Integrating imaging with EHRs through the Cloud

In advance of next month’s Society for Imaging Informatics in Medicine (SIIM) 2012 annual meeting, PARCA talked with K. Thomas Pickard of PACSGEAR. At SIIM, PACSGEAR  is announcing an upgrade to its popular MediaWriter technology to offer cloud-based open image exchange. In just 10 years PACSGEAR technology has been adopted by one in three U.S.hospitals. Thomas currently serves as PACSGEAR’s vice president of Marketing and Business Development. Previously he held roles at Emageon, eMed Technologies, and Thinking Machines. Thomas has an MBA from St. Mary’s College of California and has been working in healthcare IT for over 15 years.

Q. For those who may not be familiar with PACSGEAR, what do you do?

PACSGEAR essentially does two things: connect images to PACS and integrate them with EHRs. A new area of interest to your readers is the open image exchange.

K. Thomas Pickard

This new area is related to the PACS 2.0 announcement we made at RSNA. We talk about PACS 2.0 as the evolution of PACS. The idea of open image exchange broadens the picture to enable health information exchange—the ability to share images and results between facilities. Our focus is the interplay of open image exchanges and ultimately how those images end up in the EHR.

Q. What need does the PACSGEAR solution fill that hasn’t been addressed before?

Regarding image exchange, there are about a half dozen cloud-based exchange vendors that have developed in the last year or two in the U.S. Regionally, a group of hospitals will select a cloud-based vendor to facilitate image exchange between local facilities. While there are interesting examples of the Mayo Clinic-to-Cleveland Clinic kind of super specialty transfers, we are learning that most transfers occur locally. For example, if you have a group of mammography clinics, you want to be sure that last year’s mammogram performed across town is matched up with this year’s mammogram. Cloud-based image exchange is ideal for this scenario.

We saw cloud-based vendors gaining traction in various cities, which is great. PACSGEAR is a 10-year old company with a strategy of playing with everyone–we are sometimes referred to as the “Swiss” of DICOM. The challenge was to allow interoperability between vendors and continue being open. Since one-third of all hospitals in the U.S. have PACSGEAR equipment, we realized that customers could leverage their investment in PACSGEAR technology and add image exchange capabilities in software. We will demonstrate our open image exchange at SIIM, showing how our existing MediaWriter product can burn CDs and DVDs, as well as securely upload images to various cloud-based repositories.

Q. How are the images being uploaded to the cloud now?

Today, you sign-up with a cloud-based repository, and if you are doing a fairly large volume of images, you install what is called an edge device inside the hospital. The edge device is essentially a server that acts as a conduit between the imaging devices in the hospital and the cloud.  The challenge comes when you attempt to upload images between different cloud-based vendors. Rather than install multiple edge devices, we upgraded our MediaWriter product to function as an open edge device.  Now you have the option to write the study to CD, upload it to the cloud, or do both. It gives our customers a choice.
Q. There has been so much emphasis on connectivity among all the systems, that we sometimes lose sight of the ultimate goal. Are we getting any closer to the ideal state, from a physician’s point of view, of having all the information about a given patient right at his or her fingertips? Are we getting to a state where doctors have easy access to all the images, data, reports, and so on for a given patient?  and does the PACSGEAR open exchange solution move us toward that ideal state?

What you’re getting at is the Shangri-La—when can we provide physicians with a complete longitudinal medical record? PACSGEAR’s solutions move us in the right direction and definitely enhance patient care. It is a challenge to get all of the imaging devices within the hospital to talk to the electronic health record. Today, most hospitals are implementing electronic health records because of looming meaningful use requirements. With Stage 2 meaningful use, we are seeing interest in adding images to the electronic health record. We are very excited about our ability to integrate images between PACS and EHR—open image exchange moves us closer to that ideal state.