The concept of Vendor Neutral Archive (VNA) seems to be gaining traction in the medical Imaging market. Why wouldn’t it? It makes a good deal of sense…addressing problems directly attributed to the way department PACS manage image data. Health Imaging & IT published a list of the top 10 PACS Problems in its July 2011 issue. In my opinion, the VNA directly addresses 7 of the 10 problems listed in that article. Categories include Integration, Downtime, Hanging Protocols, Interoperability, Out with the Old (data migration), Whose PACS? (Radiology or IT), and Disaster Recovery.
Just to be clear on the concept, I offer the following succinct definition. The Vendor Neutral Archive is an Enterprise-class data management system that consolidates primarily medical image data from multiple imaging departments into a Master Directory and associated consolidated Storage Solution, thus replacing the individual archives associated with departmental PACS…systems with unfortunate proprietary characteristics that limit their interoperability. By virtue of it consolidating all of the enterprise image data, the VNA effectively becomes the unified image data repository for the Electronic Medical Record system.
The problem with VNA is not the concept, the problem is the expense.
The properly configured VNA is a BIG system. It’s often nearly as expensive as the organization’s biggest PACS, since it will be managing all of the data from all of the department PACS, and the proper architecture is a mirrored, dual-sited configuration.
The point I want to make here, is that the properly configured VNA is big enough and expensive enough to require multiple years and multiple budgets…and this is very reminiscent of those first generation PACS deployments in the early 90’s.
Even as late as the mid 90’s, those first generation Radiology PACS required large investments. And there was admittedly some doubt as to whether that generation of PACS would successfully replace film. As a consequence, early PACS deployment strategies focused on solving more manageable, smaller problems with entry-level products that were modestly priced. The mini-PACS for CT, MR, and Ultrasound, and Teleradiology systems were considered PACS precursor products that could ultimately be stitched together to create the full blown department PACS. The typical PACS deployments in the mid-90’s were phased in over several years and several budgets.
Is there a multi-phase strategy for deploying a VNA? I think there is.
As long as the organization’s image data is being managed in individual department PACS, the data format is (to some degree) proprietary to the PACS. Consequently the organization faces the liability of future data migrations, whenever a department PACS is replaced with another vendor’s PACS, or even upgrade to a next generation PACS from the same vendor. Therefore the first step in a multi-phase VNA deployment strategy should be to migrate all of the organization’s image data out of the individual PACS and into a VNA-enabled Storage Solution…converting the data into a “neutral” format in the process. In this strategy, the organization is simply “parking” a copy of its image data for future use. The hardware and software configuration does not have to support any department PACS operations. This entry-level VNA is simply managing a copy of the image data “at rest”.
I refer to this first step as the Pro-Active Data Migration, and the ideal time to initiate this migration is at the mid-life of the organization’s largest PACS, which is frequently its Radiology PACS. By the time all of the historical data has been successfully migrated and cleansed, its time to replace that largest PACS. Now that the organization is in control of its image data, both the old and the new PACS vendors have much less leverage in the selection process.
Here are a few tips. (1) Look for a VNA vendor that understands that the value of the VNA software license used to manage image data “at rest” (data that is not being accessed by a PACS or a Viewing application) should be a fraction of the value of the fully-activated VNA license. (2) Consider forwarding the migrated image data to a vendor-managed Cloud Infrastructure, whose fee-for-study costs are probably going to be considerably less than those for an on-site, self-managed solution.
Once the organization has established a repository of one neutral copy of its image data, there are numerous second and third steps that can be chosen to complete the VNA build out.