The Pioneers of Enterprise Imaging

I recently had the opportunity to spend some time with my family and a local youth group out in the sagebrush of Wyoming. We took these kids out on what was called a “pioneer trek”—a reenactment of the pioneer journeys in the mid-1800s. The goal is to get kids out of their normal world, pull them from their phones and video games, and hopefully engender a sense of gratitude for those who created the trails before them at great sacrifice.

In the name of authenticity, we neglected modern off-roading equipment and instead opted for the “handcart” model of an ATV, horsepower not included. As we hauled these handcarts up and down the rocky ridges of the western frontier, I found it best to focus on conquering one hill at a time rather than worrying about what lay beyond the next ridge.

The healthcare IT landscape has been in a near-constant state of readjustment. Many feel that they can hardly manage to hike to the top of a mountain of regulatory requirements before legislation changes and the ground gives way beneath them. We’ve seen meaningful use push EMR implementation to the forefront of HIT, and as we start to crest that hill, I often wonder what the next and most effective hill to climb in a value-based care world will be.

In healthcare, as with “trekking”, the future path is most easily seen from an elevated vantage point. Recently, KLAS sought both a higher altitude and elevated thinking as we gathered in the mountains outside Salt Lake City for the Keystone Summit on Enterprise Imaging. The Summit was comprised of great minds from both the vendor and provider sides of the imaging world.

This was a gathering of pioneers who clearly saw enterprise imaging as the next hill to climb. Much of our discussion was colored by this fact: in most of the market, enterprise imaging is in its infancy. We discussed the idea that there will probably be great benefits from adopting an enterprise imaging model but that the ROI, much like the benefits those youth received from hauling handcarts, may not be immediately obvious. Additionally, many providers still feel neck-deep in implementing and optimizing their EMRs; for many executive teams, imaging just doesn’t take precedence.

Part of moving enterprise imaging to the forefront of HIT will involve pulling it out of radiology. Our best chances at success will come when providers in the specialties that use images (dermatology, ophthalmology, etc.), as well as primary care physicians, see the need for and become passionate advocates of enterprise imaging. One Summit participant put it this way: “Don’t see enterprise imaging as simply ‘radiology plus.’”

Recruiting imaging advocates who are users of images and not just producers of images isn’t a responsibility that rests on providers alone. Dr. Tarik Alkasab of Massachusetts General Hospital, voiced a common sentiment of providers by saying, “We’re not buying from a vendor; we’re marrying them.” Many providers feel this exact sentiment when seeking out new solutions. Providers don’t just want tools; they want partners. Ideally, these partners will share a drive and passion for bringing imaging out of the silo of radiology and into full enterprise usage. If enterprise imaging is to become a reality, vendors and providers will need to start seeing eye to eye.

Before the summit began, we asked participants to pinpoint the biggest gaps in enterprise imaging. It was interesting to see where our provider and vendor participants differed in opinion:

Part of the beauty of bringing all these pioneering minds together in the same room is that, although many different opinions exist, they were able to set aside many of these disagreements and come to a consensus. It’s in the areas that we agree where we stand the best chance of moving enterprise imaging forward.

Rasu Shrestha, Chief Innovation Officer at UPMC and a member of KLAS’ advisory board, powerfully brought the Summit to a close. With many things in healthcare, it is easy to get lost in weeds and lose focus on the primary objective, which, of course, is to best serve the patient. As Dr. Shrestha said, “We are trying to treat a series of images; we need to be treating the patient.”

That was our ultimate goal at the Keystone Summit: to produce a framework that would aid in our efforts to better deliver patient care. From that collaboration came the Enterprise Imaging White Paper, which we’ve put out in the marketplace publicly. We have done this in the hope that the wisdom of these imaging pioneers can help others walk down the trail the pioneers have already begun to carve out.