What’s preventing true medical image interoperability?


Throughout our lives, most patients in the U.S. will receive care from more than one health system. To ensure a patient’s medical history travels with them means this information must be exchanged freely with other providers.

Sharing health information has proved problematic regardless of data type, but medical images pose some unique challenges due to their size and complexity. That being said, the benefits of exchanging medical images can be truly transformative.

This subject was the focus of an educational session Monday, December 2, at the 105th Scientific Assembly and Annual Meeting of The Radiological Society of North America, or more commonly known as RSNA 2019. The session, titled Interoperability: Imaging and Beyond, was led by David S. Mendelson, MD, vice chair of Radiology IT at Mount Sinai Health and co-chair of Integrating the Healthcare Enterprise (IHE) International and Didi Davis, vice president for Conformance and Interoperability for The Sequoia Project.

The technology exists today to exchange medical images. The difficult part is getting folks to agree with one another as to how these images should be exchanged.

– Dr. David Mendelson

Clinical benefits, financial scrutiny drives image sharing

There are several factors driving demand for medical image exchange, according to Mendelson. For example, there is a clear diagnostic benefit when a radiologist has all historical exams at his or her fingertips to compare with an existing study during an interpretation. Furthermore, the rapidly rising costs of healthcare in the U.S. are under scrutiny, and a great deal of focus has been placed on the unnecessary costs surrounding inappropriate utilization of imaging or duplicate imaging tests.

Healthcare organizations can address both of these areas with streamlined electronic medical image exchange. So, what’s standing in the way?

According to Mendelson, it’s not a technology issue.

“Technology is the easy part,” he said. “The technology exists today to exchange medical images. The difficult part is getting folks to agree with one another as to how these images should be exchanged.”

The true barriers to exchanging medical images are consent (opt-in versus opt-out), a reluctance on the part of health systems or IT vendors to share imaging data, disagreements regarding standards and issues about how to determine who pays for the infrastructure.

Imaging standards ubiquitous, but inconsistent

Standards are the building blocks of establishing true medical image interoperability, and Mendelson argues that the radiology community has been more progressive in this regard than other fields in healthcare. Numerous imaging standards exist including DICOM, RADLEX, SNOWMED-CT and WIA just to name a few.

However, harmonizing and implementing these standards in a universally accepted manner has been elusive.

This obstacle directly led to the development of initiatives such as IHE International and the RSNA Image Share. IHE provides a common framework for implementing multiple standards using several, carefully defined interoperability profiles. Members of IHE work to address interoperability issues that impact clinical care through thorough, standards-based product testing.

Similarly, RSNA Image Share Validation is a conformity assessment program that tests the compliance of vendor systems using quality standards determined most effective for accurate and efficient exchange of medical images.

Validated VNA and enterprise viewing tools

To help, Hyland Healthcare offers several solutions – including our vendor neutral archive solution as well as our enterprise and diagnostic viewer – that are specifically geared toward facilitating the exchange of medical images both inside the healthcare facility and with external-care stakeholders. These technologies help enable not only referential image viewing of various file formats, but a true digital exchange of diagnostic DICOM imaging studies.

Moreover, Hyland Healthcare has been committed to helping the healthcare industry knock down the cultural barriers to image sharing that currently exist. We’ve also successfully tested our products at IHE Connectathons and our Acuo VNA received RSNA Image Share Validation.

If you’re attending RSNA 2019, I invite you to check out these and other innovative enterprise imaging solutions at booth 4300 in the South Hall of McCormick Place Convention Center.

Ken Congdon

Ken Congdon

Ken Congdon is the team lead of solution marketing at Hyland. His mission is to develop engaging content that educates healthcare providers and payers about potential solutions to their most... read more about: Ken Congdon

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