ECR 2013.indd - Agfa HealthCare
ECR 2013.indd - Agfa HealthCare ECR 2013.indd - Agfa HealthCare
Canisius-Wilhelmina Ziekenhuis, Nijmegen, The NetherlandsCWZ Nijmegen goes beyondPACS vendor lock-in with newVendor Neutral Archive‘Leave no image behind’ approach extends PACS-independent view of EHR across allclinical departmentsInterviewee Pascal van Nispen, Information Advisor“With Agfa HealthCare’s VendorNeutral Archive solution we riseabove the PACS vendor lock-inconstraints and can start sharingdata with other hospitals tocoordinate care.”Pascal van Nispen, Information AdvisorA VNA concept to stop build-upof imaging silosWith a strong board of directors atits helm, CWZ has taken its futurefirmly in hand. The hospital has beenrecognized by the Dutch governmentas a top-clinical hospital in the fieldsof neurosurgery, PCI (PercutaneousCoronary Intervention) and ICD(Implantable Cardioverter Defibrillator)surgery, and it also has a strongreputation as a pioneer in severalmedical fields, such as childhooddiabetes, large vein surgery andlaparoscopy interventions. The fourthmedical training institute of the country,CWZ has a continuous influx of youngand ambitious clinicians and careprofessionals that share this dedication.Moving beyond the limits of PACSvendor lock-in and taking the lead inthe development of a regional ElectronicHealth Record (EHR) were the driversfor the Dutch Canisius-WilhelminaHospital in its implementation ofAgfa HealthCare’s Vendor NeutralArchive IMPAX Data Center (IDC).As an enterprise or regional imagingmanagement solution, IDC extends theEHR to include all medical images andrelated information to the point-of-careinside and outside of the hospital.22 THEREWith University Medical Center StRadboud nearby, Canisius-WilhelminaHospital (CWZ) is both competingand collaborating with one of TheNetherlands’ foremost healthcarecenters. Sharing patient data is part ofthis relationship and CWZ decided totake the lead in developing a regionalEHR. When Agfa HealthCare’s VendorNeutral Archive IDC becomes availableto the CWZ healthcare network,a major milestone will have beenreached.Almost 380,000 day clinic visits andover 31,000 inpatients per year acrossits six sites mean that the hospital mustorganize its workflows effectively.Pascal van Nispen, Information Advisor,conducted an inventory of the existingimage flows. “We found that ourimaging flows were diverse, to say theleast. Some departments printed theirown images and attached them in paperto a departmental paper patient file,some saved images as compressed jpegs,some stored them on offline CDs. All ofthese ‘imaging silos’ resulted in a lackof centralized management, corrupt
Solutions» IMPAX Data Center VNA with XEROTechnology Viewer» Long-term Managed Services Agreement» Serve as General Contractor withinmulti-vendor agreementAgfa HealthCare’s contribution» Meeting the aim of the customer to movebeyond vendor-based PACS and take the leadin regional EHR concept» Comprehensive Managed Services conceptthat provides peace of mind to IT and clinicalusers» Ability to take the lead in a multi-vendorenvironmentfiles, and incomplete patient records.Our findings led our board to propose acentralized approach based on a VendorNeutral Archive (VNA).”Pascal van Nispen: “We decided to askAgfa HealthCare to take the lead as ourgeneral contractor, coordinating withour local PACS vendor, and providea VNA solution to six departmentsin the first phase: gastroenterology,ophthalmology, urology, pneumology,the OR and the medical photographer,”says Pascal van Nispen. “AgfaHealthCare had already provided itsIMPAX PACS solution to radiology,cardiology and nuclear medicine, andour local hospital-wide PACS vendorjoined in, so each department haddigital access in one way or another topatient images and data. We just neededto centralize all imaging data, be able tovalidate it, and share it seamlessly withall of our care professionals.”Agfa HealthCare’s role was to providea back-end solution that would enableall images to be centrally stored, andbe HL7, DICOM, IHE and XDS/XDS-IFramework compliant. The IMPAXData Center is central to creating alongitudinal imaging-enabled medicalrecord and is designed to work withmulti-vendor solutions. “We wanted tosteer away from a vendor lock-in,” saysPascal van Nispen, “and we were lookingfor the lowest integration cost possible.Agfa HealthCare supports the hardwareinfrastructure according to the servicelevel specifications in our ManagedServices Agreement, and proactivelydetermines when to replace or upgradethe solution to improve uptime andfunctionality.A low-cost and user-friendly wayto view all images in the EHRIn line with the hospital’s aim to playa leading role in the development ofa regional Electronic Health Record,using the Agfa HealthCare XEROTechnology Viewer as the unique wayto access images coming from the VNAis a major asset. This enterprise medicalimage viewer allows clinicians to accessimaging information securely andindependent of location, on a varietyof web-enabled devices, improving thedelivery of patient care throughpoint-of-care access to patient data.“The XERO Technology Viewer is animportant asset to us, as it doesn’t requirethe installation of client software. It usesexisting infrastructure and connects onstandard browsers, such as MicrosoftInternet Explorer, Google Chrome, orMozilla Firefox,” says van Nispen. “Ourclinical users will access medical imagesfrom any location and image sourceacross the hospital, straight from thepatient record. It is a matter of timebefore we extend our VNA with the XEROTechnology Viewer to outside referringdoctors, remote sites and collaboratinghospitals, completely secure.”This will fully release the power ofthe VNA concept to the care networkand also to the patients, continues vanNispen. Instead of paper prints, CDsor even “snail mail” transfer of images,examination images and results willbe able to be accessed by referringdoctors or tertiary care clinicians almostimmediately. “This will result in fewerretakes, fewer superfluous examinationsand a more streamlined patient flowbetween care providers. With XEROintegrated in the EHR, we can completeour VNA proof-of-concept and startexpanding its use outside our campus.We will then be able to really rise abovethe PACS vendor lock-in constraints andstart sharing imaging data with otherhospitals to coordinate care.” •DID YOU KNOW…» Nijmegen is the oldest town in TheNetherlands as we know it today. It was 2,000years old in 2005.» The most famous story, known in literaturethroughout Europe and the Middle East, is thatof Mariken van Nieumeghen, an inhabitant ofNijmegen. It is a late medieval Dutch text fromthe early 16 th century, where Mariken spendsseven years with the devil, after which she ismiraculously released having confessed hersins with remorse to Saint Mary. The morale ofthe story is that no matter how sinful one is,there is always salvation through Saint Mary.THERE 23
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Canisius-Wilhelmina Ziekenhuis, Nijmegen, The NetherlandsCWZ Nijmegen goes beyondPACS vendor lock-in with newVendor Neutral Archive‘Leave no image behind’ approach extends PACS-independent view of EHR across allclinical departmentsInterviewee Pascal van Nispen, Information Advisor“With <strong>Agfa</strong> <strong>HealthCare</strong>’s VendorNeutral Archive solution we riseabove the PACS vendor lock-inconstraints and can start sharingdata with other hospitals tocoordinate care.”Pascal van Nispen, Information AdvisorA VNA concept to stop build-upof imaging silosWith a strong board of directors atits helm, CWZ has taken its futurefirmly in hand. The hospital has beenrecognized by the Dutch governmentas a top-clinical hospital in the fieldsof neurosurgery, PCI (PercutaneousCoronary Intervention) and ICD(Implantable Cardioverter Defibrillator)surgery, and it also has a strongreputation as a pioneer in severalmedical fields, such as childhooddiabetes, large vein surgery andlaparoscopy interventions. The fourthmedical training institute of the country,CWZ has a continuous influx of youngand ambitious clinicians and careprofessionals that share this dedication.Moving beyond the limits of PACSvendor lock-in and taking the lead inthe development of a regional ElectronicHealth Record (EHR) were the driversfor the Dutch Canisius-WilhelminaHospital in its implementation of<strong>Agfa</strong> <strong>HealthCare</strong>’s Vendor NeutralArchive IMPAX Data Center (IDC).As an enterprise or regional imagingmanagement solution, IDC extends theEHR to include all medical images andrelated information to the point-of-careinside and outside of the hospital.22 THEREWith University Medical Center StRadboud nearby, Canisius-WilhelminaHospital (CWZ) is both competingand collaborating with one of TheNetherlands’ foremost healthcarecenters. Sharing patient data is part ofthis relationship and CWZ decided totake the lead in developing a regionalEHR. When <strong>Agfa</strong> <strong>HealthCare</strong>’s VendorNeutral Archive IDC becomes availableto the CWZ healthcare network,a major milestone will have beenreached.Almost 380,000 day clinic visits andover 31,000 inpatients per year acrossits six sites mean that the hospital mustorganize its workflows effectively.Pascal van Nispen, Information Advisor,conducted an inventory of the existingimage flows. “We found that ourimaging flows were diverse, to say theleast. Some departments printed theirown images and attached them in paperto a departmental paper patient file,some saved images as compressed jpegs,some stored them on offline CDs. All ofthese ‘imaging silos’ resulted in a lackof centralized management, corrupt
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