I’m fortunate to have the opportunity to travel all over the country and examine different hospitals’ workflow and challenges first-hand. From small community hospitals to large, multi-state IDNs, I have a 35,000 foot view of common workflows and issues. That’s because I work for a vendor. The clients I service aren’t so lucky. “Running lean” is the common theme of this decade. Every employee is doing the work of two or more people in the same 40, 50, 60 hour work week. Finding a half-hour to complete some actual research on new solutions in healthcare is a rare luxury. There are too many budget cuts, server failures, reimbursement changes, Meaningful Use attestations, software upgrades and then bugs and then patches, and oh yeah, that teeny little task of saving lives.
Good, reliable information is tough to come by these days. Who can be trusted to provide unbiased, accountable, and educated advice when it’s time to look for a new solution to fix an old problem? For better or for worse, most of my clients end up turning to one or more vendors for this enlightenment, which I suspect has lent a hand to the creation of this list, the top five image-sharing misconceptions I see in the market today:
- Image-sharing requires a cloud. This should be corrected to read “While image-sharing can be cloud-based, it can also occur with an onsite solution owned by the medical center.”
- Electronic viewers are not HIPAA compliant. Every time I hear the word “HIPAA,” I hear a dramatic little jingle from a horror movie in my head….here comes the monster! In a world where privacy seems to be disappearing as quickly as your socks (only one though), I respect HIPAA for venturing into the cold night like a lone ranger to protect what little privacy we have left. The problem is their rules are vague while their reprimand is severe. I’ve seen looks of pure panic sweep across the faces of my audience as soon as I mention “emailing a link to a study.” That can’t be HIPAA compliant! Well, actually, it is. HIPAA mandates that covered entities must protect the availability, integrity and confidentiality of PHI (did I mention the rules are vague?). In fact, electronic image sharing is more secure than burning a CD – the information is encrypted, audited, secure, and can’t be left on a bus or train.
- Image sharing requires a VPN. Yes, while a “proper” DICOM push must occur over a VPN (virtual private network), there is plenty of technology out there that facilities HTTPS transmission (still encrypted – see #2) without destroying the DICOM at all. VPNs are annoying, expensive, and confusing. Let’s keep them for the pertinent tasks and let image-sharing live on HTTPS.
- There isn’t enough staff to manage image sharing (remember “running lean?”). The idea of introducing yet another application to the hundreds of current applications running in a healthcare facility can be daunting. Who will manage it? What my clients don’t realize is that image-sharing doesn’t just add an application; it alleviates many current headaches and time vacuums. This could be the staff managing the file room and burning CDs, the personnel running around trying to view a CD, the duplicate exams that often occur when a CD is unreadable, staff installing PACS viewers in the homes and offices of referring physicians….the list goes on and on. Our image-sharing clients will tell you that adding this application actually saved them time and resources.
- An image sharing solution is more expensive than just burning CDs. What does burning a CD cost? I ask this question often, and in all but two hospitals, my clients have no idea what the “true” cost of a CD is. They all know what the raw charge of a disk is – a dollar or less, but what about the time of the personnel burning them, the CD burners and their maintenance, courier or mail charges, and the ultimate cost – patient safety when that CD doesn’t make it to the next physician or is unreadable once it arrives? We’ve found that the true cost of a burned CD runs closer to $15. For a hospital burning just 10 CDs each day, that adds up to a whopping $400,000 every single year.
Just remember, if it’s on the internet, it doesn’t make it true.