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Navy Medicine Clinical Imaging Archive (NCIA) Symposium Brief Michael Fortier 4-6 June 2012.

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Presentation on theme: "Navy Medicine Clinical Imaging Archive (NCIA) Symposium Brief Michael Fortier 4-6 June 2012."— Presentation transcript:

1 Navy Medicine Clinical Imaging Archive (NCIA) Symposium Brief Michael Fortier 4-6 June 2012

2 BRIEFING OUTLINE 1.History 2.Current Methodology 3.A New Approach to Imaging 4.Timeline 5.Benefits of a NCIA 6.Challenges 7.Future Possibilities 8.Conclusion PURPOSE: Information briefing to provide and update and roadmap of the current lifecycle replacement of the Navy imaging archives. Slide 2 of September September 2014 – FOUO –

3 CURRENT METHODOLOGY PACS with individual archives Slide 3 of September September 2014 – FOUO –

4 CURRENT METHODOLOGY Command Centric PACS Specialty Specific Systems – Radiology, Cardiology, Dental, etc… Silos of image data – each system has it’s own (usually proprietary) archive. Sharing relevant image data between specialty systems is manual and problematic. Some PACS allow images taken from within the command to seen throughout the command. Viewing images between commands requires manual sending and receiving of images, or patients with CD. Migrate all the data to the new system (even with the same vender sometimes) TBs of data, years to complete, every time, every region, at a huge cost This is just going to get worse ~8 million radiology studies currently being stored (100+ TBs) ~1.2 million radiology new studies a year (10+ TBs) All the other imaging types are starting to be captured Slide 4 of September September 2014 – FOUO –

5 A NEW APPROACH TO IMAGING Separate the archive from the PACS / Workflow Engine Individual clinical workflow engines specific to specialty needs Workflow management separate from medical image archive management Move away from proprietary standards to open standards VNA (vendor neutral archive) PNA (PACS neutral archive) IHE compliant archive (Integrating the Healthcare Enterprise) XDS, XDS-I, PIX, DICOM part 10 Endoscopy Radiology Cardiology Dental Opthalmology Dermatology CurrentEnd State Opthalmology Dental Radiology Cardiology Dermatology Endoscopy Clinical applications Pre-decisional – FOUO – Pre-decisional Slide 5 of September September 2014

6 A NEW APPROACH TO IMAGING FOR OFFICIAL USE ONLY 6 Slide 6 of September September 2014

7 A NEW APPROACH TO IMAGING One Global Archive All images in the archive are viewable at all sites Images are federated across multiple facilities and sent to the primary Navy archive Slide 7 of September September 2014 – FOUO –

8 Slide 8 of September September 2014 – FOUO – One Global Archive All images in the archive are viewable at all sites Images are federated across multiple facilities and sent to the primary Navy archive The nodes will automatically propagate studies A NEW APPROACH TO IMAGING

9 Slide 9 of September September 2014 One Global Archive All images in the archive are viewable at all sites Images are federated across multiple facilities and sent to the primary Navy archive The nodes will automatically propagate studies Disaster recovery internal to the solution A NEW APPROACH TO IMAGING

10 TIMELINE Significant Milestones May RFP released Sep Award Oct Begin Global Archive project Nov Begin specific site projects / migration ongoing Timeline from one vender Slide 10 of September September 2014 – FOUO –

11 BENEFITS OF A NCIA All completed images are viewable Completed status is based on workflow Appears to be one archive Allow multiple IHE-complaint COTS workflow systems to use the archive Radiology PACS Cardiology PACS Optometry iOR Document Management Medical Photos Dental Imaging Reserve Health Readiness Record End State Opthalmology Dental Radiology Cardiology Dermatology Endoscopy Clinical applications Slide 11 of 18 3 September September 2014 – FOUO –

12 BENEFITS OF A NCIA Built-in disaster recovery The system can self-replicate across multiple sites and/or the two Global Archives No Migration Data stored in a standards-based system (DICOM part 10) Huge cost savings ~15% of the cost of a new system is migration The old system has to be maintained during migration Years after it is not used by providers Hardware agnostic Interface Level Storage Management Level SAN SCSI CAS/COSNAS SATA TAPE OTHER Slide 12 of September September 2014 – FOUO –

13 CHALLENGES Multiple CHCS hosts (Multiple Patient IDs) The new DEERS ID/MPI (Master Patient Index) will correct this VNA solutions can do cross-domain patient identifications Bandwidth The local sites will store 3-5 years of local images in FIFO Cache After 3 years, less than 1% of images are viewed again Enterprise Workflow Support Does not support enterprise workflow 1 st 2 nd 3 rd 4 th 5 th Views Age The retrieval of images drops significantly after the first year Slide 13 of September September 2014 – FOUO –

14 CHALLENGES Management Paradigm shift: Radiology images to medical images / artifacts System administrators are already in place Separating archives from workflow components enables easy transfer of responsibilities of archive management Potential for additional resources based upon policy decisions Policy VNA technology is mature Need policy and guidance for MTFs Compression policy Retention policy Management policy Integration policy Slide 14 of September September 2014 – FOUO –

15 FUTURE POSSIBILITIES The VNA can also be used as an imaging repository Add a zero download clinical viewer Can store multiple formats (jpg, pdf, mp4, wav) Provides XDS registry/repository Any number of XDS/IHE-compliant COTS workflow / ingestion systems can flow into it Document scanning, video recording, photography, dental HAIMS would only need one touch point for all images / artifacts within the Navy Simplify deployment Smaller footprint of HAIMS within MTFs Less hardware Smaller sustainment costs Slide 15 of September September 2014 – FOUO –

16 FUTURE POSSIBILITIES Interoperability with other Services Army heavily involved in the contract requirements generation, pursuing the same strategy System can integrate and query other archives Other Services’ archives (Air Force, AGFA IDCs) with implementation of network connections Theater Image Repository (TIR) Flexibility in infrastructure Scalability provided through increasing node storage capacity or adding nodes Reduction in number of nodes possible without migration requirements Pre-decisional – FOUO – Pre-decisional Slide 16 of September September 2014

17 CONCLUSION The initial driver for this effort is the projected savings on migration time and costs Maturity of Vendor Neutral Archives results in unprecedented capability to share information across the enterprise BUMED guidance and policy required to facilitate complete paradigm shift Can be accomplished within 18 months using COTS products Slide 17 of September September 2014 – FOUO –

18 Questions Slide 18 of September September 2014 – FOUO –


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