THE BENEFITS OF AN ENTERPRISE IMAGING STRATEGY Jon T. Devries, VP Product Solutions, Merge Healthcare Tuesday, August 28, 2012 2012 Merge Healthcare
agenda 2 Why an Enterprise Imaging Strategy Makes Sense Building an Enterprise Imaging Strategy iconnect Enterprise Archive iconnect Access iconnect Share Moving to the Cloud What Do you Need? Q&A
WHY ENTERPRISE IMAGING?
enterprise programs you have now 4 Enterprise Purchasing/Supply Chain Management Enterprise CPOE/EHR Enterprise Revenue Cycle Management Enterprise Imaging Cost Savings Standardization Simplification Leverage
drivers of enterprise imaging strategies 5 Budget Restraints Increasing Data and Image Volumes Interconnected Enterprises Referring Practices Hospital M&A State / Community HIEs Imaging Centers Electronic Medical Records Image Enablement Report Distribution
what is each of your archives costing you? 6 Software fees Maintenance fees Hardware costs / lifecycle management Archiving* Disaster recovery Per PACS Platform! Staff expertise / administration *The average cost of storing a study without business continuity/redundancy and excluding labor costs is $1.15. Add in redundancy and labor costs much more.
reducing the cost of medical image archiving 7 80% 80%of the cost of an archive is the maintenance and administration Cost Driver Purchase Downtime Contribution 20% Capital Cost 20% Costs to restore normal operations Backup and Restore 30% Manual, error prone processes Environmental Administration Management 14% Space, power and cooling 13% Silo maintenance 3% Resource cost Gartner Group The Hidden Costs of Archival Storage
and yet we still have these challenges 8 Patient records are incomplete Images are not easilyavailable at the point of care Multiple DICOM viewers needed for your referring physicians Duplicate testing is common Patients are being exposed to unnecessary radiation Providers will not be reimbursed for duplicate tests Care is being delayed Time to treatment is getting longer due to missing images and/or incompatible formats We are still burning images to CD/DVD and sending them on their way!
enterprise imaging strategy benefits 9 Network Simplicity Single Storage Pool Single Enterprise Viewer Interoperability Internal Data Exchange External Data Sharing Manage YOUR Data ILM & Policy Based Deletions Eliminate Future Migrations DICOM and non-dicom
enterprise imaging strategy benefits 10 Network Simplicity $MMs Saved over 5 years Save $7 -$9/CDs Shipped Interoperability Control of 80% Storage Costs Save ~$70 / CD Imported Manage YOUR Data 40% Reduction in Storage $3K -$5K / TB / Migration Improved Efficiency
when to roll out an enterprise strategy 11 You don t have the luxury of ripping and replacing your existing imaging infrastructure / investment There is a natural refresh cycle today hardware How do you maximize the investment you have, yet move to a simpler, more efficient (and less expensive) enterprise relationship?
iconnect IS A PLATFORM FOR AN ENTERPRISE IMAGING STRATEGY
today isolated departments and image silos 13 Radiology* Cardiology* Orthopedics Dermatology, etc Eye Care * Two largest sources of imaging in a health system.
the move to enterprise imaging strategies 14 1 Archive Images to Eliminate Silos and Centralize Storage Archive Images in Merge s Enterprise Archive Radiology* Cardiology* Orthopedics Eye Care Dermatology, etc * Two largest sources of imaging in a health system.
Merge: world s #1 VNA provider 15 Merge accounts for 37% of the global VNA market and 61% of US market Merge clients have stored over 200 million studies or over 13 billion images Clients continue to add 150 million images every month to iconnect Enterprise Archive
market leader 16 First true standalone VNA in the market Over 50% of Merge s VNA customers have integrated thirdparty PACS and workstations to iconnect Enterprise Archive(48 different PACS vendors) More enterprises store endoscopy and pathology images in iconnect Enterprise Archive than any other enterprise archive (KLAS) Replicated Content Management (RCM) Customers with multi-million exam volumes able to run for 8+ years with 0 downtime * Resource: InMedica s study: World Market for Medical Enterprise Data Storage Vendor-Neutral Archiving (VNA) - 2012
the move to enterprise imaging strategies 17 1 Archive Images to Eliminate Silos and Centralize Storage 2 Share Images with other hospitals, and imaging centers Share Archive Images in Merge s Enterprise Archive Share Radiology* Cardiology* Orthopedics Eye Care Dermatology, etc * Two largest sources of imaging in a health system.
the move to enterprise imaging strategies 18 1 Archive Images to Eliminate Silos and Centralize Storage 2 Share Images with other hospitals, and imaging centers 3 Access Images through EMR / EHR or Physician Portal Access Share Archive Images in Merge s Enterprise Archive Share Radiology* Cardiology* Orthopedics Eye Care Dermatology, etc * Two largest sources of imaging in a health system.
iconnect ENTERPRISE ARCHIVE Vendor Neutrality Disaster Recovery and Business Continuity Manage YOUR Data and Migrations Implement Retention Policies
the enterprise archive solution 20
iconnect Enterprise Archive: proven compatibility 21 Connected 3 rd Party PACS Specialized W/S & Cad Acuson KinetDx Agfa Impax Camtronics VERICIS (with VIS) Carestream /Kodak PACS Cerner ProVision ClearCanvas DR Systems dcm4che DCV Dental PACS Digisonics Fuji Synapse Fuji / Prosolv Cardiology GE Centricity GE / Vingmed EchoPACS Harris Pathology Hologic IDX ImageCast Intelerad Kodak / Cemax-Icon KPACS McKesson / ALI UltraPACs McKesson Horizon Radiology R10+ McKesson Horizon Cardiology (Medcon) Merge VERICIS (with ECM) MOSAIQ Oncology Philips / Stentor isite Philips / Sectra PACS Philips Inturis Suite Philips EasyVision Philips Xcelera Scimage Siemens Syngo Dynamics Siemens Syngo Workspace Siemens MagicView TeraRecon AquariusNet TomTec Image Arena Vital Images VitalConnect Vital Images Vitrea Enterprise Suite icad R2 Image Checker CAD Applicare QC workstation GE Advantage Windows GE entegra GE Xeleris MedImage MedView Medis QAngioXA Medis QMASS Mercury / Visage Merge CADStream Merge efilm Merge ProPlanner Merge I-Response Merge WebAccess / CAP Osiris Osirix Philips Brilliance Workspace PIE CAAS Invia Corridor 4DM Sante Viewer Siemens esoft TeraRecon Trillium Showcase Representative, but not exhaustive list of supported systems
RCM replicated content management 22 50% of Storage Costs are associated with Downtime and Backup and Restore Customers run for multiple YEARS with no overall system downtime
DIY morphers 23 Build and Manage Do-It- Yourself Morphers in WebAdmin Catalog of morphers Rules engine to build the morphers Manage your own migrations Ability to test your morphers before rolling them out Audit the performance of the morphers
policy-based deletion 24 Keep the data you need for as long as you need it clinically Data kept past the legal retention period can be a liability 400,000 350,000 300,000 250,000 200,000 150,000 100,000 50,000-30 Days 90 Days 1 Year 2 Years 3 Years 4 Years 5 Years Younger Than Older Than PCT 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Hear Ascension Health s story in the next session!
policy-based deletion: steady state benefits 25 Annual Volume: 250,000 exams growing at 3% Steady State Archive is 10 years old Reduce storage by 229 TB or 43% over 10 years Total Storage (TB) 600 500 400 300 200 100-9 10 11 12 13 14 15 16 17 18 19 20 229 TB Storage (w/0 PBD) Storage (w/ PBD) Savings (TB)
iconnect ACCESS How it Works Use Cases
iconnect Access: how it works 27 Server side rendering of the image Transmission of lossy and loss-less images via the Internet Ability to embed the link within physician and provider systems Images are viewable from any browserbased device No additional software required on the viewing device Provide composite access to images in disparate locations
real world scenario 28 Problems with this Current State: Unnecessary costs Duplicate tests Inefficient process for patients Specialist can t view original scans Ice & Pediatrician Local Imaging Center Referred to a Specialist Josh finishes the game and puts it on ice. The next day, he heads to his doctor. His pediatrician recommends he goes to the local imaging center for a scan of his leg $$ $$ Based on their initial read, the imaging center refers Josh to an orthopedic surgeon who takes another set of scans $$ $$
iconnect SHARE How it Works Use Cases
iconnect Share: how it works 30 Sending site will drag and drop studies onto the iconnect Share application Transmission via HTTPS, no VPN required iconnect Share Server receives the studies morphs them into the native PACS format Physician is alerted that the study is available for reading After reading, study can be saved in local native PACS storage
real world scenario 31 Problems with this Current State: Trauma patients arriving hourly with unreadable CDs Very costly duplicate tests Potentially life-threatening delays in treatment for patients Rushed to Local ER Life Flight to Trauma Center Treatment at Trauma Center CT of the head shows that the injury is serious and that Brad needs immediate attention A CD of Brad s CT scan is strapped to his chest Brad arrives but the CD is not readable so more scans are needed before treatment can begin $$$$ $$$$ $$$$ $$$$
MOVING TO THE CLOUD Several Options: Disaster Recovery Backup Business Continuity Solution Single Archive for image enabling an EMR Image Sharing Hybrid Onsite / Offsite Solution Complete Move to the Cloud
Merge Honeycomb: our cloud platform 33
how Honeycomb archiving works 34 PACS Merge Gateway Merge Honeycomb RIS Compress Route CD Import Image Sharing Any device No VPN No Software
what s important for cloud storage? 35 Data Security Data can reside in multitenancy environments and is limited in breach exposure Data Integrity Assurance that data is consistent, certified and can be reconciled Data Protection Protect data from failures or corruption of disks, storage nodes or locations Availability System is operable and performs in routine as well as unexpected circumstances Multi-site Performance Place frequently accessed content closer to users, parallel reads and writes for performance Scalability System can scale from multiterabytes to Petabytes, and is Always On
WHAT DO YOU NEED?
QUESTIONS? Jon T. Devries, VP Product Solutions, Merge Healthcare jon.devries@merge.com