By Cat Vasko
 The Children’s Hospital of Philadelphia (CHOP) was an early pioneer in establishing an enterprise image repository; its enterprise medical storage platform went live in 2005, and its vendor-neutral archive (VNA) went live in 2009, followed by an enterprise viewer in 2010. Chris Tomlinson, MBA, has helped to lead the charge in his role as administrative director for the department of radiology. “We were early adopters in the world of VNAs, and today everyone is talking about them,” he notes. “Everybody’s talking about them—but from the perspective of people who are doing it, what does an enterprise archive really look like?”
Like many in the field of imaging informatics, Tomlinson takes issue with the blanket term “vendor-neutral archive,” and in a talk at the 2012 meeting of the Society for Imaging Informatics in Medicine (SIIM), he proposed that the term “PACS neutral archive,” or PNA, be utilized instead. “Even though this starts in radiology, it’s an enterprise platform and something the enterprise owns,” he says. “Radiology is almost all DICOM, and it would be a very radiology-centric view to assume the whole enterprise will be DICOM as well.”
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Has your organization implemented an enterprise imaging archive? Why or why not?
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By Cat Vasko
Following years of experience working on the enterprise IT team at Iowa Health System as an infrastructure architect, Tom Coppa takes a strong stance on the terminology used to refer to enterprise-wide image repositories—what some have taken to calling vendor-neutral archives (VNAs). “The idea of a VNA makes a lot of sense—it remains a very solid and very good thing to have,” Coppa, who today serves as a technical consultant for McKesson, says. “But the reality is that there is nothing neutral about the vendor you’re going to deal with as a health care organization.”
 Coppa observes that the term “VNA” is, at its core, a play on words. “I might even argue that when you reverse the acronym, things start to get more interesting,” he says. “Most companies today are actually archive-neutral vendors, which is to say that they avoid proprietary aspects of their solutions, or if they do have something proprietary, they still maintain the core essence of the data.”
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Which term should be used to describe providers of enterprise imaging archives?
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By Cat Vasko
 Mecklenburg Radiology Associates (MRA), Charlotte, North Carolina, is the oldest continually operating radiology group in the state; its 40 radiologists and 10 physician assistants serve Novant Health’s four hospitals and nine imaging centers in the Southern Piedmont region of the state, as well as a number of other imaging centers, physician practices, and Lake Norman Regional Medical Center in Mooresville. “We’re very geographically diverse,” says Robert Barr, MD, president of the practice. “We have studies coming in from a wide area, and making sure the right people are reading the right studies at the right time is a complicated
endeavor.”
The Novant facilities for which MRA reads include imaging centers that the health system purchased from MedQuest in a 2007 acquisition. That transition required special attention to the enterprise PACS, ensuring that prior studies from the MedQuest facilities were available in its archive so that patients of the imaging centers in question could be assured continuity of care. “We made a big priority out of making sure that the patient imaging history was seamless,” Barr says. “We needed it to have the same look and feel as if it were part of the long-standing integrated entity.”
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What is your organization’s biggest image sharing challenge? #enterpriseimaging
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Web-based Image Transfer: Impact and Outcomes
A JACR study looks at the effect on CT repeat rate, cost, and radiation exposure from a regional web-based image transfer project.
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Big Med: Can the Chain Model Work for Health Care?
Atul Gawande looks at the potential advantages of the institutionalization of medicine, including lower costs and more consistent quality.
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ONC Opens 2014 EHR Draft Tests for Comment
The procedures will be used by certifying entities to evaluate the conformance and functionality of EHRs.
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VNAs Need Better Definition: InMedica
Successful implementation of vendor-neutral archives will rely on development of clear guidelines for their use, the research firm says.
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Radiology Benchmarks Collaborative
A vendor-neutral, subscription-based service provides a monthly view of radiology performance benchmarked against three peer groups.
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