1. © 2012 TeraMedica, Inc. Take Control of your Image Data Jonathan Shoemaker Senior Consultant Ascendian Healthcare Consulting

2. © 2012 TeraMedica, Inc. Course Presenter Bio Overview 18 years experience Clinical / Technical Background Solutions Engineer, 3 rd Party PACS Integration Engineer, HL7 Integration Engineer, Database Configuration Architect, Workflow specialist, Manager Radiology Informatics, PACS Administrator, Radiology Technologist Experience in large, complex installations as well as small single facility imaging centers. Published many articles (Executive Insight Magazine, HIMSS, Advance for Imaging)

3. © 2012 TeraMedica, Inc. Lesson One Taking Control of Your Image Data

4. © 2012 TeraMedica, Inc. Current Environments Silos Non Interfaced systems Non Standard Deployment Non Adherence to IT Standards Dirty Data Non Redundant storage Multiple applications Zero Interoperability No Direction/Vision

5. © 2012 TeraMedica, Inc. Business Verticals involved with a VNA Departmental service lines which may contain clinical imaging data RadiologyEndocrinology CVISHematology ER / Trauma FAST US ScansNephrology PathologyNeurology LABPulmonology ObstetricsPediatrics OphthalmologyRehab Medicine GastroenterologyUrology DermatologyOncology

6. © 2012 TeraMedica, Inc. Current vs Future PACS Data Growth **Client Storage Calculations

7. © 2012 TeraMedica, Inc. VNA Requirements Ability to utilize current and future architecture Ability to intelligently integrate into information systems Ability to apply ILM to data objects Ability to reduce image migrations Ability to Manage DICOM and Non DICOM Ability to provide or work with 3 rd party univiewer Ability to provide facility with migration tools Ability to securely segment data for clinical and non clinical use.

8. © 2012 TeraMedica, Inc. VNA Restraints At the mercy of the Clinical Archiving System to follow Standards and Standard file formats. Require the Clinical archiving system to provide adequate file header information for proper file aggregation and dissemination Proprietary fields in DICOM Header Proprietary Data Types Clinical Archiving Systems non adherence to Standards.

9. © 2012 TeraMedica, Inc. Defining your need What is your Strategic Roadmap? What is your Storage Roadmap? What are your Clinical Dependencies? How should your enterprise obtain Object Access? What is your plan for HIE, RHO? What is your plan for ACO? What are your legacy dependencies? What is your need now and in the next 10 years?

10. © 2012 TeraMedica, Inc. Meaningful Use - Dissemination VNA Manages dissemination of images to other repositories. Remains record keeper for longevity of the object. If Univiewer is utilized, Images are streamed from archive to client. Maintains security accounting and audit, where as if a DICOM push is used there is no record of how the receiving system manages the data. Deliver all content in consistent clinically relevant manner.

11. © 2012 TeraMedica, Inc. Questions Take Control of your Image data with a VNA Jon Shoemaker Senior Consultant, Ascendian Healthcare Consulting jshoemaker@ascendian.com