Authored By John Hansen, Director of Product Management, Synapse VNA

The mobile workforce has arrived in healthcare. Smartphones and tablets have become ubiquitous in the workplace and are increasingly being used at the point of care. Meanwhile, healthcare organizations are increasingly investing in vendor neutral archive (VNA) technology to embark on their enterprise imaging journey and have recognized mobile solutions for point-of-care imaging is an essential aspect of their strategy. 

These enterprise imaging strategies must account for  mobile solutions capturing images at the point-of-care. Thinking about the convergence of mobile and enterprise imaging, here are three areas of importance, and what to look for in a well-designed solution to capture images at the point-of-care.

1. Improve Productivity. Health care professionals are some of the most patient and compassionate people on earth, but not when it comes to dealing with poorly designed software applications that slow them down, add steps and are frustrating to use.

Software solutions intended for use by health care professionals must be intuitive,  elegantly simple to use, require minimal training and enhance productivity. The software should be harmonized to the workflow at the point-of-care, rather than requiring the care provider to conform to a poorly designed workflow built into the applications.

Speed to the ‘capture flow’ with the fewest clicks and steps possible are essential. The time between when a care provider decides to capture point-of-care images to the time when they are capturing images should be as instantaneous as possible. For example, this may start  with facial recognition or touch ID for authentication. Manual entry of username & password is a productivity killer at the point-of-care.

Manual patient lookup is another productivity killer. An intelligent, department-specific, easily navigable patient list is preferred. The patient list should be encounters-based and not require orders to be placed ahead of time. Alternatively, a barcode scan is also preferred over manual patient lookups.

Once in the capture flow, applications need to enable the user to do everything quickly and seamlessly in a single experience to improve productivity. For example, a form should be provided to capture supporting documentation such as body site, clinical notes and observations at the point-of-care. We shouldn’t force the care provider to capture images in one place and document those images in another.

2. Improve Care. The ultimate objective of any point-of-care solution should be to improve patient care. If implemented properly, mobile solutions to capture patient photos, videos and audio clips at the point-of-care can positively impact care. 

Care providers require access to imaging from across the enterprise to see the full patient picture so they can make better informed decisions on behalf of their patients. This includes images taken at the point-of-care. For maximum benefit, this content must be available in the context of the patient record in the EHR, be easily accessible to the care team, and include body site labeling for those close up photos where it may be difficult to discern the body site and laterality.

3. Risk Reduction. Simply enter ‘HIPAA data breach’ into your favorite search engine and you’ll get the idea. HIPAA data breaches (and corresponding lawsuits and fines) can be costly to healthcare providers and tarnish their reputation in their markets.

Increased security and risk reduction are a major aspect of the overall VNA value proposition and securing the mobile workforce is a win-win for the organization.

In absence of a secure mobile application, care providers may be tempted to use the native features of their own device resulting in PHI on their device which exposes the organization to risk. A well designed mobile capture solution should ensure no PHI is stored on the mobile device thereby eliminating the risk of PHI leaving the premises inadvertently. 

Healthcare organizations have seen for some time the introduction of mobile image capture during patient procedures. What has been missing are the workflows and solutions to support these images being accounted for in the patient record. With a valued partner and an overall enterprise imaging strategy, the VNA can provide seamless solutions to the end user to capture, store and manage these images, all in a secure location- which in the end are accessible throughout your organization in the EHR. 

By Sara Osberger, Senior Director of Marketing, Fujifilm Medical Systems, U.S.A., Inc.

Radiology and cardiology departments have dominated the enterprise imaging arena for more than 40 years. About one billion radiological imaging exams are performed worldwide every year, making radiology the clear leader in medical imaging volume. Add to that the global surge in echocardiography, cardiac MR, cardiac CT, and cardiac catheterization studies and there you have the lion’s share of all enterprise imaging.

So when it comes to a vendor-neutral archive (VNA), can healthcare professionals use a VNA to collect, store, manage, and share imaging data outside of these two service lines? What about imaging from specialty departments, such as ophthalmology, wound care, or dermatology? Can a VNA manage those images as well?

In order to bring the complete patient picture to the healthcare enterprise, a true VNA can and should be used outside of radiology and cardiology departments. Keep reading to learn more about the many ways your enterprise can benefit from expanding the use of its VNA.

Strengthen Radiology and Cardiology Departments

Although VNAs have applications beyond radiology and cardiology, the bulk of their imaging storage comes from these two service lines. In both radiology and cardiology, the digital imaging and communications in medicine (DICOM) format is king. This file format is produced by CT scans, MRIs, and other prominent types of medical imaging procedures.

Even with the bulk of DICOM images coming from radiology and cardiology, those two departments are often independent of each other and unable to share images. By implementing a single PACS solution or a robust VNA for both departments, healthcare professionals can cross-reference patient imaging.

Improve Image Management across Specialties

DICOM may be the most common medical image format, but many specialties collect images and media in non-DICOM formats as well. This data has undeniable clinical value, particularly as more specialty departments begin to capture patient images. For example, video clips taken during surgery and endoscopy procedures can assist with treatment planning and follow-up care. Although you could attempt to integrate these videos with a traditional PACS, the large file size and need for editing can make integration unrealistic. Additionally, non-DICOM still images have been proven to be difficult to integrate with PACS due to departmental workflows. To overcome this challenge, a VNA helps to make image management across specialties significantly easier.

At the TeraMedica Division of Fujifilm, our Synapse® VNA can handle multiple types of non- DICOM media to seamlessly connect imaging content from more than 30 specialty departments, including:

Enable Essential EHR Interoperability

Most electronic health record (EHR) systems can’t access departmental images through various departmental viewers. This forces physicians to find and reference images, which can be a tedious and frustrating task, not to mention a major roadblock to their workflow. One application for a VNA beyond radiology and cardiology is creating an image-enabled EHR that allows users to view any image type directly within the EHR workflow through the VNA’s enterprise viewer.

Synapse VNA provides full EHR interoperability, so physicians can reference all of a patient’s images directly from the EHR, regardless of the image’s original source or file format. As a HIPAA-compliant VNA, Synapse VNA can also implement rules to limit access to images on a need-to-know basis in an effort to keep sensitive information secure.

Capture Images at the Point of Care

As more enterprises adopt bring-your-own-device (BYOD) policies, physicians have the ability to capture images at any point during the patient encounter. Emergency care, dermatology, and wound care are already using mobile devices to capture images at the point of care. If your enterprise uses a mobile capture strategy, a VNA can help to minimize PHI risks and securely manage these real-time image captures for your care team.

With Synapse VNA Connext Mobile, for example, physicians can capture images and automatically archive them within the VNA. The VNA then communicates to the EHR that images are available for that patient encounter. Features such as secure sign-on, encrypted transmission, and intelligent data-lifecycle management help keep this tool secure and compliant, while also respecting patient privacy.

Fujifilm TeraMedica Division’s VNA Solution

The right VNA can benefit all departments across the enterprise, not just radiology and cardiology. Synapse VNA from the TeraMedica Division of Fujifilm is designed to provide true interoperability across departments. With Synapse VNA, you can view DICOM and non-DICOM images and share them with other physicians, departments, and facilities, and even with patients.

Whether you’re working in cardiology, radiology, or another specialty department, Synapse VNA can benefit you by:

• Reducing data-storage costs: By simplifying data storage and eliminating the need for expensive data migrations, Synapse VNA can significantly reduce data-storage costs over time.
• Streamlining workflows: Synapse VNA makes it easier to provide image access to physicians, care teams, and the clinical departments that need them, saving time and allowing staff to be more efficient.
• Helping improve patient care: Synapse VNA gives physicians access to all of a patient’s images in one central location. With the full picture of the patient, physicians can make more-informed diagnosis and treatment decisions, helping to improve the overall quality of care.

Applications for Synapse VNA

Synapse VNA connects imaging content across the care continuum, so it has many potential applications. Enterprises that could benefit from Synapse VNA include:

• Large hospitals and healthcare enterprises
• Integrated delivery networks (IDNs)
• Multispecialty healthcare networks
• Pediatric hospitals
• Outpatient imaging centers
• Pharmaceutical companies
• Biotech companies
• Enterprises conducting clinical trials

Contact Fujifilm TeraMedica Division to Learn More

VNAs help to bring the full patient picture to the entire healthcare enterprise. For more information about applications for VNA technology beyond radiology and cardiology, or to schedule a demo of the Best-in-KLAS Synapse VNA, reach out to us today.

By Laurence Yudkovitch, Product Manager – Synapse VNA, TeraMedica Division of Fujifilm

This post is going to contradict most of what we generally preach for enterprise imaging. Typically, the goal of enterprise imaging is to increase the availability of any medical image for any clinician, and that is appropriate in 80 to 95 percent of cases. However, some images are more sensitive and shouldn’t be shared with every clinician. Instead, these images must be restricted and made available only to a very limited number of care providers based on their role in the patient’s care. An optimal enterprise imaging solution supports workflows that protect this sensitive, restricted content.

Some of this sensitive content includes graphic images that may frighten or shock people who aren’t expecting them. Examples can be photos of large wounds, nudity, or abuse victims. One of the most frequent requests for managing access to restricted content relates to abuse victims. Images of children who have been sexually abused, neglected, or physically harmed are especially sensitive. Rape victims and subjects of domestic violence are other examples of patients whose data should be closely guarded, especially when friends or family members may be hospital employees and otherwise have access to those records. The third class of patients who often warrant additional privacy when being treated is VIPs. Wealthy customers, celebrities, and politicians often seek treatment for issues such as depression, substance abuse, or cosmetic surgery that they don’t want publicized.

For these reasons, it’s vital that an enterprise imaging solution has tools in place to protect these records. When a suspected child abuse or neglect patient shows up in the emergency department, it’s crucial that hospital staff is able to identify the concern and capture all the evidence needed for use by community agencies and law enforcement to ensure patient safety and privacy. Data security has always been core to Synapse® VNA; its hierarchical org structure was designed to provide data segregation and controlled access, and its robust audit trail ensures chain of custody is clearly documented.

Modern workflows are enhanced with additional tools to support more granular controls. With recent improvements, Synapse VNA lets you flag individual records as sensitive or restricted. If the Plastics department considers everything they capture as sensitive, since nudity is often involved, Synapse VNA can flag the entire department. Abuse victims may be seen by multiple specialties, so the VNA supports flagging all content for the patient. You can also flag individual studies, groups of studies, and folders of images that include DICOM and specialty (non-DICOM) imaging.

One of the most important aspects in caring for victims is documenting evidence of the abuse. Stanford Medicine provides extensive guidance on what should be documented in suspected child abuse and neglect (SCAN) cases. Connext Mobile, TeraMedica’s mobile app, lets you capture images, videos, audio, and text notes at the point of care. This is perfectly suited for workflows that require taking pictures of the victim’s face and body to capture any evidence of bodily harm. The audio and video features can be used to record the patient (e.g., the abused child) and any witnesses or family members describing the abuse in their own words so there is no risk of misinterpretation later on. This is recommended by Stanford for child abuse, domestic abuse, and elder abuse.

Clinicians can flag content as sensitive or restricted while they are capturing it in Connext Mobile as part of a routine encounter, and not specifically as it relates to the abuse. If a patient is in for another reason, it’s easy to create an extra folder to document the abuse to ensure vital information is immediately captured. Synapse VNA can also include forms or checklists to make it easy for those reporting the abuse to document everything necessary to support the legal health record. SCAN departments can create a series of questions users must fill in while documenting the case. Questions can be optional or required, and users can be offered a drop-down list with frequently used answers (including optional default responses and/or help text) to make easy and efficient to fill out. The goal is to capture all the necessary information without adding unnecessary burden to the caregiver.

Many facilities want only two or three staff members to have access to restricted abuse photos. Synapse VNA supports configurations in which multiple staff members can capture the photos and mark them as restricted. Once uploaded to the VNA, only staff with an explicit “view restricted” permission may then access those images. The system can also be configured so that all content stored in a specific department or regarding an individual patient is restricted. In this manner, X-rays and other specialty imaging related to the abuse can also be automatically flagged as restricted. These images can easily be exported for use by law enforcement.

For more-typical VIP patient workflows, the sensitive and restricted flags on patients and departments are compatible with the Connext encounters-based worklists. In fact, unless the user has “view restricted” permission, they won’t be able see worklist entries for a restricted patient. This helps to ensure privacy for even the most sensitive guests. And if download and export capabilities are disabled, there’s no risk of facility staff sharing a compromising post-plastic surgery video with the paparazzi; unfortunately for celebrity clients, we are unable to prevent loving moms from sharing such compromising evidence with Jimmy Fallon.