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  • November 29 2011

    RSNA 2011: Creating a visual EHR

    Cerner's booth at RSNA 2011

    Adding digital images to a patient's electronic health record (EHR) greatly simplifies the problem of capturing, managing, storing, and distributing these images. Cerner's ImageAware solution allows you to capture all media types including document imaging, ECG and other waveforms, wound care photos, dermatology photos, PACS images and pathology images in a single virtual archive, creating a visual EHR.

    There are numerous advantages to this model. Clinical efficiency and accuracy are enhanced by having access to both EHR data and images in a single location. By eliminating silos of information across various departments, IT management is also simplified. This will help keep the cost of expensive imaging procedures down and improve patient safety by eliminating the redundant request for images.

    We had the pleasure of interviewing Scott Porter, Cerner's vice president of ImageAware, about this technology:

    Why is digital imaging such a critical component of the EHR?

    The integration of medical objects with patient data is essential to creating a comprehensive EHR. Modern health care generates and regularly uses a variety of media files—video, audio, signal data and images—for diagnosis and treatment. As a result, it is critical that all of this information is readily available to physicians, nurses and clinicians in a meaningful context. Furthermore, by automating image-centric workflows, it allows organizations to increase productivity and create a single enterprise wide visual electronic health record.

    What does end-to-end cardiology integration entail?

    Cerner's approach to providing our clients with an end-to-end cardiology solution is to integrate all the disparate Cardiology workflows through our PowerChart Cardiovascular solution embedded in Cerner's EHR. While offering tight integration with 3rd party components, PowerChart Cardiovascular centers its users in the patient record, offering the necessary solutions for the varying workflows while offering quick and easy access to the relevant EHR data that cardiology care givers need.

    How does digital imaging relate to hospitals achieving Meaningful Use attestation?

    Unfortunately, the Meaningful Use rules as they stand today are not conducive to specialists like radiologists and pathologists that typically don't directly interact with patients. However, most of the radiologists qualify as eligible providers. This poses a significant challenge to these providers since they would need to acquire HIT systems and add workflow processes that don't directly benefit the care they provide today. The cost and productivity impact will often far outweigh any benefit from the MU payments, but with the penalty phase on the horizon it's not something they can ignore.

    Given all that, we're seeing a mix of approaches in the radiology domain around Meaningful Use. Radiologists that are associated with a broader institution should work with their institution to be included in their comprehensive MU approach for eligible providers. For the ones that cannot be included in a broader institution's approach… Some are adding the needed HIT and processes so they can attest and avoid the penalties – Cerner can provide all the necessary tools if radiologists choose to go this direction. Others are in a ‘wait and see' mode with the hope that the rules are altered to accommodate for their unique situation. There are actually discussions taking place with the appropriate MU committees around this topic, but nothing has changed so far.

    One other aspect worth noting with regard to media and Meaningful Use is that there have also been discussions around the total lack of media in stage 1. Media is part of the patient record, whether that's radiology images, would care photos, waveform data, or a video from a gait study. The current state of how this is handled across institutions is not conducive to effectively providing care or care coordination. Our hope is that future stages will address this shortcoming.

    How would you describe the ImageAware framework?

    The ImageAware framework is built and designed to be the single source of truth for all imaging and multimedia content in the context of the EHR. This platform is capable of handling all imaging and media generated as a byproduct of the care process. It's all about making the right information available to the right people, at the right time… and that means it should all be in the context of the EHR, not in various disparate silos of information.

    Describe some of the advancements Cerner has been able to make in regards to radiology information systems?

    We have been focused on leveraging the power of our integrated EHR, making critical, relevant EHR data readily accessible to radiologists during image interpretation, thus providing our clients with an “only Cerner can” feature.

    What has Cerner done to position itself as a global radiology information systems leader?

    Cerner is dedicated to achieving success in the global radiology markets. Our associates have held face-to-face meetings and walkthroughs to understand key geographical workflow challenges. By identifying key collaboration partners, Cerner has addressed international workflow gaps and turned around needed enhancements to address these. While there are obviously key requirements per location, the overall workflow and clinical needs for the radiologist and the department are essentially the same throughout the world. RadNet is a world class radiology information system on its own, and when you combine that with the EHR integration, it's a solution that can't be topped.

    Cerner is exhibiting at the Radiological Society of North America National (RSNA) conference at McCormick Place, Chicago Nov. 27- Dec. 2, 2011, booth #6208.

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