So you have a VNA. Now what?

So you have done the right thing. You’ve coordinated the efforts of your organization to realize the benefits of a vendor neutral archive (VNA) for your medical images. You will never again need to migrate PACS. You’ve consolidated the storage for all of your imaging departments. You’ve significantly lowered the resources needed to acquire into a new PACS. You now own your own imaging data. Great! Now what?

The VNA is a great start in your journey to mastering medical image management. What else can you accomplish with your VNA?VNA-Image-Exchange

  • Image-enable your EMR
  • Eliminate CDs from your workflow
  • Automatically exchange studies with affiliates
  • Ingest studies from critical access facilities
  • Exchange studies on demand with providers
  • Enable real-time study collaboration
  • Image-enable your regional HIE
  • Get patients involved by giving them access to their images

You can do these things by purchasing individual applications that require you to manage each individually, or you can accomplish this with an All-in-One solution that integrates seamlessly into your VNA.

At GNAX Health, we see the bigger picture. Eliminate the stacks of apps! Individual applications just add up, increasing expense and burdening your resources. Don’t just buy an image archive, image exchange or image viewer; invest in a holistic image management platform. When you do, you will solve your current issues, while laying a foundation for the future.

If you already have a Perceptive-Acuo VNA, GNAX Health can integrate our SDEX Image Management Platform seamlessly, taking your VNA investment to the next level. Your VNA is just the beginning. Let us show you where you can go next.

Also see:

Attaining Value with VNA & Image Exchange

VNA Technology: The Best of Both Possible Worlds

Understanding HIM’s Role in Medical Image Exchange: 6 Steps


Contact GNAX Health to learn more.


Healthcare Organizations Must Embrace Collaboration

Healthcare organizations are realizing in growing numbers the true value of collaboration. More specifically, organizations must cultivate collaboration between physicians to reap the full benefit of innovations in image sharing technology. They must develop and implement enterprise-wide imaging strategies that can both improve patient care and their bottom line. They must transcend simply sharing images, whether they’re part of an HIE (health information exchange), an ACO (accountable care organization) or other integrated delivery system. Total success is possible only through promoting collaboration.

Our Mantra: It’s Not Just About Viewing

It’s not just about viewing medical images. At GNAX Health, we’ve known this for quite a while. It’s part of our daily dialogue. Image communications, including the migration of information, must be included in image exchange. Image sharing has evolved dramatically across the healthcare industry, and the value of collaboration is finally on the tip of everyone’s tongue.



New technologies are at the heart of this brave new world of image exchange. An enterprise-wide vendor neutral archive and a universal viewer are the requisite tools for enabling HIEs, ACOs and other large delivery systems to improve their image sharing capabilities. An added benefit of utilizing a VNA and a uni-viewer is the weight they lift from overburdened legacy PACS applications.

But there is so much more to consider. The adoption of these new technologies, while improving storage and sharing capabilities, is not guaranteed to improve patient care. For that to happen, hospitals must ensure that physicians are up-to-speed in using the new system—and that the systems themselves are designed to collaborate with each other.

GNAX Health kills several birds with one stone (sorry to you bird lovers) by integrating its VNA with a universal viewer and a secure DICOM image exchange. The integrated product indexes every study and its location, no matter where it was created, providing a means of universal identification. This allows physicians the luxury to search for images by patient name, even if the file is being stored in a temporary queue and hasn’t been imported into the VNA.

The GNAX VNA also allows images from different modalities, as well as any corresponding text, to be shown in a single view. This added functionality allows doctors to share and collaborate on a single image or multiple images in real time. This reduces the need for an image to be retaken and decreases the time spent trying to send images to other providers.

Additionally, after physicians have been authenticated and have gained access to the images, they can manipulate the images by zooming, panning, marking them up and layering visual annotations on it. They can also add diagnostic summaries to the images—all valuable details during the process of collaboration.

So while implementing technology to improve image sharing is a great first step, there are greater fish to fry. Physicians must be trained to maximize the benefits of a VNA. In other words, technology is great, but collaboration is king. Collaboration not only accelerates the decision-making process, but it increases productivity and improves patient outcomes.


HIMSS Study Shows Hospitals Neglect Data Archiving

GNAX Health Data ManagementHealthcare organizations continue to evolve in spectacular fashion, implementing an impressive array of technological advancements that heal patients more often and faster than ever before. The data these new devices generate—critical to the organization’s clinical, financial and operational well-being—is growing at an unprecedented pace.

Healthcare IT departments are at the core of this success. They’re responsible for installing the hardware, making the software function within new networks and training staff to use complicated applications—an education that can literally mean the difference between life and death. So it’s no wonder that “little things” like data management can go neglected. There are obviously bigger fish to fry.

A recent study conducted by Healthcare Information and Management Systems Society (HIMSS) asked 150 senior-level technology professionals at a variety of U.S. hospitals to assess “how they protect data from potential loss or disaster.”

The study also asked how these professionals archived data to meet long-term compliance requirements. The results were humbling.


How Do You Manage Your Data?

In a nutshell, the HIMSS study shows that a majority of hospitals have set low priorities in the areas of data archiving, disaster recovery and business continuity. Nearly half of all respondents admitted to having no data archiving strategy in place. Among those that do have an archiving strategy, 83% say the policy was created solely for compliance purposes. If your organization has placed issues of data governance on the back burner, you are not alone.

Interestingly, hospitals said they classify 75% of their clinical data as “active,” indicating that they store this data onsite so that it can be immediately accessed. Given that just 30% of this data is actually accessed after 18 months, it would seem a more efficient solution to move this data to less expensive storage mediums.


Clinical Data Takes a Back Seat

The study provides other statistics that don’t bode well for data security or business continuity. Thirty-one percent of hospitals in the survey don’t currently have disaster recovery or business continuity plans in place, indicating that they are ill-prepared to continue to operate effectively in an emergency situation. And 42% of hospitals don’t have a documented data retention policy that specifies how long they should keep data, or when they are legally permitted to destroy it. This seeming lack of focus on backup, archiving and disaster recovery can have serious consequences. In a worst case scenario, healthcare workflow can virtually stop when calamity strikes.

The HIMSS study suggests that data takes a backseat to patient care. The study shows that 70% of clinical data is accessed within six months of its creation, but the percentage drops radically for “older” data. One-year-old data was accessed just 39%, and two-year-old data sank to just 25%. While patient care is paramount, obviously, hospitals must find the IT “bandwidth” to effectively backup and archive very relevant clinical data.


A Better, Safer, More Efficient Path for Data

Organizations must position themselves to have access to all legacy data while, at the same, retaining immediate proximity to new medical tests and images. GNAX Health provides healthcare organizations with a variety of cost-effective solutions for life-critical data storage, protection and scalability. We’ll assist you in freeing up primary storage, reducing total storage needs, and better preparing your hospital for recovery from disaster.

Technological advancements in healthcare have dramatically improved patient care in America. Don’t let issues of data archiving and storage tarnish your IT success story. Give your critical data the attention it deserves.


Healthcare Now Radio Features Interview with George Robbie

Carol Flagg of HITECH Answers, an online site dedicated to “helping you achieve meaningful use of certified EHR technology,” interviewed George Robbie, GNAX Health’s vice president of sales, at HIMSS 14 in Orlando.

Carol and George discussed GNAX Health’s expertise in managing medical images; the subtleties of archiving medical data; the importance of image-enabling the EHR; and how implementing a vendor neutral archive (VNA) in concert with medical image exchange (MIE) satifies a variety of interoperability challenges.

Listen to the interview on Healthcare Now Radio by clicking here.


Understanding HIM’s Role in Medical Image Exchange: 6 Steps


Hospitals face a multitude of digital challenges. One of the most pressing involves the management of images generated by Radiology, Cardiology, Neurology and other departments. Problem is these images come from devices purchased from a wide variety of vendors. Their unique imaging technologies generate proprietary file formats, each requiring a custom viewer. This creates a situation in which many medical images and study types are stored in a hospital’s PACS and Mini-PACS in proprietary formats, making it cumbersome to migrate a patient’s medical images through the system. The only viable option, until recently, was to burn a CD. To improve this process, hospitals must leverage the expertise of health information managers (HIMs).



Hospitals must remain cognizant of the role their image exchange solution plays in release of information (ROI). Access, controls and reporting functions are often detached and not integrated components, and few of these systems provide work queues to support release processes. However, it is intrinsic to an MIE to enhance an organization’s ability to share patient information within the health system, as well as outside the network. That makes this component one of the most important applications HIM professionals might encounter. HIPAA privacy and security, patient consent and opt-in/opt-out procedures for medical image sharing are all dependent on HIM expertise to re-engineer traditional imaging release workflows.


So what can HIM professionals do to gain control of the release process of medical images? How can HIM expertise limit liability and improve the expediency of the sharing of medical images?



Six Steps HIM Can Take to Improve the Sharing of Medical Images

1)   Build an infrastructure that utilizes a vendor neutral archive (VNA).

2)  Add the MIE on top of the VNA.

3)  Add a uni-viewer—a single, non-proprietary device for viewing a variety of study types.

4)  Take appropriate security measures to safeguard your MIE.

5)   Add integration to the EHR, to provide enterprise access.

6)  Add web services, including physician and patient portals.




Step 1: Use VNA to Reel-In Your Medical Images

The first step in improving your imaging capabilities is to centralize all medical images, collecting them from all the PACS and Mini-PACS. This important step creates a centralized infrastructure, which serves as the foundation for the next four steps. Use a VNA as the central archive across all study types, since the VNA combines the medical image formats found in DICOM and non-DICOM data. This allows the images to move to a single system that can leverage several key enterprise benefits. Not only does the VNA translate the proprietary formats used by all vendors, storing divergent types of information in a single, convenient system, it also consolidates disparate study types. It provides tangible financial cost savings as hospitals create one infrastructure for archiving, a boon in the event of disaster recovery.


Step 2: Implement an MIE Solution

The second step is to install and deploy a Medical Image Exchange solution on top of the VNA. Many exchanges interface with a few PACS systems and retain information for a limited time, based on the estimated life cycles of how that information is used. This sort of solution can be effective, yet more and more solutions are basing their MIE systems on centralized archives. This is the preferred approach. Access to all studies, both current and historical, creates tremendous value and is beneficial in supporting the ROI process.


Step 3: A Room with a (Single) View

The third step along the path to enhanced medical image sharing is to add a uni-viewer—a single, diagnostic-quality viewer to the infrastructure you are creating. This is the exciting part of this process—the ability to view medical images from any desktop or any device, stationary or mobile. Many common viewers are not considered to be diagnostic quality. Some other viewers, while deemed diagnostic quality, are not paired with devices that have diagnostic quality monitors. In any event, these viewers can’t be trusted to produce the quality of images required for competent diagnosis. A diagnostic-quality uni-viewer will maximize your imaging capabilities.


Step 4: Keep It Safe

Hospitals must remember to protect the confidentiality, privacy and security of the medical images being shared—just as they protect the data contained in EHRs. The release process for medical images is more complicated than ever–and riskier than ever–as images course across departments and are accessed by multiple users. When observing medical images through a remote viewer–an integral part of the optimal infrastructure we’re describing–users leave no trace of having visited the data. This is because the viewer features a Zero Footprint download, an important security feature. No software is loaded onto the device, and no patient data is downloaded to local drives. When the user is done viewing the image, all traces of the user, the image viewed and accompanying patient data are gone. Think of it this way: The images don’t move to the device; they are simply displayed.


Step 5: Integrate Medical Images into the EHR

The fifth step in this optimal solution is to promote medical images to full-fledged members of your electronic health record. What started as simply providing patients a copy of their films has evolved into a complex process for integrating medical images from several study types into the EHR, allowing access for physicians and caregivers. As an added benefit, these new workflows let radiologists and physicians collaborate while viewing medical image studies from separate locations. Patient care improves because of the improved accessibility to the studies, which are now conveniently housed within the EHR.


Step 6: Making Sense of the Tangled Web

The sixth step in our solution involves adding all of the web services that can pave your road to image exchange success. Consider this: In this day and age, many of us are constantly working. When we’re not working, we’re still connected, with the ability to react to critical issues. Good web services—especially ubiquitous Wi-Fi and cellular signals—make this possible, for better or worse. So since the technology exists, the ability to connect to our image exchanges through several methods should be cultivated. Physician portals, patient portals, health information exchanges, URL or smart links to key web pages and hospital websites are all part of an optimal solution. Don’t settle for less than what you need.


In Conclusion

There you have it—a simple six-step process. What’s next? Now you must determine how best to implement medical image sharing technology within your own organization. Take the time to carefully produce an organizational impact report, and you’ll be astounded at how strong your argument will be. The road to implementation may seem very long and circuitous. Just remember that a journey of a thousand miles begins with a single step.


See also:  A Complicated Matter: Six Steps to Understanding HIM’s Role in Medical Image Exchange  (For The Record, March 2014-HIMSS Conference Supplement)



Calculating the Benefit of VNA in Dollars and Cents


For the past several months, we’ve discussed how a vendor neutral archive will consolidate your medical images and data access points, liberating your data from proprietary file formats associated with PACS applications, enhancing data integrity and preparing you to navigate the slippery slopes of disaster recovery and business continuity. VNA will revolutionize your organization’s ability to store data, share data and protect private health information. But there is even more to the picture. The adoption of VNA will dramatically benefit you bottom line.


Economies of Scale

VNA solutions help hospitals harvest tremendous cost advantages by leveraging economies of scale. Costs decrease and organizational efficiencies increase when you centralize your archive, versus attempting to manage multiple PACS archives. The cost benefits can further blossom over time as your operation grows.


Eliminating Data Migration Roadblocks

VNA eliminates the stumbling blocks proprietary file formats present during the migration from one PACs or storage system to another. Before VNA, providers were required to budget additional resources for data migration to cover the added costs of “translating” disparate file formats and dedicating IT staff hours to babysit tedious transfers. With VNA, there is no need to translate file formats and additional supervision is eliminated. This particular cost savings grows over time as migration from PACS to PACS becomes less necessary.


Taking the “A” from PACS

We are fond of saying that VNA removes the “A” for “archive” from PACS. In the past, providers were required to purchase separate archive storage for each and every PACS in their network. Depending on the number of PACS, this expense could become prohibitive. VNA, by funneling the data from all PACS into one centralized archive, dramatically reduces the overall cost of data storage. As an added benefit of removing the “A,” providers “own” their own data, simplifying their central access to key data that was previously warehoused deeply within a PACS.


Limit the Unabated Growth of Medical Data

VNA addresses another age-old, cost-inducing issue: how to deal with legacy data and images that are no longer relevant. It’s been determined that images typically account for 60 to 80 percent of a provider’s storage footprint. VNA can enable Image Lifecycle Management (ILM), which assists providers in legally and safely purging dated data. ILM allows providers to custom configure parameters for security and expiration policies. Obviously, there is tremendous financial benefit in limiting the unabated growth of data to be archived.


Trimming the Fat

By creating a centralized archive, VNA assists in the ongoing process of organizing images. The proper archiving and exchange of images can help eliminate duplicate studies. Many of these studies, generated due to ACO requirements and other insurance programs, are less and less likely to get reimbursed. This type of study, with very little historical relevance and zero fiduciary importance, should be weeded from your archive.


The Bottom Line

While the benefits of a vendor neutral archive are exceedingly clear from a process point of view, the financial benefits may be just as attractive.



Reducing Cancer Risk with Image Exchange

A recent article in the New York Times revealed some scary statistics implying that our penchant for medical imaging significantly contributes to the likelihood of developing cancer. The article, entitled We are Giving Ourselves Cancer calls into question computed tomography, or CT studies in particular, stating the radiation exposure from one CT scan equates to between 100 and 1000 conventional X-rays. In fact, the article suggests that 3 to 5 percent of all cancers in the future may be caused by exposure to medical imaging.

There are many reasons explored for the meteoric rise in the number of CT scans over recent years, including the invaluable benefit of early diagnosis, the exorbitant cost of these machines and the need to attain return on investment, and incorrect usage. Eerily absent from these reasons are duplicate studies ordered because of inadequate image exchange. For example, a patient has a CT completed and is referred to another facility or specialty physician. The patient is handed a CD of her CT study. When she arrives at the other facility, she is given another CT scan because she lost the CD, or the study is not saved on the CD in diagnostic quality or the CD is damaged in transport. Rather than go back to the original provider to retrieve the study, which could take days, the new physician simply orders another study, needlessly exposing the patient to more radiation.

Duplicate studies occur more than one might think, with 5.4 percent of all patients getting double scanned according to Medicare data. One study published in the Journal of Pediatric Surgery showed 91 percent of pediatric trauma transfers from a community hospital to a level I pediatric trauma center (PTC) resulted in a duplicate CT study. Compare this to studies performed initially at the PTC which required zero duplicate studies.

Another study published in the Journal of Trauma and Acute Care Surgery showed that nearly 30 percent of patients transferred between regional trauma centers resulted in duplicate studies. The most common reason for duplicate CT scanning was due to inadequate image quality on the CD used to exchange the study.

In addition to the patient care issue, financial cost is the other side of the story. The average per study charge found in the Journal of Trauma and Acute Care Surgery study was $409. Needlessly raising medical imaging costs between 3 and 91 percent is mind-boggling. Not to mention the future costs of treating those patients who develop cancer caused by the increased doses of radiation.

It is amazing to think of the impact we could make on reducing these needless duplicate studies simply by adopting a sound image exchange strategy. We all know that CDs and snail mail are not adequate. We have this thing, called the Internet, that could facilitate the real-time exchange of medical images among facilities, providers and patients across the nation.

The solution is an image exchange service that solves the problems of individual providers while creating a platform for interoperable image exchange. We are talking about a solution that can integrate directly with a hospital’s existing IT systems, automate this exchange and secure and track all transactions for compliance. We need to do all of this in a patient-centric fashion, creating a longitudinal representation of patient care. So all authorized clinicians can access prior imaging studies and eliminate these duplicates.

That is our mission here at GNAX Health with our VNA Based Image Exchange. Sure, we can help you reduce your costs or more efficiently allocate your dollars with our solution, but in the end, we do it for the patients.

Visit us at HIMSS14 to learn more about how image exchange solutions can help your organization and your patients.


The Costs and Cons of Running Your Own Data Center

Hospitals are for maintaining health and healing sick people. It takes a lot of data to accomplish that mission. So data—in a constant, unabated, seamless flow—is critical. Clinical metrics, quality of patient care, billing and reporting are all dependent on the mountains of data hospitals generate every day. All of this data, and our thirst for it, make data center downtime unconscionable. Downtime, in any way, shape or form, disrupts our work and tarnishes our quality of care. In a nutshell, data center downtime is our worst enemy. It must be avoided, at all costs.

The Cost of Data Center Downtime

Speaking of costs, a recent study conducted by the Ponemon Institute/Emerson Network Power Report calculated, in dollars and cents, the true cost of data center outages. Here are just a few eye-opening findings from that report:

  • On average, an outage cost organizations $690,000 in 2013.
  • The cost of a typical outage has risen 41% since 2010.
  • Larger organizations, with more elaborate networks, incurred greater expense—up to $1.74 million per incident.
  • Data center downtime costs $7,900 per minute of outage.

Drilling down even deeper, the report showed where organizations incurred the greatest costs:

  • Business interruption—an average of $238,717 per outage.
  • Lost revenues—an average of $184,000 per outage.
  • End-user productivity—an average of $141,000 per outage.

That’s a lot of money. And it’s only going to get more expensive as healthcare providers need data centers to support even more of our most critical data.

What Causes Data Center Outages?

As healthcare providers grapple with the critical decision of how to archive their data, it’s beneficial to know what causes data center outages. Here are some of the main culprits:

  • UPS system failure
  • Accidental/human error
  • Cybercrime
  • Weather incursions
  • Failure of water/heat or CRAC (computer room air conditioning) systems

There is so much that can go wrong. The thorough folks at DataCenterKnowledge.com actually compiled a list of the Top 10 Outages of 2013. Fires, floods, power surges and even corrupt software updates contributed to these massive outages that affected millions of individuals. It seems that no one was immune, from the U.S. government (healthcare.gov), to major credit card companies (VISA’s major outage in Canada), to gaming developers (Xbox went down on launch day) and the City of Toronto (a flood incapacitated the cooling system of its data center).

Is it obvious yet? Data center downtime can stop your business in its tracks. When catastrophes strike, revenue flow comes to a grinding halt; client acquisition becomes paralyzed; the data retrieval needed to complete nearly every aspect of your operation freezes. In healthcare environments, clinical trials come to a grinding halt, patient care is compromised, billing stagnates and even corporate identity suffers, as patients blame the facility for the inconvenience wrought by the outage. This is certainly not optimal.

Light at the End of the Tunnel

You’ll be relieved to know that it’s possible to mitigate the effects of data center downtime. Healthcare organizations that choose to keep their data in house are exponentially more prone to extended downtime than those that store data in the cloud. Think of it as having one, single set of keys for your car. If you misplace your keys, you won’t be driving anytime soon. If your in-house data center receives a lightning strike, or if the regional power grid goes black, you’re down.

At GNAX Health, we’re fond of saying that utilizing a colocation center, or other remote-hosted data storage service, is akin to having multiple sets of keys for your car, stored safely in various locations across town, which can be delivered to you when you need them. Colocation centers “colocate”—or create a mirror image of your data—so that a single, regional incident can’t debilitate your enterprise. Data remains available, downtime is dramatically reduced (or entirely eliminated), and revenue continues to flow.

Hosted Solutions: The Key to Dodging Downtime

Hosted solutions, due to their shared bandwidth, offer your organization economies of scale unimaginable to in-house data centers. They provide expert staff to monitor your data, freeing you from hiring staff to oversee data storage. Your focus can remain with your core business competency—healing sick people. And isn’t that what hospitals are all about?



Downtime Intolerance and the Costs of Data Center Downtime in Healthcare

According to a recent report covered by Healthcare IT News, data center downtime will cost you an average of nearly $8000 per minute. In total, healthcare organizations face averages costs of $690,000 per downtime incident. Furthermore, these large dollar figures do not consider the critical, intangible costs of the disruption in patient care.

How do you ensure that your IT infrastructure is running 100% of the time?

Healthcare is a unique IT environment. To put it in context, we can categorize applications into two distinct types (critical and non-critical) and two types of application environments for every organization (homogeneous and heterogeneous). Organizations fall into those basic categories with variations in between.

Where you fall as a healthcare provider is critical to how you deploy your IT infrastructure. As a healthcare provider, you must think differently than most enterprises.

Datacenter Downtime Intolerance

If your IT infrastructure goes down, you may not be able to admit patients or care for them properly. It is what we call a life-critical operation that is downtime intolerant.

Plenty of downtime tolerant applications such as Twitter, Facebook, and Google are homogeneous and scaled across many datacenters. They can tolerate downtime at the datacenter level, encountering only a small degradation in service. They have no need for 100% uptime in all of their datacenters.

As a healthcare provider, you have many, possibly hundreds of distinct applications, which make your environment heterogeneous and located in one or two datacenters at the most. Furthermore, many of these applications could be considered “critical” – whether they are directly related to patient care or directly affect your ability to generate revenue.  You cannot tolerate downtime at the datacenter level. All levels of your operation must be redundant, highly available and backed up.

Achieving 100% uptime in your data center is no easy task. It is a full-time business. According to the study cited earlier, the average organization experienced an average of two complete data center outages over the past two years. That is unacceptable by GNAX standards.

GNAX Health can claim 100% uptime in its operating history. With over 13 years in the data center business, our state-of-the-art, Tier-IV power data center is built as a world-class facility backed by a third-party audited HIPAA and SSAE 16 Type-II compliance program.

Whether you need a primary data center or a hardened disaster recovery site, GNAX Health can provide the solution.

Come and see us at HIMSS14 to learn more about how we can help you.

Not going to HIMSS? Contact us today to learn more about GNAX solutions.



VNA Technology: Why It Makes Sense

In my last few posts, I told you about VNA technology, the next generation of medical image management. I’ve evangelized the benefits of implementing this integrated storage, viewing and exchange platform for medical images. Who wouldn’t like to improve clinical decision making, enhance quality of care and expedite treatment for patients, all the while improving inter- and intra-hospital efficiencies?

To illustrate the current state of medical image management, I’ll present two scenarios—one that includes VNA and one that doesn’t. Decide for yourself which is preferable.


Scenario 1: A Slippery Slope

Steve Nelson, an extreme sports athlete from Atlanta, suffers a debilitating knee injury while snowboarding in Aspen. It’s the second serious injury to his right knee. The first occurred 18 months earlier when he tore his anterior cruciate ligament (ACL) while skateboarding in Atlanta. (He had just recently completed rehab from that surgery.) They take a digital radiography X-ray of the knee in Aspen and decide to medevac Steve to Denver, where orthopedic care and surgery are more readily available.

Before transporting him, personnel in Aspen call Steve’s primary care physician in Atlanta to inquire about last year’s injury. After gathering that information, they burn a CD of the new X-ray and strap it to Steve’s chest for delivery to Denver.

Once in Denver, a physician assistant (PA) loads the CD into her workstation, but the disk seems to be scratched and is unreadable. With Steve in obvious discomfort, the PA orders another X-ray, which takes another 90 minutes and exposes the accident-prone athlete to more radiation.

Once the physician sees the X-ray, his findings are inconclusive and he orders a full MRI. After completing the MRI, the onsite radiologist and physician require two separate workstations to review the X-ray and the MRI at the same time. The physician calls Steve’s primary care physician in Atlanta to describe the extent of the new injury and discuss treatment options. Together, they make a diagnosis and devise a course of action.

Outcome: After various delays and a few communication breakdowns, a stressed-out Steve undergoes surgery to repair his damaged knee.


Scenario 2: Smooth Sailing

Steve Nelson, an extreme sports athlete from Atlanta, suffers a debilitating knee injury while snowboarding in Aspen. It’s the second serious injury to his right knee. The first occurred 18 months earlier when he tore his anterior cruciate ligament (ACL) while skateboarding in Atlanta. (He had just recently completed rehab from that surgery.) They take a digital radiography X-ray of the knee in Aspen and decide to medevac Steve to Denver, where orthopedic care and surgery are more readily available.

They move Steve immediately. While still in the helicopter, the Aspen physician initiates a medical image collaboration session with Steve’s primary care doctor in Atlanta, the attending radiologist and the surgeon in Denver, as well as the EMT on the medevac chopper. All of the participants view the exact same diagnostic-quality image simultaneously and they manipulate the image in real time, despite connecting from a variety of network types including Wi-Fi, 3G and 4G cellular connections, as well as desktop computer, tablet computer and PACS workstation.

In this scenario, diagnosis and likely treatments are discussed well in advance of the timeline in Scenario 1. The decision to order an MRI is actually made while Steve is still in flight. Upon arrival in Denver, Steve is transported directly to the MRI modality. The general physician in Denver then initiates a second collaboration so that the primary care physician in Atlanta and the radiologist in Denver can study the MRI and initial X-ray simultaneously, through a multi-modal universal viewer. The diagnosis and treatment plan are finalized.

Outcome: VNA technology allows the attending physicians to expedite Steve’s care, avoiding delays and getting Steve straight into surgery (which is ultimately successful, by the way). Now Steve can plan for a parasailing adventure in Mexico next summer.


VNA Means Speed, Quality and Efficiency

In Scenario 2, Steve’s care was dramatically improved by GNAX Health’s Medical Image Archiving and Exchange Solution, which completed his electronic medical record with his X-ray and MRI throughout his treatment.

Scenario 1 highlighted the downside of burning medical images onto CDs, while using the patient as courier. This technique is a technological roll of the dice, failing much too frequently to be considered efficient. CDs can be lost in transit, or they can get damaged, rendering them unreadable to the receiving party. Additionally, the receiving party must import the data from the CD into their PACS, at which point the image may lose valuable notes, measurements and tags set by the previous physician.

GNAX Health digitally facilitates this critical transaction. We automatically import images into a vendor neutral format that is readable by any PACS. We provide the exchange and collaboration layer that allows physicians to hold remote, real-time consultations on demand, no matter what device attendees use or where they are located.


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