VNA’s Role in the Healthcare IT System

Vendor neutral archives (VNAs) have become a staple within the healthcare IT system. At the Radiological Society of North America’s (RSNA) 2021 annual conference, Tara Martyres, a product development manager for Intelerad, discussed the important role of the VNA during an industry presentation titled Vendor-Neutral Archives: Empower Your Medical Imaging Enterprise. As defined, a VNA allows healthcare providers to migrate between vendors without worrying about imaging data loss. It enables a single, centralized location to store the large volumes of data that come from a variety of sources in varying formats. 

“Historically, the attraction of VNAs was that it was an archive developed in such a way that it could easily integrate with any viewing acquisition and workflow engine on the market, thereby allowing clients to cut ties with proprietary archives,” said Martyres in her presentation. “Today, it has become more about empowering healthcare organizations to control, manage and consolidate imaging data in a standard way.”

She went on to explain that when looking at the data sphere growth by industry, it becomes apparent that healthcare is the fastest growing sector, which can be attributed to advancements in healthcare analytics, increasing frequency and image resolution of magnetic resonance imaging (MRI), and other data being captured for medical files. “In addition, a number of factors such as the presence of government regulations, and the growing demand for standard base storage, disaster recovery and image lifecycle management solutions are also propelling the growth of the VNA market,” she stated.

Some of the primary advantages provided by VNAs include:

• Flexibility as it facilitates the addition, consolidation or replacement of overlying
IT systems;

• Improved cost control by allowing interface with multiple systems;

• Reduced cost of ownership through storage management tools; and

• Accessibility to the image data provided outside the enterprise.

 

“VNA is a powerful archive that provides a lot of benefits, especially in complex environments, given the complexity of healthcare IT systems,” explained Martyres. “The need for VNA is much more about how it facilitates interoperability as it leverages advanced technologies to provide centrally managed access to all imaging information. As an image management platform, it can integrate with all systems and becomes the central hub that allows for the streamlining of workflows.” 

Understanding the Key Features of VNA Systems

Martyres stressed it is important to understand some of the key features that make the VNA such a powerful application. 

Image object change management (IOCM). Martyres explained that image object change management (IOCM) ensures data integrity between systems as it specifies how one system can communicate local changes to other systems that manage copies of the same imaging objects in their own local systems. This typically includes deletions of studies, mergers of studies and deletions of images. “We’re looking at empowering the client to manage their own storage needs and reduce total cost of ownership,” she explained.

Image Lifecycle Management (ILM). This data retention tool is used to manage the lifespan of a study, and create rules to determine when archived studies can be hard deleted from the system. “Typically, these rules can be set based on a combination of factors such as insertion date, study date, modality, type, patient age, and so on,” Martyres stated. 

Tag morphing. This is the ability to change the values of one or more DICOM attributes. Martyres explained that there are different reasons why tag morphing is used. “For example, when non-compliant DICOM data is sent, the data can be standardized so that it can be successfully ingested on the other side,” she said. “It is also used to facilitate patient matching by allowing for the addition of things such as National Provider Identifier (NPI) identifiers and accession numbers.”

Hanging protocols. A VNA helps to meet the needs of external systems so that things like hanging protocols can work. “A VNA has to provide a disaster recovery solution which speaks to the ability to provide storage and retrieval of the information reliably independent of hardware and software failures or even natural disasters,” she stressed.

Non-DICOM file formats. Non-DICOM file formats including PDF, XML, or images generated by specialized equipment must be recognized. 

“The most obvious argument for adoption of a VNA or central archive is the consolidation of organizational image data within a single repository. Managing all the image and non-image data in the patient’s medical record in a single consolidated data repository is the less expensive and more efficient way to go,” she concluded. “A VNA is a platform that allows organizations to streamline workflows between different healthcare systems and offers features that are key to enterprise level workflows.” 

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