Developing an imaging strategy for Cleveland Clinic

BOSTON--Most imaging decisions are made based on service line in the hospital and at the end of day nothing is integrated and nothing ties back to the business unit. Lou Lannum, director of MyPractice Imaging Solutions at Cleveland Clinic, spoke during mHealth + Telehealth World about developing an enterprise-wide imaging strategy.

He said well over 40 departments in your hospital are producing some type of imaging content but there’s no ability to exchange and access images. And, those departments managing their own technology assets aren’t doing a very good job.

Facilities face escalating storage complexity and costs as well, he said. Large organizations that bring in images from outside often end up storing the same image multiple times. “It’s a phenomenal number that continues to grow. In the imaging space, there’s no lifecycle management. We keep everything because we think it’s cheap. It’s not. There’s an ongoing cost of keeping that data.”

Organizations should spend some time reviewing their actual storage costs and risks, he advised. An assessment of your organization’s imaging will probably surprise you, he said.

The proliferation of standalone, point-of-care imaging devices and a lack of a HIPAA-compliant strategy outside of radiology are just some of the reasons Cleveland Clinic developed an enterprise-wide strategy for connected health.

First up was the definition which is: an enduring initiative to capture all digital clinical multimedia, securely store the content and make it accessible and viewable within the EHR. “Every image has to be correctly identified, correctly indexed and stored in a central container so it is seamlessly available.”

Clinical and business analytics are the pillars of Cleveland Clinic’s strategy. “If you don’t have a strategic vision of how this is going to fit together and what business model and use cases you want to solve, it won’t work. Build a strategy first. Understand what you’re trying to accomplish and then layer on the technology.”

Cleveland Clinic’s governance model provides direction and oversight across facilities and departments. “Most EMR implementations that fail do not fail because of poor project management, they fail because of poor oversight,” said Lannum. “It’s the same thing here. If you don’t have correct oversight by your executive administration bringing all these departments together, you’re not going to be successful.” Governance is different from project management. Governance helps to ensure everyone is moving down the right path. It’s making sure everyone is calling a wound picture the same thing, for example, and manages it the same way.

Lannum also advised getting the doctors who do imaging in the room to talk to one another and design a multi-department imaging strategy coordinated with enterprise goals. “Don’t let departments design their own strategy,” he cautioned. “Develop department and enterprise workflows. We’re creating a clinical imaging health record that stands right next to the EHR. They’re linked and as a physician works in the EHR, [he or she] has access to all the images we’ve generated and have come in from outside.”

Lannum also advised the audience to start deleting any content that no longer must be saved. The current trajectory of storage needs will lead to zetabytes within the next 10 years, he said. A tiered strategy for storage is needed but “we have to start deleting.”