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Nowrangi R, Perry LA, Regan J, Hulefeld D, O'Brien S, OConnor TJ, Towbin AJ. Creation of a Multi-vendor Image-Sharing Solution. J Digit Imaging 2022; 35:754-759. [PMID: 35995902 PMCID: PMC9485507 DOI: 10.1007/s10278-022-00624-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 10/15/2022] Open
Abstract
Transferring medical imaging studies from one institution to another is a common occurrence in today's medical practice. For the past two decades, radiology departments have relied on physical media (compact discs and digital video disks) and human couriers to accomplish image transfer. This mode of transfer is slow, prone to failure, and reliant on outdated technology. To address these shortcomings, multiple image-sharing vendors have created electronic, cloud-based solutions. While these solutions solve multiple problems, a new problem has been introduced: it is difficult to send or receive images across image-sharing platforms. In this work, we describe how we have developed a solution to share images across multiple vendor platforms.
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Affiliation(s)
- Rajeev Nowrangi
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Laurie A Perry
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Jennifer Regan
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - David Hulefeld
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Sarah O'Brien
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Timothy J OConnor
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA. .,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. .,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Larson DB, Krishnaraj A, Mendelson DS, Langlotz CP, Wald C. Moving Toward Seamless Interinstitutional Electronic Image Transfer. J Am Coll Radiol 2022; 19:460-468. [PMID: 35114138 DOI: 10.1016/j.jacr.2021.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022]
Abstract
The fact that medical images are still predominately exchanged between institutions via physical media is unacceptable in the era of value-driven health care. Although better solutions are technically possible, problems of coordination and market dynamics may be inhibiting progress more than technical factors. We provide a macrosystem analysis of the problem of interinstitutional medical image exchange and propose a strategy for nudging the market toward a patient-friendly solution. The system can be viewed as a network, with autonomous nodes interconnected by links through which information is exchanged. A variety of potential network configurations include those that depend on individual carriers, peer-to-peer links, one or multiple hubs, or a hybrid of models. We find the linked multihub model, in which individual institutions are connected to other institutions via image exchange companies, to be the configuration most likely to create a patient-friendly electronic image exchange system. To achieve this configuration, image exchange companies, which operate in a competitive marketplace, must exchange images with each other. We call on these vendors to immediately commit to coordinating in this manner. We call on all other stakeholders, including medical societies, payers, and regulators, to actively encourage and facilitate this behavior. Specifically, we call on institutions to create appropriate market incentives by only contracting with image exchange vendors who are committed to begin vendor-to-vendor image exchange by no later than 2024.
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Affiliation(s)
- David B Larson
- Chair, Commission on Quality and Safety, ACR; Member, Board of Chancellors, ACR; and Vice Chair, Education and Clinical Operations, Department of Radiology, Stanford University School of Medicine, Stanford, California.
| | - Arun Krishnaraj
- Chair, Commission on Patient- and Family-Centered Care, ACR; Member, Board of Chancellors, ACR; and Chief, Division of Body Imaging, Department of Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Virginia
| | - David S Mendelson
- Vice Chair, Informatics, Department of Radiology, The Mount Sinai Medical Center, New York, New York
| | - Curtis P Langlotz
- Member, Board of Directors, RSNA, and Associate Chair, Information Systems, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Christoph Wald
- Chair, Commission on Informatics, ACR; Member, Board of Chancellors, ACR; and Chair, Department of Radiology, Lahey Hospital and Medical Center, Burlington, Massachusetts; Tufts University Medical School, Boston, Massachusetts
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Johnson L, Callaghan C, Balasubramanian M, Haq H, Spallek H. Cost Comparison of an On-Premise IT Solution with a Cloud-Based Solution for Electronic Health Records in a Dental School Clinic. J Dent Educ 2019; 83:895-903. [PMID: 31010892 DOI: 10.21815/jde.019.089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 01/29/2019] [Indexed: 11/20/2022]
Abstract
Electronic health records (EHRs) are increasingly moving towards cloud-based web environments. While cloud-based EHRs claim substantial benefits at reduced cost, little cost-benefit research exists for dental schools. The aim of this study was to examine the cost-benefits of a cloud-based EHR compared to an on-premise client-server EHR in the University of Michigan School of Dentistry (U-M Dent). Data were collected in 2016 from the U-M Dent cost-benefit comparison of tangible and intangible factors associated with implementing a new EHR, using the Total Cost of Ownership (TCO) framework from EDUCAUSE. The TCO framework assessed three factors: foundational (overarching aspects: three items), qualitative (intangibles: 56 items), and quantitative (actual costs). Stakeholders performed factor grading, and relative assessment scores were derived for each item as well as the overall factor. The cloud-based EHR solution received higher foundational and qualitative factor summary scores. The overall cost of an on-premise solution over a two-year period was approximately $2,000,000 higher than a cloud-based solution. Cloud solutions did not carry any hidden costs, while such costs accounted for 8% (~$540,000) of the overall costs of the on-premise solution. Across the two-year period, both one-time and ongoing costs were higher for the on-premise solution than the cloud-based solution (by 40.5% and 20.5%, respectively). This study found that a cloud-based EHR system in the U-M Dent offered significant cost savings and unique benefits that were not available with the on-premise EHR solution. Based on cost, the U-M Dent has made a case for cloud-based EHR systems.
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Affiliation(s)
- Lynn Johnson
- Lynn Johnson is Professor and Associate Dean, University of Michigan School of Dentistry; Cassandra Callaghan is Director of Dental Informatics, University of Michigan School of Dentistry; Madhan Balasubramanian is Sidney Sax National Health and Medical Research Council Research Fellow, University of Sydney, Australia and King's College London, United Kingdom; Haris Haq is a Consultant, Collaboration for Health IT; and Heiko Spallek is Professor, Head of School, and Dean, The University of Sydney School of Dentistry, Sydney, New South Wales, Australia.
| | - Cassandra Callaghan
- Lynn Johnson is Professor and Associate Dean, University of Michigan School of Dentistry; Cassandra Callaghan is Director of Dental Informatics, University of Michigan School of Dentistry; Madhan Balasubramanian is Sidney Sax National Health and Medical Research Council Research Fellow, University of Sydney, Australia and King's College London, United Kingdom; Haris Haq is a Consultant, Collaboration for Health IT; and Heiko Spallek is Professor, Head of School, and Dean, The University of Sydney School of Dentistry, Sydney, New South Wales, Australia
| | - Madhan Balasubramanian
- Lynn Johnson is Professor and Associate Dean, University of Michigan School of Dentistry; Cassandra Callaghan is Director of Dental Informatics, University of Michigan School of Dentistry; Madhan Balasubramanian is Sidney Sax National Health and Medical Research Council Research Fellow, University of Sydney, Australia and King's College London, United Kingdom; Haris Haq is a Consultant, Collaboration for Health IT; and Heiko Spallek is Professor, Head of School, and Dean, The University of Sydney School of Dentistry, Sydney, New South Wales, Australia
| | - Haris Haq
- Lynn Johnson is Professor and Associate Dean, University of Michigan School of Dentistry; Cassandra Callaghan is Director of Dental Informatics, University of Michigan School of Dentistry; Madhan Balasubramanian is Sidney Sax National Health and Medical Research Council Research Fellow, University of Sydney, Australia and King's College London, United Kingdom; Haris Haq is a Consultant, Collaboration for Health IT; and Heiko Spallek is Professor, Head of School, and Dean, The University of Sydney School of Dentistry, Sydney, New South Wales, Australia
| | - Heiko Spallek
- Lynn Johnson is Professor and Associate Dean, University of Michigan School of Dentistry; Cassandra Callaghan is Director of Dental Informatics, University of Michigan School of Dentistry; Madhan Balasubramanian is Sidney Sax National Health and Medical Research Council Research Fellow, University of Sydney, Australia and King's College London, United Kingdom; Haris Haq is a Consultant, Collaboration for Health IT; and Heiko Spallek is Professor, Head of School, and Dean, The University of Sydney School of Dentistry, Sydney, New South Wales, Australia
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