If you're like most people, your medical history is probably scattered across multiple healthcare facilities and locked within the walls of each hospital. As a result of these healthcare information silos and an educated patient population already accustomed to using web-based technology, relationships between patients and physicians are changing, and patients are taking a more active role in managing their medical history.
In diagnostic imaging, patients have assumed the responsibility of medical courier, transporting their imaging data from provider to provider in an increasingly complex role. This increased level of participation in the healthcare process leads many patients to want more from their “radiology experience.” According to a Wake Forest University study published last year in the Journal of the American College of Radiology, in general, patients are dissatisfied with the level of detail and amount of time it takes to get medical imaging results.
This article will explore challenges of medical image sharing, describe new technology that is empowering patients to better manage their imaging records, and discuss the benefits that this technology provides for patients, their providers, and the medical community as a whole.
CHALLENGES WITH IMAGE SHARING
A survey conducted by GfK Roper for Practice Fusion reveals that patients in the U.S. see an average of 18.7 different physicians throughout their lives. This introduces a number of challenges. For medical imaging, the challenges come in the form of image sharing.
When a patient attempts to take medical imaging data from one provider and share it with another facility outside the originating healthcare institution's walls, a huge problem presents itself. Even with significant capital investment by providers in IT systems, medical imaging data exchange between organizations is often plagued with workflow challenges, many of which place the burden on the patient. Traditional image sharing methods involving CD/DVD media are inefficient and limiting and force patients to manage their own imaging records and transport physical media from provider to provider. This workflow introduces a number of technical and physical obstacles that must be addressed, including:
• CD/DVD susceptibility to damage;
• incorrect or incomplete study information;
• data access and security concerns, no audit trail;
• lack of a self-launching image viewer and incompatible or unreadable data; and
• omission of PACS/EMR import functionality.
Relying on CD/DVDs to share imaging studies is time-consuming and may result in patients undergoing unnecessary, duplicative scans when data cannot be retrieved. This not only exposes the patient to possible unnecessary radiation, but also contributes to billions of dollars wasted on imaging services.
A BETTER WAY
More efficient methods of sharing and accessing patient imaging data across the boundaries of diverse healthcare facilities are becoming more prevalent in the marketplace. To overcome physical media limitations, healthcare organizations are turning to medical imaging e-sharing solutions. Image e-sharing technology makes it possible to securely collect, view, and share diagnostic cases among hospitals, physicians, and patients without the need for physical media.
Most e-sharing solutions offer technology that is designed to address specific needs ranging from the management of incoming CD/DVDs to sharing diagnostic imaging data and reports with external providers and patients. This technology can be installed onsite, hosted remotely in a cloud-based platform, or a combination of both.
In their most basic form, e-sharing solutions act as reliable tools to view, store, and share the contents of incoming patient CD/DVDs. Many of these solutions further expand their usability by allowing communication across provider institutions. These solutions also let users share data with outside referring physicians and patients, independent of their location. Some applications even allow physicians to nominate outside exams for import into their PACS, a significant advantage over physical media sharing.
Beyond the basics, e-sharing solutions can provide benefits for specific groups. For example, e-sharing technology can allow a trauma center to assign permanent and temporary privileges, set up incoming data notification alerts, allow non-DICOM data uploads, and locally share information. These types of solutions ensure that prior exams are accessible and give the trauma center the ability to review exams in the cloud and make early decisions on transfer requests.
BENEFITS FOR THE PATIENT
The benefits of e-sharing are far-reaching. Providers gain from being able to import and view outside imaging data in a consistent format while patients benefit from taking ownership and managing their own medical history. Patient image e-sharing:
• Gives patients a place to upload and store all of their diagnostic images and reports, independent of originating hospital or imaging center;
• Improves accessibility by allowing patients to access their data from anywhere there is an Internet connection;
• Provides a safe and secure platform for sharing medical imaging studies, eliminating loss of material and unauthorized data access;
• Frees patients from the burden of transporting physical media;
• Allows patients to electronically share images and reports with physicians prior to appointments and for second opinions; and
• Reduces duplicative testing and unnecessary exposure to radiation.
ONE HOSPITAL'S EXPERIENCE
In mid-2009, the Massachusetts Gener-al Hospital medical imaging team identified e-sharing as an important technology to help our organization achieve care coordination goals. We began our search for an e-sharing platform with very specific goals, including the elimination of CD/DVDs, in-stitution of enterprise and cross-provider sharing, and provision of online access to imaging data for patients. We evaluated the available solutions and chose the lifeIMAGE (Newton, MA) platform.
We chose to implement this solution in phases. First, we deployed the lifeIMAGE Local Appliance (lila), which was installed locally to allow authorized users on our network to share medical imaging throughout the enterprise. This initial phase has equipped our hundreds of physicians' offices with the ability to upload and view the nearly 8000 incoming CD/DVDs they receive each month. In addition, this technology allows our physicians to tag and index studies and nominate outside exams for import into our RIS/PACS, something new for us.
The next phase focuses on incorporating the patient aspect of image sharing. Like most facilities, our current process involves burning a patient's medical images and report to a CD/DVD. We will soon be able to offer our patients their own universal inboxes through this cloud-based e-sharing platform. In their private inbox, patients will be able to collect their images and reports in one place and share them with healthcare providers by inviting them in and assigning access privileges.
With the proliferation of medical data aggregators, we recognize that e-sharing extends beyond medical imaging. One reason we selected the solution we did was for its open architecture and support of standards such as XDS-I. Implementing a standards-based solution allows our organization to integrate e-sharing with our EMR as well as third-party personal health records (PHRs).
When evaluating e-sharing platforms for your organization, you will have many factors to consider, including security, access control, HIPAA compliance, identity management, backup options, and EMR/PHR integrations. Taking into account these critical factors and their associated benefits will lead to a more successful implementation and deployment of a system that sufficiently addresses your unique organizational needs.
TYING IT ALL TOGETHER
Technological advancements will continue to fuel growth of the patients role in medicine. For medical imaging, there are clear benefits to sharing images with patients over the web. Above all, it empowers patient's to better manage the diagnostic imaging aspect of their medical history. It also overcomes security and privacy concerns and collection, viewing, and sharing limitations associated with physical media.
Basic IT infrastructures that ease e-sharing are already in place, while cloud-based computing fuels expansion of the technology. This growing adoption is supporting the shift in patient/physician relationships by unlocking patient data and providing medical imaging management tools. Improving access to existing medical imaging data, for both patient and physician, will lead to faster diagnosis and treatment. This powerful alternative to physical media offers a distinct competitive advantage while ultimately allowing patients to have a heightened radiology experience.
