incrementally

Building an enterprise imaging infrastructure isn’t something that occurs all at once. Your governance strategy should plan for an incremental or phased implementation that potentially starts with transformation in radiology, and then moves to other imaging departments, such as gastroenterology or wound care, over a period of time. Your governance plan should shift appropriately as one department completes adoption and another embarks on implementation.

4. Give the governing body the proper authority

An enterprise imaging governing body must have ultimate authority to make decisions for the enterprise while balancing the more specific needs of individual departments. This includes managing the culture and politics of those departments.

5. Establish a clear escalation path

To avoid lengthy delays from the inevitable disagreements that are bound to arise, it’s important to have a well-documented escalation procedure to resolve issues and keep the enterprise-imaging project moving forward.

Not every decision needs to be made at the upper levels of governance, only those that carry certain weight or the clear majority of the governing body can’t agree upon.     

Get ahead of the curve

In my own experience, I was fortunate to be able to incorporate many of these fundamental governance strategies to address the issue of enterprise imaging with HDOs where I was previously employed. As a result, these organizations benefitted from early deployments of enterprise imaging components, such as a vendor neutral archive (VNA), enterprise visualization and vendor-neutral workflow.

Organizations that are able to address governance that can encompass imaging within an enterprise model are capable of supporting a much more flexible and cost-effective imaging infrastructure that is supported by IT. Ultimately, this enterprise imaging infrastructure can help HDOs prepare for value-based reimbursement and deliver the imaging information necessary to improve patient care and outcomes.

Phil Wasson

Phil Wasson

Phil Wasson, FACHE, is a healthcare industry manager and consultant at Hyland. His mission is to develop content and create alignment with healthcare organizations focusing on information management and imaging solutions so healthcare organizations can realize more efficient operations that improve patient care. Phil joined Hyland after a three-year stint at Lexmark Healthcare as a consultant, and later as a healthcare industry manager. Phil has more than 25 years leading healthcare IT functions as a CIO and holds a fellowship in Healthcare Management with the American College of Healthcare Administrators. He received his B.S. in Healthcare Management from Southern Illinois University at Carbondale, IL.

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