The electronic health record is meant to aggregate all the necessary patient information into one accessible, streamlined platform. While EHRs are being lauded for their abilities to compile such pertinent data, it's surprising that one of the most ubiquitous pieces of a patient's diagnostic process has been almost completely left out of the loop: medical imaging.
"In traditional systems, what usually happens is an X-ray image is taken, a CT or MR, and then it's interpreted by radiologists, and radiologists send out a written report that goes to the physician with a diagnosis or comments," says Michael Green, president and CEO of the Americas region of Agfa HealthCare, a provider of integrated IT solutions. "There's been clinical use to have the image for the physician to look at instead of simply reading the text report."
While imaging is nothing new to healthcare, its presence in shared, centralized data systems is only a recent innovation. Enterprise imaging, or visualizing the EHR, has evolved over the past three or four years, stemming from switching diagnostic imaging from an X-ray film image to an electronic image, making the image easier to share, Mr. Green says. Similarly, he explains, the increasingly common use of digital cameras, smart phones and multispecialty imaging systems presents clinical information that can be shared to improve patient care.
The technological ability is slowly emerging that allows the images to be sent out of the radiology and non-radiology departments and into the wider enterprise via the EHR where other physicians within the hospital, as well as a patient's physician outside the hospital, can have secure access to the images.
"Enterprise imaging is the ability to bring all of those images together and make them available in the EHR of the patient to all the caregivers who are caring for that patient," he says.
When all caregivers have access to an image, overutilization and unnecessary imaging orders decrease because physicians can see what images have already been taken and can avoid repeat pictures.
"Without access to images, you can have a lot of cases where physicians may request additional imaging procedures they don't require," Mr. Green says. "Every hospital can identify a certain percentage of images that are done that are not necessarily needed, purely because the particular physician at the time cannot see those images."
The accessibility of images goes both ways, with patients being able to access and even send pictures to their providers. For example, Mr. Green says enterprise imaging has proven useful in wound care treatment. While patients discharged with wounds may have to come back to the hospital to have the wound treated, with enterprise imaging, the patient can simply send an image taken with a digital camera to physician to examine and address, potentially saving an unnecessary hospital trip, he says.
Enterprise imaging is still in its early adoption phase, but it is evolution and expansion is growing, Mr. Green says, estimating approximately 10 to 15 hospitals have implemented this approach to data sharing.
"Nearly every hospital has a [picture archiving system], so they're doing the departmental imaging. Now, enterprise imaging is a kind of second stage of that," he says. "Having access to the complete imaging picture would hopefully give a more reliable diagnosis. There should be an improvement in patient care and more productivity from a physician point of view."
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