What to Consider when Selecting an Enterprise Imaging System

Efficient use of digital images is becoming increasingly important for the delivery of healthcare. No longer is radiology the only producer and user of clinical images. Most clinicians expect to be able to easily access images produced in other facilities, and administrators want to streamline storage and avoid unnecessary redundancies. Traditional image management systems, like picture archiving and communication systems (PACS), are not designed to manage, access, and share the ever-increasing volume of data from different departments and facilities and therefore cannot meet today's needs. Enterprise imaging systems were introduced to address these needs. This article describes the capabilities of today's enterprise imaging systems, explains the advantages of the vendor-neutral archive (i.e., where images are stored in a nonproprietary format to allow sharing among different systems), and discusses the factors healthcare providers must consider when looking at updating their image management systems.

Enterprise imaging systems provide a platform that utilizes a centralized database for storing, accessing, sharing, analyzing, and manipulating patients' images in conjunction with the content of the patients' electronic health record (EHR). Additionally, artificial intelligence (AI) is being offered by enterprise imaging system vendors as a tool to help prioritize the worklist and automatically change the workflow if needed and as a tool for clinical decision support and computer-aided diagnosis capabilities. AI is only in its infancy as a tool for diagnostic imaging. However, it is recognized that having structured data from multiple sources—as is provided by enterprise imaging systems—is a prerequisite for the further development and implementation of AI.

Enterprise imaging systems are designed to seamlessly integrate with EHR systems so that patients' health information of any type, including images, can be shared and accessed by all members of the care team, regardless of the source of the information. They are also usually equipped with tools for storing, managing, and viewing DICOM (Digital Imaging and Communications in Medicine) diagnostic images and the associated reports from different departments such as radiology, cardiology, nuclear medicine, and point-of-care ultrasound modalities. Additionally, these systems have tools for storing, managing, and viewing non-DICOM images from endoscopy, pathology, ophthalmology, and dermatology, as well as other documentation images such as scanned paperwork and the associated reports from other departments.

Traditionally, clinical images have been archived in PACS. But by providing all of the services necessary to support image management and image interpretation, including diagnostic tools and reporting, an enterprise imaging system acts as a PACS that is designed to also integrate with other information systems to share images and provide enterprise-wide coverage and access for clinicians in all departments and locations. Enterprise imaging systems eliminate the need for several different imaging and information systems (e.g., radiology, cardiology, pathology, oncology, ophthalmology, dermatology), which can lead to a potential cost saving and simplification of equipment needs.

In modern medicine, clinical multimedia content, including imaging, plays a vital role in the course of treatment. And each department that generates multimedia content has its own unique information management model. The radiology model is a pioneer model for integration between imaging modalities and other systems, and best practices and processes have been developed and implemented for it. In this model, various systems—including patient data entry, source-based scheduling, image acquisition, quality assurance, report management, data management, and image archive and distribution systems—have been integrated and implemented in one system. But because PACS could not keep up with the needs of other specialties, enterprise imaging was developed to extend the radiology model to other departments that often do not have standardized formats, data flow, and data management processes. Enterprise imaging systems unify multiple archives, integrate with other information systems, and provide clinical data management tools and features that are used in each department.

Enterprise imaging offers...