Lenny Reznik, Vice President of Commercialization for North America, presents his views on the recent 10th Anniversary of the HIMSS-SIIM community. 

This week I was honored to be a part of the 10^th anniversary of the HIMSS-SIIM Community, which is leading educational and networking focused opportunities on enterprise imaging. There were many inspiring leaders and innovators who discussed the latest trends and advancements in the field. I was privileged to talk about Enterprise Imaging in the Cloud and a path to success. To expand on that presentation, I’ve provided a few additional thoughts on cloud solutions and the benefits to imaging data in the healthcare setting.

Cloud computing, a significant trend in IT, is increasingly benefiting healthcare providers.   The explosion in medical imaging data requires new solutions for handling, storing and protecting data. Cloud solutions that are more secure, scalable and accessible; easier to maintain and use – and at a more predictable cost – are needed. However, cloud technology with its seemingly easy provision of scalability, accessibility and reconfigurable compute and storage resources is not a universal remedy – it’s essential to understand how it fits within your organization’s strategic planning and growth goals. To maximize the benefits of the cloud as it relates to medical imaging, it starts with a strategic plan.   While some vendors are touting a one size fits all strategy, AGFA HealthCare has a more nuanced approach for the diverse healthcare landscape we serve.

Cloud Storage

The simplest way to leverage cloud technologies is to consider utilizing the cloud for storage, or Storage as a Service, STaaS.  Cloud storage has been utilized in radiology settings for over a decade, offering numerous options and many different configurations.   The first step is to identify your organization’s goals for cloud storage.

Do you aim to move your organization’s long-term deep archive from on premises to an off-site solution? This decision carries many practical and financial implications, but there is more to consider.   First, do you need all those images? Does your facility have a records management policy? Does it align with your imaging records management policy or do you need to create one?   Do you want all your long-term images in the cloud, a copy of images in the cloud or only images of a certain age in the cloud?

Moreover, with the increasing cybersecurity threats in healthcare, do you need immutable storage- a copy of that data that cannot be modified or deleted for a set or indefinite time?  Many organizations plan a low-cost offline copy of their archive designed for data protection as ransomware protection.

These considerations are crucial for STaaS, and your Vendor Neutral Archive (VNA) must be able to accommodate them.   Whether its Intelligent Lifecycle Management (ILM), data migration tools, routing rules, or multi-tiered archive source configurations, these are some of the consultative questions you should be asking your imaging IT vendor.

VNA and Universal Viewer in the Cloud

A second strategy to consider for utilizing cloud in Enterprise Imaging is deploying VNA and a Universal Viewer in the cloud.   This configuration keeps the ‘diagnostic’ capability, compute, and cache on-premises.  This hybrid approach is a popular option for large, sometimes loosely affiliated health systems that need to share economies of scale for storing and viewing but not necessarily diagnostic reading.   This model has been successfully deployed in Canada, albeit in private clouds, with provincial wide diagnostic repositories.  These petabyte sized diagnostic pools of data have provided improved access, enabling untethered sharing and viewing of diagnostic images and associated reports across hospital-based and community-based clinicians throughout the provinces they serve.

In the U.S., a cloud based VNA and universal viewer is underway at the Veterans Affairs (VA). Many health systems in the North American commercial market have opted for this strategy to help them  increase clinical efficiency and reduce operational costs.

Enterprise Imaging in the Cloud

This comprehensive option includes all compute and storage resources in the cloud, holds the most promise for maximizing cloud benefits.  Enterprise Imaging (EI) has transformed how radiologists and other diagnosticians practice medicine.  Presenting the entire patient multimedia record enables a more comprehensive view of a patient’s health, leading to more informed decisions. Recent innovations in cloud and web technologies has opened up a whole new way to support this key imaging application.

Traditionally, PACS systems were purchased as capital models with almost all required storage for a set period purchased up front.  The primary reason for this model was that it was relatively easy to predict radiology storage needs, and hospitals set aside money for PACS as it became a medical necessity.

However, Enterprise Imaging (EI) is different- it’s is a strategic initiative that impacts most of the health system’s clinical services, not just one department.  EI is often described as a journey, starting in a few departments and expanding over time. AGFA HealthCare has identified over 60 image-generating service lines that will benefit from Enterprise Imaging.

Expanding your Enterprise Imaging to cardiology, wound care, ophthalmology, point of care ultrasound (POCUS), and pathology, can make it challenging to estimate compute and storage needs in advance. Cloud addresses this issue with fast, on-demand growth. Cloud solutions offer flexibility with timelines and exact compute and storage needs. No one wants to overcommit resources or inhibit progress due to hardware constraints. Cloud’s pay-as-you-go model with virtually unlimited compute and storage availability is ideal for this. A cloud-based EI deployment means you don’t overspend and increase your Total Cost of Ownership (TCO) by overbuying resources early.  It also prevents budget and IT constraints from delaying your expansion plans.

These are just a few considerations- many more details must be considered when moving enterprise imaging to the cloud with your current or new vendor. But remember, it all starts with a plan, a list of strategic goals your organization has agreed to. However, it’s clear that when it comes to cloud solutions, one size does not fit all. At AGFA HealthCare, we have a three-tiered cloud strategy offering that has been helping clients on their cloud journey for many years.  AGFA HealthCare is here to consult with you as you consider embarking on your cloud journey.

Watch the HIMSS-SIMM webinar “From Data to Diagnosis: Advancing Enterprise Imaging Through Key Trends and Innovations” for more in-depth information.

Lenny Reznik, August 2024.