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Taking the “A” out of PACS

Taking the “A” out of PACS. Standards Based VNA Concepts. Agenda . Current State Market Research The “next” PACS Vendors considered for VNA Reasons for Considering a VNA Vendor Neutral Archiving Requirements for a VNA Providers of VNA Architecture of a VNA Next Generation VNA

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Taking the “A” out of PACS

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  1. Taking the “A” out of PACS Standards Based VNA Concepts

  2. Agenda • Current State • Market Research • The “next” PACS • Vendors considered for VNA • Reasons for Considering a VNA • Vendor Neutral Archiving • Requirements for a VNA • Providers of VNA • Architecture of a VNA • Next Generation VNA • Strategy for deploying a VNA 2012 Acuo Technologies® Proprietary and Confidential

  3. Current State

  4. What are the drivers for Healthcare IT • Growth of Data • Size of Studies Increasing • CT – Cath – Path • Number of Studies Increasing • Access to Data • Number of Users Requesting Data • Big data sets moving across the wire • Complex Business Models • Association and integrations of healthcare providers • EMR enablement – images critical • Requirements Are Constantly Changing • Government Mandates Compliance with Current and Future Rulings • Dynamic Vendor Environment • Standards Become More Important 2012 Acuo Technologies® Proprietary and Confidential

  5. What is Current Situation in Imaging? Applications Own The Data • PACS control Data Format and often the Storage Hardware, OS, and Networks • PACS Proprietary Format Makes It Difficult To: • Replace a PACS • Add New Applications To Existing Storage System • Share Data Between Applications • Add New HW or IT Strategies, i.e. Business Continuity • Integrate with HIS, EMR and other IS systems • Data Migration Is Required When: • Selecting A New Vendor • Upgrading - Either Replacing Storage or PACS SW Upgrade • Adds Cost, Reduces Flexibility and Increases Complexity 2012 Acuo Technologies® Proprietary and Confidential

  6. Market Research

  7. Gray ConsultingP.O. Box 972Novato, CA 94948-0972Phone: 415-892-0943Cell: 415-328-2842Fax: 415-897-0384Email: graycons@well.com http://www.graycons.com/about/

  8. Vendor Neutral Archiving

  9. What a VNA MUST Do • BREAK the Proprietary Link to YOUR data • Eliminate Custom Engineering • Integrate via Configuration • Must be GUI driven by the customer • Require full Standards-based Interoperability • Manage Storage as an Enterprise Resource • Enable PACS as Applications, Not Storage Systems • Provide Efficient Access and Administration • Results: • Higher Quality of Service - BC – Dedicated Viewer • Streamlined Operations/Improved Productivity • Effectively Lower TCO In All Areas 2012 Acuo Technologies® Proprietary and Confidential

  10. Vendor Neutral Archiving • A True Vendor Neutral Archive solution is a single set of software tools to centralize all medical imaging systems into one perpetual repository. • Simpler management • Seamless migrations • Independent of PACS deployment • Scales to meet all your capacity needs After Before 2012 Acuo Technologies® Proprietary and Confidential

  11. What is expected now Any-ology 2012 Acuo Technologies® Proprietary and Confidential

  12. How are non-DICOM objects handled? B C A D DICOM Wrapping File System Interface XDS Native Content Management • Standards based – IHE driven • Standardized Information Model for store / retrieve / display • Standardized Information Model for store / retrieve / display • Normally existing integration through CIFS/NFS • Web Services Integration Custom API XDS Application Neutral Middleware Direct Application Read/Write Enterprise Storage Platform • Costs associated with integration • Adapter development • Portability (compatibility with other systems) • Accessibility challenges • Increases migration liability • Normally lower cost integration • Proprietary file format • Proprietary Information Model • Doesn’t solve data mobility issues • Many systems store content in database directly • Can facilitate ILM • Uniform Image Viewer Portability • Established use in healthcare • Additional DICOM SOP’s being added all the time • Does not easily support non-image content types • Can facilitate ILM • Requires deployment across entire enterprise • Expected to emerge in HIE projects • CONSIDER: If this route is chosen use an XDS information model 2012 Acuo Technologies® Proprietary and Confidential 15

  13. Additional Expectations of a VNA • Enables a Clinical viewer for the EMR that allows viewing of all images • Provide one integration point for images • Move to a rendering viewer strategy with no image cache • End of Migrations • It is a replacement market in PACS • Robust support of next generation storage • Business continuity • Cloud Hosting 2012 Acuo Technologies® Proprietary and Confidential

  14. Who provides VNA • Pure Play VNA Vendors • Software only – smaller - innovative • No Diagnostic Viewer • Infrastructure Providers • Often already providing enterprise storage solution • Often use Pure Play VNA Vendors for software • Solution Providers • Combine software, hardware, network and service • Offer “one-throat-to-choke” • PACS Providers • Send us everything, we can manage it. • Many deployments, few if any without their PACS • Will require future migration 2012 Acuo Technologies® Proprietary and Confidential

  15. CIFS, NFS, API TAPE OTHER Cloud based CAS SATA Choice Enterprise Archive Strategy Image Enabled RIS / HIS / EMPI Future Imaging DICOM DICOM HL7 DICOM / WADO ??????? EMR Enterprise Image Archive (VNA) Interfaces Custom Radiology PACS Cardiology PACS Storage Management Software HTTP/REST Proprietary File Access iSCSI CIFS, NFS, API SCSI SAN DISASTER RECOVERY SITE MAIN FACILITY

  16. Next Generation VNA’s • Multiple Patient ID’s • PIX (Patient Identifier Cross Referencing) • Universal Viewer • Provide one integration point for images • Separate the PACS viewer from EMR viewer • Ensure that the clinical viewer is robust • XDS Registry and Repository • XDS provides standards support for management of non-DICOM without locking customers into vendor proprietary technology • VNA’s should provide simplified Web Services for ease of non-DICOM compliancy the create XDS context automatically within the VNA 2012 Acuo Technologies® Proprietary and Confidential

  17. Develop the Strategy Build a Plan to Gain Control • Sever the Proprietary Link Between Applications (PACS, CPACS) and Storage • Require Applications to Interoperate in a High Performance, Standards-based Format • Identify PACS as a Valuable Departmental Workflow Application, NOT Storage Systems • Decide on an Infrastructure Solution • Storage/Network • Business Continuance Strategy • Bring DICOM Skills into IT • Come to Terms With the Inevitable Migration Commit to Make it Your Last Migration! 2012 Acuo Technologies® Proprietary and Confidential

  18. The Solution! There are a number of strategic approaches to building a Vendor-Neutral Enterprise Archive Take the “A” out of PACS • Migrate to VNA platform BEFORE PACS replacement • Put out RFP for the non-archiving portion of PACS • Connect new PACS directly to VNA • Shut Down Legacy PACS quickly after new PACS is up 2 4 3 5 1 PACS B Lifetime PACS A Lifetime Data Migration phase VNA Lifetime 2012 Acuo Technologies® Proprietary and Confidential

  19. Questions?

  20. Thank you Gillian Ryan – Director of Sales (773) 368 – 6899 gryan@acuotech.com

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