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Enterprise Imaging Summit 2022 White Paper
Avoiding Long-Term Challenges through Sensitive Image Management & Effective Remote Work

author - Monique Rasband
Author
Monique Rasband
author - Emily Paxman
Author
Emily Paxman
 
August 3, 2022 | Read Time: 6  minutes

Current Time Inside Cache Tag Helper: 8/14/2022 6:28:49 PM and Model.reportId = 2939

Since 2017, KLAS has hosted four separate summits on enterprise imaging (EI), each time bringing together healthcare executive thought leaders to discuss EI issues and define guidelines. The insights gleaned from these summits represent the combined wisdom of some of the industry’s top EI experts. This white paper summarizes the discussions from the most recent summit held in May 2022. The following sections are included:
  • A definition of enterprise imaging
  • Keys to success outside of technology, including strategies for (1) safely managing sensitive images within an enterprise imaging infrastructure and (2) navigating enterprise imaging in a post-pandemic world

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HtmlReportContent Current Time Inside Cache Tag Helper: 8/14/2022 6:28:49 PM and Model.reportId= 2939 and Model.HtmlReportContent_LastWriteTimeUtcInTicks=637952415797747988

What Is Enterprise Imaging?

KLAS defines enterprise imaging as the ability to store and/or view images across the enterprise from more than one service line, PACS, or long-term storage solution. Organizations that have adopted such a strategy feel that the ability to consolidate critical patient images and integrate them into the clinician workflow has the potential to revolutionize patient care across the continuum. While an enterprise imaging strategy can encompass many technologies, such as workflow solutions and document management tools, providers feel that at the heart of enterprise imaging are three primary technologies: vendor neutral archives (VNAs), universal viewers, and image exchange solutions (with PACS solutions playing a role in diagnostic viewing for the bulk of their studies). Some organizations are new to using these solutions for enterprise imaging and are working to fit these solutions into a meaningful strategy. See the 2016 Enterprise Imaging report for more information.

enterprise imaging

Beyond Technology Solutions, What Contributes to Success in Enterprise Imaging?

Keeping Sensitive Images Safe in an Enterprise Imaging Environment

At KLAS’ 2022 enterprise imaging summit, one highly mentioned topic was managing sensitive images (i.e., images with nude, gruesome, or personal content that can cause shock, embarrassment, grief, or emotional distress). As images become more accessible to more providers via technology, the potential for security breaches and staff members using the images inappropriately increases. Keynote speaker Dr. Alex Towbin from Cincinnati Children’s Hospital Medical Center shared examples of how some organizations’ failure to secure sensitive images has impacted their reputations and caused serious harm to patients and their families.

In the 2022 pre-summit survey, just over half of provider attendees said they currently do not have procedures in place for storing and accessing sensitive images. Providers who do have procedures in place said the most common methods are to restrict access to images deemed sensitive and to use standard labeling for sensitive images. For organizations who do not yet have procedures in place, conversations about developing these procedures are still in the early stages, and procedure development is generally not being pursued.

provider organization has procedures for storing accessing sensitive images

2022 summit attendees engaged in small-group discussions to (1) identify common barriers to developing effective procedures for managing sensitive images, (2) share tips for getting organizational buy-in, and (3) list other best practices for successfully managing sensitive images. Across all eight discussion groups, the general sentiment was that while the industry still has foundational EI issues to solve, failing to have early discussions about the management of sensitive images could potentially cause both ethical and legal problems down the line.

Common Barriers to Developing Procedures for Sensitive-Image Management

  • The industry needs a standard approach to labeling, though it is unclear who (i.e., provider organizations, vendors, or the government) should be driving progress.
  • Reaching a consensus on best practices within your organization can be difficult, particularly outside of cases that involve abuse.
  • Implementing procedures solves only part of the problem—storing images securely on devices and workstations is critical.

Tips for Obtaining Organizational Buy-In for Sensitive-Image Management

  • Legal departments can serve as partners to make sensitive-image management an organizational priority (though both provider and vendor attendees noted that without strong governance and policy input from providers, too much data may be restricted).
  • Education needs to take place at all levels and in all departments (e.g., organizations can help radiologists understand why clicks are being added or help nurses think about how images can be used).
  • Technology vendors can serve as a hub for learnings and best practices across their customer bases. They can share examples of the challenges provider organizations may encounter if they lack effective sensitive-image management procedures.

Other Best Practices for Successfully Managing Sensitive Images

  • EMR vendors have a critical role to play, especially when it comes to tagging functionality. Provider organizations can engage their EMR vendor in imaging discussions to help drive progress around sensitive-image management.
  • Focus on visible-light image capture, as this area is where much of the vulnerability exists today.
  • AI has the potential to help, but until the industry standardizes body part names and labels, AI’s utility is limited. Organizations should be wary of relying too much on AI when developing procedures for sensitive-image management.
  • Cases of sexual assault and abuse are critical starting places for governance, policy, education, and standards.
  • We can learn from other industries and use cases—for example, how does Google manage sensitive images in searches, or how do behavioral health departments manage sensitive information?

Navigating Enterprise Imaging Post-Pandemic

Coming out of the height of the pandemic, both provider and vendor attendees say their enterprise imaging strategies have shifted somewhat. While most respondents to the 2022 pre-summit survey haven’t made significant changes, several mentioned adjusting some areas to address emerging problems and leverage new technology.

change in enterprise imaging strategy throughout the pandemic

Remote Work and Image Exchange Are Top Technology Investments to Bolster Enterprise Imaging Strategies

Unsurprisingly, one of the top areas for additional technology investment is remote work. One provider organization shared that they invested a significant amount into virtual care and adopted mobile technology to facilitate real-time consulting sessions between radiologists and physicians. Provider organizations also mentioned investing in cloud technology, workstations, collaboration tools, and other tools to drive efficiency in the face of staffing shortages.

aspect of provider organiations strategies that have changed during the pandemic

Another frequently mentioned area of investment is image exchange to support patient care in a remote environment (e.g., patients who are seen virtually cannot bring physical copies of CDs to their appointment). Adoption of image exchange solutions was accelerated by COVID-19, but for many provider organizations, other methods—like HIEs, burned CDs, and VPNs—are still a critical part of imaging interoperability.

usage of image exchange solution vs other methods

Amid Imaging IT Budget Cuts, Provider Organizations Point to Tools That Offer Much-Needed ROI

Diminished funding for enterprise imaging is hampering organizations’ ability to address the evolving care and work landscape. Provider attendees shared that their margins in departments like cardiology and radiology are shrinking significantly and that there is more departmental competition for limited funds. Because of the increased scrutiny of IT purchases, it is critical for organizations to make investments that will drive value. In the group discussions, providers often highlighted the following technologies as driving the biggest ROI outside of the VNA, the universal viewer, and organizations’ work-from-home infrastructure:

  • Health data exchanges and other interoperability tools
  • Image exchange solutions to eliminate the use of CDs
  • AI tools or worklist-orchestration tools that target efficiency
  • Point-of-care ultrasound deployment across multiple departments (though this can lead to large amounts of new billing)
  • Clinician collaboration tools

How Can Provider Organizations Mitigate the Impact of Staffing Shortages?

No organization is immune to the difficulties of managing staffing structure, turnover, and labor shortages. Many 2022 summit participants shared their struggles and turned to their peers for suggestions. The following approaches were frequently mentioned:

  • Use contractors to build out the capabilities of ground-level IT analysts, and invest in outside training sources to supplement knowledge replacement after experiencing turnover. Contractors are best to use when the knowledge is easily transferrable, and full-time staff should be reserved for activities that require more strategic knowledge.
  • Find ways to cut technology costs to retain staff (e.g., hold on to perpetual software licenses when possible).
  • Plan to address clinical and IT staff gaps jointly rather than separately; this reduces churn and maximizes the time both groups spend on optimization and planning.
  • Simultaneously redesign IT and workflows to quickly gain efficiencies that boost imaging volumes.
  • Build a culture of effective remote communication to retain clinical quality.
  • Standardize IT solutions where possible.
Current Time Inside Cache Tag Helper: 8/14/2022 6:28:49 PM and Model.reportId = 2939

What Is Enterprise Imaging?

KLAS defines enterprise imaging as the ability to store and/or view images across the enterprise from more than one service line, PACS, or long-term storage solution. Organizations that have adopted such a strategy feel that the ability to consolidate critical patient images and integrate them into the clinician workflow has the potential to revolutionize patient care across the continuum. While an enterprise imaging strategy can encompass many technologies, such as workflow solutions and document management tools, providers feel that at the heart of enterprise imaging are three primary technologies: vendor neutral archives (VNAs), universal viewers, and image exchange solutions (with PACS solutions playing a role in diagnostic viewing for the bulk of their studies). Some organizations are new to using these solutions for enterprise imaging and are working to fit these solutions into a meaningful strategy. See the 2016 Enterprise Imaging report for more information.

enterprise imaging

Beyond Technology Solutions, What Contributes to Success in Enterprise Imaging?

Keeping Sensitive Images Safe in an Enterprise Imaging Environment

At KLAS’ 2022 enterprise imaging summit, one highly mentioned topic was managing sensitive images (i.e., images with nude, gruesome, or personal content that can cause shock, embarrassment, grief, or emotional distress). As images become more accessible to more providers via technology, the potential for security breaches and staff members using the images inappropriately increases. Keynote speaker Dr. Alex Towbin from Cincinnati Children’s Hospital Medical Center shared examples of how some organizations’ failure to secure sensitive images has impacted their reputations and caused serious harm to patients and their families.

In the 2022 pre-summit survey, just over half of provider attendees said they currently do not have procedures in place for storing and accessing sensitive images. Providers who do have procedures in place said the most common methods are to restrict access to images deemed sensitive and to use standard labeling for sensitive images. For organizations who do not yet have procedures in place, conversations about developing these procedures are still in the early stages, and procedure development is generally not being pursued.

provider organization has procedures for storing accessing sensitive images

2022 summit attendees engaged in small-group discussions to (1) identify common barriers to developing effective procedures for managing sensitive images, (2) share tips for getting organizational buy-in, and (3) list other best practices for successfully managing sensitive images. Across all eight discussion groups, the general sentiment was that while the industry still has foundational EI issues to solve, failing to have early discussions about the management of sensitive images could potentially cause both ethical and legal problems down the line.

Common Barriers to Developing Procedures for Sensitive-Image Management

  • The industry needs a standard approach to labeling, though it is unclear who (i.e., provider organizations, vendors, or the government) should be driving progress.
  • Reaching a consensus on best practices within your organization can be difficult, particularly outside of cases that involve abuse.
  • Implementing procedures solves only part of the problem—storing images securely on devices and workstations is critical.

Tips for Obtaining Organizational Buy-In for Sensitive-Image Management

  • Legal departments can serve as partners to make sensitive-image management an organizational priority (though both provider and vendor attendees noted that without strong governance and policy input from providers, too much data may be restricted).
  • Education needs to take place at all levels and in all departments (e.g., organizations can help radiologists understand why clicks are being added or help nurses think about how images can be used).
  • Technology vendors can serve as a hub for learnings and best practices across their customer bases. They can share examples of the challenges provider organizations may encounter if they lack effective sensitive-image management procedures.

Other Best Practices for Successfully Managing Sensitive Images

  • EMR vendors have a critical role to play, especially when it comes to tagging functionality. Provider organizations can engage their EMR vendor in imaging discussions to help drive progress around sensitive-image management.
  • Focus on visible-light image capture, as this area is where much of the vulnerability exists today.
  • AI has the potential to help, but until the industry standardizes body part names and labels, AI’s utility is limited. Organizations should be wary of relying too much on AI when developing procedures for sensitive-image management.
  • Cases of sexual assault and abuse are critical starting places for governance, policy, education, and standards.
  • We can learn from other industries and use cases—for example, how does Google manage sensitive images in searches, or how do behavioral health departments manage sensitive information?

Navigating Enterprise Imaging Post-Pandemic

Coming out of the height of the pandemic, both provider and vendor attendees say their enterprise imaging strategies have shifted somewhat. While most respondents to the 2022 pre-summit survey haven’t made significant changes, several mentioned adjusting some areas to address emerging problems and leverage new technology.

change in enterprise imaging strategy throughout the pandemic

Remote Work and Image Exchange Are Top Technology Investments to Bolster Enterprise Imaging Strategies

Unsurprisingly, one of the top areas for additional technology investment is remote work. One provider organization shared that they invested a significant amount into virtual care and adopted mobile technology to facilitate real-time consulting sessions between radiologists and physicians. Provider organizations also mentioned investing in cloud technology, workstations, collaboration tools, and other tools to drive efficiency in the face of staffing shortages.

aspect of provider organiations strategies that have changed during the pandemic

Another frequently mentioned area of investment is image exchange to support patient care in a remote environment (e.g., patients who are seen virtually cannot bring physical copies of CDs to their appointment). Adoption of image exchange solutions was accelerated by COVID-19, but for many provider organizations, other methods—like HIEs, burned CDs, and VPNs—are still a critical part of imaging interoperability.

usage of image exchange solution vs other methods

Amid Imaging IT Budget Cuts, Provider Organizations Point to Tools That Offer Much-Needed ROI

Diminished funding for enterprise imaging is hampering organizations’ ability to address the evolving care and work landscape. Provider attendees shared that their margins in departments like cardiology and radiology are shrinking significantly and that there is more departmental competition for limited funds. Because of the increased scrutiny of IT purchases, it is critical for organizations to make investments that will drive value. In the group discussions, providers often highlighted the following technologies as driving the biggest ROI outside of the VNA, the universal viewer, and organizations’ work-from-home infrastructure:

  • Health data exchanges and other interoperability tools
  • Image exchange solutions to eliminate the use of CDs
  • AI tools or worklist-orchestration tools that target efficiency
  • Point-of-care ultrasound deployment across multiple departments (though this can lead to large amounts of new billing)
  • Clinician collaboration tools

How Can Provider Organizations Mitigate the Impact of Staffing Shortages?

No organization is immune to the difficulties of managing staffing structure, turnover, and labor shortages. Many 2022 summit participants shared their struggles and turned to their peers for suggestions. The following approaches were frequently mentioned:

  • Use contractors to build out the capabilities of ground-level IT analysts, and invest in outside training sources to supplement knowledge replacement after experiencing turnover. Contractors are best to use when the knowledge is easily transferrable, and full-time staff should be reserved for activities that require more strategic knowledge.
  • Find ways to cut technology costs to retain staff (e.g., hold on to perpetual software licenses when possible).
  • Plan to address clinical and IT staff gaps jointly rather than separately; this reduces churn and maximizes the time both groups spend on optimization and planning.
  • Simultaneously redesign IT and workflows to quickly gain efficiencies that boost imaging volumes.
  • Build a culture of effective remote communication to retain clinical quality.
  • Standardize IT solutions where possible.
author - Sarah Hanson
Writer
Sarah Hanson
author - Jess Wallace-Simpson
Designer
Jess Wallace-Simpson
author - Jill Knapp
Project Manager
Jill Knapp
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2022 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.