(HealthTech Wire / Interview) - Health authorities worldwide are recognising both the economic and clinical values of providing seamless access to a patient’s clinical data, images and administrative data, from whatever source, in a virtual system that spans departmental, organisational and even geographic boundaries. Hans Vandewyngaerde, Agfa HealthCare’s Vice President, EMEA region, discusses the company’s vision and practical solutions for achieving this aim.
Major healthcare issues such as chronic disease management are driving a move to 'patient-centric' care. What are the advantages of a patient-centric approach — which implies a whole-system level?
A patient-centric approach in healthcare — and thus the IT tools to support it — is becoming more and more indispensable. As we become older, diagnostic patterns change and there is a tendency to move from acute diseases to chronic diseases. A consequence is that people have multiple diseases at the same time. Hence healthcare becomes multidisciplinary, implying that one discipline is not anymore in the centre. This will make healthcare de facto patient-centric. Failure to adapt to this model will jeopardise delivery of good quality healthcare.
How should hospitals develop their systems to enable this?
The very beginning of a successful transition is a change of mind and a willingness to adapt the way healthcare providers work. Clinicians have to work in multidisciplinary groups, even reaching outside the boundaries of the hospital. This requires proper support from the IT tools they use. Hospitals should insist on the openness of their IT systems and compliance with communication standards. Hospitals should agree on a semantic interoperability roadmap which is both realistic and ambitious: sharing electronic documents, followed by clinical coding and structured export, then using semantic technology to reach full semantic interoperability.
Many hospitals are in the position of needing to modernize legacy systems and move away from paper records. What are the issues that should be considered and the best strategy to adopt?
Hospitals are taking one of three approaches to modernize legacy systems: a ‘single supplier’ route, in which they invest in an EPR system from a single vendor; a ‘best of breed’ route, in which they add to a suite of core systems, using technology from a range of vendors; and an ‘in house’ route, in which they attempt to undertake major development themselves.
The move towards a paper light (less) hospital should also include a plan to enable operational processes to take place electronically. This could include the move towards EPR solutions to enable real benefit from electronic workflows. It is not all about software, however; there needs to be a significant transformation programme within organisations in line with EPR programmes to manage both images and documents.
Whatever approach is taken, experience across the globe has shown that clinical engagement by those involved in using the systems is fundamental to effective implementations and the successful uptake of systems.
The rapid increase in the use of imaging in healthcare is having large implications on eg budgets and IT resources. How can hospitals cope with the increasing demand?
Hospitals have started to use imaging systems in a wide array of departments such as surgery, endoscopy, ophthalmology, paediatrics, pathology, dermatology, and many others. The problem is that these departmental systems do not support healthcare standards and therefore the information is not linked. Outside radiology and cardiology, medical imaging is virtually unmanaged and data is hidden away in departmental silos. This prohibits the use of medical imaging data for clinical and business benefits.
Hospitals can overcome the above issues by creating a comprehensive electronic medical record (EMR) that includes a patient's imaging information. Agfa HealthCare’s Imaging Clinical Information System (ICIS) is an enterprise imaging workflow platform that provides the longitudinal patient view, easily available to physicians within the hospital enterprise and beyond. It does so by consolidating all the imaging data from different departmental image management systems into a single repository. ICIS ensures a high quality of imaging metadata by applying standards based imaging workflows. Furthermore, ICIS embeds the XERO clinical image viewer inside the EMR and puts multidisciplinary imaging data in a clinical context, allowing physicians to make informed clinical decisions.
How important is it for neighbouring hospitals to collaborate in providing these services and how best can they do this?
Effective sharing of patient information is rightfully perceived as critical to patient care delivery. This can be achieved by the creation of a comprehensive electronic healthcare record (EHR). One vital component that is often overlooked is to have feature-rich, easy access to integrated, patient-centric, medical imaging records. There are two models for effective sharing of imaging data: a centralized model with a single imaging repository that consolidates imaging information originating from different facilities or enterprises; and a federated model with individual enterprise imaging repositories that are linked using standard IHE Cross-Enterprise Document Sharing for Imaging. Both models are supported by Agfa HealthCare’s ICIS.
Do you have any examples of where this is happening already?
The regional projects in France and the Nordics include a mechanism for sharing images and making them accessible to all, public and private, health facilities, as well as private practitioners. The image sharing infrastructure will be a basis for the development of the use of telemedicine.
In Germany, Diakonische Dienste Hannover created a ‘One HIS’ project aiming to unify their IT landscape and optimise the collaboration across the hospitals and clinics. The group selected Agfa HealthCare’s ORBIS HIS and RIS because it could easily be adapted to the specific requirements of the hospitals in their group. In particular, the nursing documentation, management of vital data and medical documentation were especially convincing to them. In addition, ORBIS integrates without interfaces, providing a seamless exchange of information.
Mr Vandewyngaerde, thank you very much for the interview. (HTW)
This interview is part of HIMSS Insights. © HIMSS Media c/o so2say communications
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