'Using Information to Drive Integrated Care'
"Healthcare Content in Context"
Mark O’Herlihy
Director of Healthcare
Europe, Middle East & Africa
Perceptive Software
© 2012 Perceptive Software. All rights reserved.
Presentation Focus
VNA + ECM: Build a Foundation for Data Liquidity
 ECM

Enterprise Content Management
 VNA

Vendor Neutral Archive, Enterprise Clinical Content Management
 Interoperability

The ability to share information between systems, internally or externally
 Data Liquidity

Delivering useful, relevant data to each stakeholder, users or
applications
© 2012 Perceptive Software, LLC. All rights reserved.
Healthcare Today
Content Challenges
Manage, Store, Access
Archived, existing and new
 Store Efficiently, Access on Demand
Healthcare Today
Content Challenges
Manage, Store, Access
Archived, existing and new
 Store Efficiently, Access on Demand
Process Challenges
Manual Unmanaged Processes
Business and clinical inefficiencies
 Discover, Design, Execute, Improve
Healthcare Today
Content Challenges
Manage, Store, Access
Archived, existing and new
 Store Efficiently, Access on Demand
Process Challenges
Manual Unmanaged Processes
Business and clinical inefficiencies
 Discover, Design, Execute, Improve
Application Challenges
Proprietary, inflexible systems
Access and functionality limitations
 Eliminate Silos, Deliver in EMR context
Your Enterprise Environment
Unified Content Platform;
Other Clinical Systems
• Eliminate content silos
• Radiology, Cardiology, Lab, HIM
• Optimize your EMR
• Complete the patient record
-Enterprise
Processes
outside ofSystems
EMR
non-clinical
•• Chemo
Treatment
Management
ERP, HR,
RevenuePlan
Cycle,
+ EMR
Process Strengths
• Provider
Credentialing
Registration
/ Admissions
 All
content
• Clinical Pathways, CPOE, Clinical
Messaging
 Any
source
 Any purpose
 In context
+ EMR Content Strengths
• Physician/nurse populated data,
Nursing
assessments,
MD
- Content
outside
of EMR
• Documentation
Photos, paper documents,
Correspondence, Faxes, Radiology
Dictation and Imaging, Pathology
HR
LAB
RIS
REG
HIM
EMR
ERP
© 2012 Perceptive Software, LLC. All rights reserved.
ECM + VNA
Build a Foundation for Data Liquidity
© 2012 Perceptive Software, LLC. All rights reserved.
VNA: Definitions
 VNA, PNA, PEA, ANP, UCA, CCF, UCP – WHAT!
 So what is it?
 VNA & ECM Combined Market Response
What is a
Vendor
Neutral
Archive
Acronyms
VNA – Vendor Neutral Archive (Industry)
PNA – PACS Neutral Archive (Mike Gray)
PEA – PACS Enterprise Archive (Industry)
ANP – Archive Neutral PACS (Paul Chang)
UCA – Universal Clinical Archive (Dell)
CCF – Clinical Content Foundation (Dr.
Rasu Shrestha - UPMC)
 UCP – Universal Clinical Platform (Acuo)






What is a VNA?
 “Platform” that provides long-term, disaster recovery, lifecycle
management
 Ability to easily share medical (data) by communicating with
different PACS
 Central repository for medical imaging data and other patient
data based on open architecture for multiple departments of
multiple hospitals.
 Accepts data irrespective of the originating PACS or other
viewing, acquisition and workflow management system
 Makes originating sources changeable without having to
change the data formats or interface of the archive.1
1
InMedica Research – Data Storage – Vendor
Neutral Architecture – 2012 Edition
VNA – Key Points
 Platform – much more than an archive, a platform “enables”
 Open architecture – based on standards or standards based
interfaces
 Accept data irrespective – source and format should blur and
become unimportant
 Sharing – data becomes liquid
 Originating source(s) changeable – customer has choice and
control to change data sources and consumers
VNA – Key Point
Interoperability Delivers Data Liquidity – Useful,
Relevant Data to Each Stakeholder, User or Application
Market Research
 IMS Research – Lexmark Acquires Acuo Technologies –
InMedica’s View http://www.imsresearch.com/blog/Healthcare_Data_Man
agement_Intelligence_Service_Monthly_Analysis_Feb_2
013/33
 ImagingBiz - The VNA Revealed: Understanding Its
Role in a Health-delivery system http://www.imagingbiz.com/articles/radinformatics/thevna-revealed-understanding-its-role-in-a-health-deliverysystem
 Applied Radiology - Enterprise vendor neutral
archive: Guide to riding the bandwagon http://www.appliedradiology.com/Issues/2013/02/Articles
/Enterprise-vendor-neutral-archive--Guide-to-riding-thebandwagon.aspx
 Gartner – Lexmark’s Acquisition of Acuo Technologies
Heralds a new ECM Focus for HDOs http://www.gartner.com/technology/reprints.do?id=11E1KL8D&ct=130211&st=sg
VNA and
ECM
Combine
– Market
Response
IMS Research – Rise of the Middleware
 It highlights the potential for
VNAs to help drive
hospitals towards crossenterprise data integration.
However, it also shows the
potential limitations of
VNAs to do so on their
own.
 It signals a trend towards
integration of third-party
systems to bring together
major hospital IT systems –
something we are calling
“The Rise of the
Middleware” (see third
section).
 It begs the question – what
is next for VNAs?
© 2012 Perceptive Software. All rights reserved.
Radinformatics – Need for Interoperability

Hospitals aren’t the only ones
consolidating, as evidenced by
Lexmark International’s recent
acquisition of Acuo
Technologies—a trend that
Shoemaker also views as a
natural progression.
“…especially as VNAs begin
to move out of the
radiology/cardiology space.
There is a large need for
interoperability between
enterprise contentmanagement systems and
clinical systems to provide a
complete record of structured
and unstructured content to
the EMR systems.”
© 2012 Perceptive Software. All rights reserved.
Applied Radiology – Not all VNA’s are created equal

Not all VNA solutions are
created equal, however, and
as each of these categories
continues to evolve, the story
keeps on getting better for all
of us. Enterprise content
management (ECM) firms
bridging with VNAs seems to
be the next logical
evolution, and this makes for
perfect sense in terms of a
broader strategy to manage all
content across the healthcare
enterprise. Across the board,
there is a push for greater
degrees of maturity around
content management in
healthcare, and my prediction
is for continued innovation in
this area.
© 2012 Perceptive Software. All rights reserved.
Gartner – New ECM Focus for HCOs




View ECM as an enterprise wide
information infrastructure that will
support multiple business and
clinical applications and
workflows.
Create a content ecosystem that
puts the user (the patient, clinician
or employee) at the center.
Resist installing stand-alone ECM
components such as document
management and imaging (DMI),
Web content management, and
digital asset management
applications.
Consolidate content repositories
and develop exit strategies for
departmental content applications
that are not considered critical and
can be addressed by an ECM
solution.
© 2012 Perceptive Software. All rights reserved.
Creating a New Reality in Healthcare
Completing The Patient Record
© 2012 Perceptive Software, LLC. All rights reserved.
Challenges of EMR/EHR Integration
Disparate departmental systems
and clinical data silos
Unstructured content in digital and paper formats, in
standalone servers, physical file cabinets and desk drawers,
sent by courier and carried by patients
Radiology PACS
?
Cardiology PACS
?
RIS/HIS/eMPI
Other clinical content
Typical
EMR/EHR
Installation
?
?
?
?
? ?
?
Missing health content =
incomplete picture of patient
healthcare experience
Unified Content Platform
 Enterprise Content Strategy
Liberated data – to capture, manage and access in context
ECM
Cardiology PACS
Radiology PACS Specialty PACS
EMR
Universal Access
ILM
Storage
SAN
NAS
Cloud
Deliver in Context




Semantic searching of multiple data elements from a single view
Pretrieve patient clinical content
Scanned
Analytics of unstructured content
Content
Eliminate information silos
Electronic
Forms
Digital
Photos
Enterprise
Imaging
© 2012 Perceptive Software. All rights reserved.
Content-based medical record
© 2011 Perceptive Software, LLC. All rights reserved.
Healthcare Vision
Device Output
DICOM
External Content
Traditional Content
Core System (EMR)
Clinical content
intermingled
with ECM in
results grid
Integration with patient
data from EMR
EMR
NHS #: 200803768
A powerful healthcare solution that drives both cost efficiencies and better
patient care through a single, enterprise-wide and content-based medical
record that is accessible via any electronic medical record (EMR) system
© 2012 Perceptive Software. All rights reserved.
Unified Healthcare Content Platform
Radiology PACS,
Cardiology PACS,
RIS/HIS/eMPI, other
clinical content
VNA
vendor neutral
archive
CAS/Cloud
NAS
SAN
Content-Based
Medical Record
Scanned documents,
reports, notes, photos,
videos, wave forms,
other content
ECM
enterprise content
management
CAS/Cloud
all content,
any source, any
purpose, in context
of the patient record
NAS
SAN
Questions?
Mark O’Herlihy
Director of Healthcare
Europe, Middle East & Africa
Perceptive Software
© 2012 Perceptive Software. All rights reserved.