Dr. Mohammed Hussein VNA/XDS and their influence on clinical workflow

VNA/XDS and their influence on

clinical workflow

Dr. Mohammed Hussein

Healthcare Imaging & UCA Lead - UK

Infrastructure & Cloud Computing - Dell Services

Dell Healthcare & Life Sciences

• 13,000+ healthcare & life sciences professionals

• We support over 10,000 Healthcare providers, health plans, pharmaceutical, biotech, medical device, diagnostic and scientific instrumentation customers worldwide

• Leading Healthcare Information Technology Services provider1

• Dell Healthcare & Life Sciences is with $2.6 billion (FY11) the second largest Healthcare IT company2

• We provide OEM services to 70+ Healthcare and Life Sciences software, medical device and scientific instrument providers

• Our Clinical Archive Cloud manages more than 70 million clinical studies and 4.8 billion diagnostic imaging objects on behalf of more than 800 clinical sites in North America3

1) Source Gartner 2011 [url] 2) Source Healthcare Informatics 2011 [url] 3) See real-time ticker

http://www.businesswire.com/news/home/20110901006233/en/Dell-Ranked-No.-1-Global-Healthcare-Information

http://www.healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications::Article&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=B5DC4B9AA9174FD8BA40BD195F60618B

http://marketing.dell.com/uca-archive-ticker

Services

Transformation of Medicine

Episode

based

Translational

Medicine

Healthcare

Information

Exchange

Systems Efficiency

Non-specific Episode by Episode

Better Organized to Reduce Duplicate Effort

Patient Centric Disease Prevention

Decision Support Systems

Information Correlation

Diagnosis

Services

Clinical and Operational Challenges -Fragmentation

Services

What is the Issue? Currently healthcare IT deals with numerous silos of data found in a number of specialised ‘ology’ silos with

different storage tiers and modalities as well as different care delivery sites, formats and systems (Images,

PDF, Word documents, Excel sheets, etc…)

This results in a multitude of data formats often only accessible through the specific vendor who created it

within the site it was acquired/created at.

These silos require the clinician to go to multiple sources to gather a holistic view of the patient condition.

PAS/EPR

Image / Clinical Documents Silos Systems

Locations

PACS

Labs

Hospital 1 Hospital 2 GP ??

??

Services

Current Sharing Flow (Imaging/Clinical Docs)

CTCR

US

Diagnostic Workstation

PACS

Site A

CTCR

US


PACS

Site C

CTCR

US


PACS

Site B

Images shared via CDs

With its limitations and issues

Services

Sharing Flow

CTCR

US


PACS

Site A

CTCR

US


PACS

Site C

CTCR

US


PACS

Site B

Viewing WorkstationWeb Viewer

Images shared via Web access

with its limitations and issues

Services

Data Locked in Departmental Silos

Radiology Oncology Cardiology Women’s health Pathology

• Clinical Information Silos

• Expensive and redundant procedures are performed

• Diagnostic collaboration among departments is

inefficient

• EMR systems are incomplete and lack certain critical

patient information

• Painful vendor application migrations

• Expensive and risky data migrations

– Lengthy scope of work negotiations

– Months to prepare, inspect, and migrate

data

• True…for every application silo in

your environment

Services

Unified Clinical

Archive

-Consolidation -Standardisation

Services

Dell Unified Clinical Archive Helping Healthcare providers efficiently store, manage and share medical image data

Radiology Oncology Cardiology Women’s

health Pathology

Medical

Record

Unified Clinical Archive

Dell On-Premise Clinical Archive Object based storage platform

Dell Cloud Clinical Archive Managed Enterprise Archive

Dell Clinical Data Management Data Consolidation and Information Life cycle Management

Dell Clinical Collaboration Portal Cross Enterprise Data Access and Distribution

Unified Clinical Archive

•D

ell

Serv

ices

•D

ell

Security

Services

UCA – Portfolio At a Glance

Unified Clinical Archive Portfolio

Data Virtualization and VNA Software layer

On-Premises Archiving Hardware

- Compellent

- DX6000 Series

- Equalogic

- PowerVault

- Servers & Infrastructure

Cloud based Managed Archival Service - Dell Cloud Clinical Archive

- Dell Cloud Clinical Recovery

Tools for Data Sharing and exchange - Apollo

- Calgary Scientific

- Dell Cloud Clinical WebAccess

- MEDecision

- Aperio*

SERVICES (Migration, Assessment, Deployment, Support)

SECURITY (Encryption, Access Control, Audit Logs, Role based access)

Dell Clinical

Data Management Dell On-Premise

Clinical Archive

Dell Cloud Clinical

Archive Dell Clinical

Collaboration Portal

* Solution available later in 2012

Healthcare and Life Sciences

BridgeHead /Dell Solution

Manage and control clinical and non-

clinical documents, records and

images in a searchable, centralized

repository

• DICOM Storage Class Server

• HL7 interface

• Microsoft® Exchange Storage

Management, Compliance

Journaling and PST Migration

• File System Archiving from

Windows® and Linux

• Direct integration with Microsoft®

SharePoint® Server

• Mixed content and meta-data

index

• Full search and Web portal

access

Services

inFrame differentiators Unrivaled medical imaging distribution/visualization

InDex provides a turnkey infrastructure that is image-enabled empowering the sharing of patient centric information

UCA Clinical Collaboration: Dell Cloud Clinical WebAccess

• Integrated Web-based portal

for viewing medical images

• True Zero-Footprint

• Multi-browser support

• Access to DICOM and HL7

updates

• User/group management

controls

• Accesses documents across

multiple institutions (XDSi)

• Enables image sharing with

referring physicians

Services

Dell UCA Benefits • Infrastructure Simplification

• Application Neutral Enterprise Archive – accessible information and easier sharing.

• Clinical Workflow and Automation overcoming silos and locked up clinical information

• Disaster Recovery and Data Protection

• No more Data Migration

• Easier Data Sharing and Information Exchange

• Business Continuance and Physician Access

• New Capital / Operational acquisition models

Tier 1 Tier 1

Clinical On

Premise Archive Clinical Cloud

Archive

Clinical

Collaboration

Portal

Healthcare and Life Sciences

Dell’s UCA - Market Leadership Leading provider of digital medical image archiving

• Providing digital medical archiving services for 11+ years

• 800 clinical sites generating 60 TB monthly

• Managing over 4.7 billion images and 70 million+ studies and growing daily

• Largest number of concurrent systems integrated into secure cloud based archive delivery model

• Over 28+ PACS and hundreds of modalities, DICOM versions and associated non-imaging data sources

• ISO 13485:2003 certification on quality systems within Dell Data Centers

Multiple configurations and deployment models

• Licensed software with capital / operational business models

• Includes long term storage, disaster recover, and business continuance

• Provides SLAs on access to your data and full support for automated IHE integrated workflow

Tight integration with a large Eco-System of partners, to meet diverse customer

needs

– Mobility and Ease of Access

– Collaboration and Exchange

- Vendor Neutral Archive

- PACS and Workflow management

Services

Cross Enterprise

Document Sharing

(XDS/XDS-I)

-Sharing -Flexibility

17 Confidential Services

IHE (Integrating the Healthcare Enterprise)

• Anatomic Pathology

• Cardiology

• Eye Care

• IT Infrastructure

• Laboratory

• Patient Care Coordination

• Patient Care Devices

• Radiation Oncology

• Radiology

• Consistent Time (CT)

• Audit Trail and Node Authentication (ATNA)

• Request for Information Display (RID)

• Enterprise User Authentication (EUA)

• Patient Identifier Cross Referencing (PIX)

• Patient Synchronized Application (PSA)

• Patient Demographic Query (PDQ)

• Cross Enterprise Document Sharing (XDS)

• Cross Enterprise Document Sharing for Imaging (XDS-I)

• Personnel White Pages (PWP)

• Cross Enterprise Document media Interchange (XDM)

• Cross Enterprise Document reliable Interchange (XDR)

• Cross enterprise sharing of scanned document (XDS-SD)

• Retrieve Form for data capture (RFD)

Domain Profiles

Services

Cross Enterprise Document Sharing (XDS)

Cross-enterprise Document Sharing for Imaging (XDS-I)

Registers and shares electronic health record documents between healthcare enterprises,

ranging from physician/GP offices to clinics to acute care in-patient facilities.

While XDS-I extends XDS to share images, diagnostic reports and related information

across sites.

Ref:

IH

E_IT

I_T

F_R

ev7-0

_V

ol1

_F

T_2010-0

8-1

0.p

df

Services

Enhanced Workflow (Imaging/Clinical Docs)

CTCR

US


PACS

Site A

CTCR

US


PACS

Site C

CTCR

US


PACS

Site B

Repository

Registry

Manifest sent

Manifest sent

Manifest sent

Services


CTCR

US


PACS

Site A

CTCR

US


PACS

Site C

CTCR

US


PACS

Site B

Repository

Registry

Query

Services


CTCR

US


PACS

Site A

CTCR

US


PACS

Site C

CTCR

US


PACS

Site B

Repository

Registry

Manifest Retrieved

with Image location

Services


CTCR

US


PACS

Site A

CTCR

US


PACS

Site C

CTCR

US


PACS

Site B

Image retrieved

Services

Solution • Consolidation of the different silos using a UCA (Unified Clinical Archive) with a web

based viewer.

• Allowing interoperability and seamless sharing using XDS/XDS-I, this facilitates bottom

up approach to building a national patient data sharing infrastructure especially with the

development of ITK and CUI within the NHS.

Outcome • Better clinical workflow and more time spent with patients

• Sharing of information more quickly and effectively across clinicians and enterprise,

especially in emergencies

• The safety, quality, and efficiency of care for the patient is immediately improved

• Reduce cost of care – reduce procedures, cross utilise resources, informed decision

across boundaries

• Improve quality of care, reduce errors/duplication, improve clinical decisions and better

patient satisfaction

• Critical patient information is safe and protected; clinical record is complete and

longitudinal

New standard of future patient care – truly effective, affordable healthcare

Thank you Dr. Mohammed Hussein International Healthcare - Dell Services [email protected]

mailto:[email protected]