In early 2019, Dicom Systems hosted a webinar on teleradiology and enterprise imaging in partnership with Life Image. We discussed the methods available to healthcare businesses today for improving imaging data flow, enterprise imaging, teleradiology, and how they have come to evolve. We were also privileged to have a representative of Southern California Permanente Medical Group (a Kaiser Permanente subsidiary) join the discussion and share a perspective from the trenches. This discussion elucidates how you can take steps to streamline and speed up the dissemination of imaging data across the healthcare enterprises, improving efficiency and the continuum of care.
Historically, healthcare enterprises have had to manage multiple fragmented systems for internal radiology versus external imaging workflows, such as cloud image sharing and teleradiology. In this webinar, SCPMG, a user of both platforms, will share common clinical use cases on the results they have seen from leveraging complementary systems to automate workflows that previously required substantial manual intervention. Learn how you can optimize your next-gen Enterprise Imaging by integrating extramural and intramural data, resulting in elegant and streamlined imaging workflows.
This timely conversation will cover how your healthcare business can benefit from maximizing clinical impact and building a deeper level of interoperability.
- Florent Saint-Clair, EVP, Dicom Systems
- Richie Pfeiffer, VP, Product and Market Development, Life Image
- Bruce W. Hoel, Imaging Solutions Architect, SCPMG
This excerpt from the webinar examines:
- A sample image workflow from Southern California Permanente Medical Group (AKA KP).
- How KP providers ensure longitudinal patient records are intact and available at all locations.
- A vision for the future where image sharing and enterprise imaging are one and the same.
Note: This conversation has been edited for length and clarity.
Florent Saint-Clair: Good morning and good afternoon everybody. I am absolutely thrilled to be joined by my co-panelists, Mr. Richie Pfeiffer from Life Image and Bruce Hoel from Southern California, Permanente Medical Group, also known as Kaiser Permanente, Southern California. We will have an opportunity for Q&A towards the end of our presentation, and we very much look forward to everyone’s participation.
A Vision For The Future of Enterprise Imaging
Florent Saint-Clair: The intent of this webinar is for us to portray what our vision is for this industry. And I believe, we’re joined among our participants by one of our illustrious colleagues, Mr. David Brown, also from Southern California Kaiser Permanente. I’m hoping, David can hear us and will also enter some questions in our Q&A box, but the reason I mention David is very specific. Ten years ago, I was a panelist with the founder of Life Image, and he asked us a very fundamental question like only David knows how. He said,
Why don’t you, image sharing vendors, function more like the cell phone companies?
And it’s true if I have an AT&T phone and I want to call a Verizon customer, I don’t need to first make sure that there is interoperability between the two phone vendors, I can just dial the number and I’m now on the phone with a Sprint or a Verizon customer without having to do any kind of interoperability work to do so.
Why doesn’t image sharing work that way? It’s very simple, it’s market forces. Making it easy to interoperate with other vendors means relinquishing power, which is not good for their bottom line at times. And so, our vision for this industry is to take the split vision of enterprise imaging and turn it into a really elegant framework where image sharing and enterprise imaging are one and the same.
A little bit about Life Image: we were the company that started the medical exchange business 11 years ago. And it all began because we were trying to get medical images and reports that were on a CD from a referral provider into the PAC system of an academic medical center, those centers like UCSF, UCLA and MD Anderson. And then over time, we developed a digital technology that allowed our network to grow, initially across just the US, but then globally. And we were able to eliminate the use or even the need for hard copy media, so we could allow for the transfer of those medical images and those associated reports over our cloud network. And that dramatically improved the speed and the efficiency for the benefit of those patients and providers.
How Kaiser Powers Teleradiology
Customers like Kaiser Permanente utilize this capability. And Bruce will go over this later in the webinar. We currently connect over 150,000 providers, and that is across 1,500 hospitals with 8,000 affiliated sites to those hospitals. In addition to the medical images and reports, we can also transport all file types, those file types could be lab results, EEGs, genomic data, phenotypes, all kinds of information, right? We serve all providers across the entire health care continuum. So, over this past year, we’ve exchanged over 10 million clinical encounters per month, that’s significant. And in addition, we are also the only exchange network that actually works with the federal government and that’s due to our security standards today. We’re able to sustain being the largest exchange network in the country and that’s because we have a standards-based technology built-in through our entire platform, so it makes it significantly easier for providers to connect into the Life Image network and share information as needed. The value of our Exchange Network and our overall Interoperability Suite is due to improved operational efficiencies and economic benefits, but most importantly, we’re improving patient care because of the advanced network capabilities. Since we enable providers to digitally exchange, we eliminate the need for patients going through the tedious efforts of getting those CDs from providers and then taking them to other advanced care centers or other providers, that are outside of the networks that they get them from.
Larger academic and medical centers and advanced care centers receive a lot of outside medical data from referral sites. Both have different Life Image components of the Interoperability Suite, but they easily exchange medical data bidirectionally, and that’s to help ensure longitudinal patient records for that patient is with the providers and it’s intact, and it’s available at all locations. So we offer also, for those clinicians a direct integration to the EHRs. We know that it improves clinician interaction with outside images and other medical information about the patient because it brings it into their main UI. And the most common integrations that we have in Life Image are with Cerner and EPIC. We also have something that’s called Clinical Connector, and that allows our customers to send images and reports directly to patients so that they have a digital copy for when needed. That eliminates the need for a CD or for that patient to have some sort of hard copy media.”
A Partnership That Enables Billions of Records
We’ve partnered with a couple of companies lately. We’ve partnered with a company called Mendel.ai and that’s so that we can help our customers and new customers work within the clinical trial space. Our most recent partnership is with Dicom Systems. We are hoping that we can provide their customers with the opportunity to use the Life Image network with other Dicom Systems sites and also to exchange with Life Image providers. It is extremely important that I highlight that we have partnered with Dicom Systems, because they are an expert in interoperability and workflows within the institutions, and we are complementary technologies that work together for the benefit of our customers.”
Florent Saint-Clair: “Dicom Systems has been around for about 11 years, and we’ve grown quite a bit as you can see in terms of our numbers. On an annual basis, we power about a little bit closer to 12 million annual teleradiology reads. Our Interoperability Suite enabled us to grow within the enterprise, so to power a lot of those intramural workflows that are so vital to enterprise imaging environments. On an annual basis, we handle about 8 billion images flowing through our servers across the board. And most recently, about two years ago we started getting involved increasingly in machine learning. We have a pretty close partnership with Google, we’re also available in AWS and we’re doing more and more projects involving massive amounts of imaging data that need to be deidentified scientifically to feed into deep learning algorithms.
In terms of archiving some of our customers or using us as an archive, the US Army Dental Command, for example, had us migrate 27 million historic dental exams from their proprietary archive into our VNA in San Antonio, Texas on-prem. And then every 24 hours, the VNA gets hit with an additional 5,000 new exams. So, we are no strangers to high volume workflows. Our Interoperability Suite is also at the heart of everything we do. You can use us as an archive, although the vast majority of our customers today, these 8 billion images flowing through us, are transient data, not necessarily ending up in our VNA, so many of our customers are using us for moving data, massive amounts of data, from point A to point B securely. Then you can deploy us in a cloud environment, you can deploy us on-prem. Really, we don’t restrict you as to what kind of IT environment you want to use to deploy our technology. We’re a very simple Linux-based appliance that fits with virtually any IT environment, and then increasingly you can rely on our toolsets to participate and use us as an on-ramp to the AI world.
I’d like to introduce Bruce Hoel. Bruce is a 35-year veteran of the industry at Southern California Permanente Group. Take it away, Bruce.”
Bruce Hoel: “I wanna thank Life Image and Dicom Systems for putting together this webinar and I do appreciate being invited, and I’m hoping I can add to this discussion. As this slide points out, I work for the Southern California region of Kaiser Permanente, specifically, I work for the physicians’ group as their principal imaging solutions architect. For those of you that know Kaiser, our regions are quite large, we have 15 medical centers here in Southern California, and of the 221 other medical offices, approximately 120 of those produce medical images. We have been working with Life Image and Dicom Systems for several years now, and in both cases, we started by using only a subset of those systems capabilities but we continue to use additional functionality as our requirements changed.
I’m gonna go over some simple workflows that show how we use these two products together to meet our business needs. As you might expect for this sort of demonstration, these examples are very simplified and the real-world implementation can be much more complex. While Kaiser Permanente’s general practice is to perform imaging studies in-house, there are some exceptions to that. For example, on the edges of our region, we may outsource certain procedures and we also have mobile providers that travel from hospital to hospital, like our PET/CT trucks that we contract with. In those cases where an outside provider is sending large volumes of studies to KP, we wanna make that process as simple and automated as possible. The first two use cases will show some of the ways we’ve met that goal.”
In this webinar, Southern California Permanente Medical Group (a Kaiser Permanente subsidiary), a user of both platforms, shared common clinical use cases on the results they have seen from leveraging complementary systems to automate workflows that previously required substantial manual intervention. Learn how you can optimize your next-gen Enterprise Imaging by integrating extramural and intramural data, resulting in elegant and streamlined imaging workflows.