Q&A: Bill Lacy on implementing an effective enterprise imaging strategy

Enterprise imaging is one of the hottest topics in all of medicine, and healthcare and health IT leaders around the country are working hard to develop and carry out a successful enterprise imaging strategy.

Bill Lacy, vice president of medical informatics at FUJIFILM Medical Systems U.S.A. Inc., talked to Health Exec about how Fujifilm is helping providers better understand the ins and outs of enterprise imaging.

Read below for the full interview.

We heard a good deal about enterprise imaging at last year’s HIMSS. Where is this new focus on enterprise imaging coming from and how is Fujifilm responding?

The market right now is at a point where the EHR deployments have more or less been completed—we’re through that phase, which lasted over a decade. During that period, enterprise imaging was really focused on radiology and cardiology, the major imaging-producing areas. Now, as you look at EHRs and physicians see that imaging is being created all over the health system, healthcare organizations are realizing that they have to have an imaging strategy that goes beyond radiology.

We are now seeing a common focus on enterprise imaging in the vendor community, I believe this is because we’re hearing clearly from customers that this need is growing. Fujifilm uniquely has experience in many of the imaging-producing areas as well as the visualization areas, so adding the neutral storage management component—which we did through our acquisition of TeraMedica—it was a natural fit for us to be an end-to-end solution provider for enterprise imaging. That’s why you’ve seen a shift in our messaging around the portfolio to really be more organizational and not just specific to areas such as radiology and cardiology.  

Mergers, acquisitions and consolidated enterprises continue to be a trend in the world of healthcare. What impact will that have on enterprise imaging?

It adds a lot of complexity to the ability of a large organization that is growing, or has consolidated with another large organization, to standardize applications and information systems. You don’t want to have a lot of disparate applications, specifically in the same domains, so enterprise imaging is very complicated for a large health system that is growing and merging with other health systems. For these large health systems having an effective enterprise imaging strategy is now an absolute necessity, and ideally, they have the proper framework planned in advance of any significant growth or merger activity.

Frequently, we have health systems coming to us and talking about their needs around VNA, image sharing and image exchange, enterprise viewing, system migrations all as a result of organizational changes they’ve experienced.  We are doing a lot of educating that these technology decisions need to be considered as part of an organizational enterprise imaging strategy that goes beyond radiology and cardiology and involves leadership at the physician level and IT leadership.

What about the multitude of devices—iPads, cell phones, etc.—out there that now create and contain medical images, video, and clinical information.  How are health systems adapting to this new world of mobile devices, and what is the impact on enterprise imaging strategy?

Well, it’s creating a lot more imaging. You have iPads and phones available in any area where a physician would like to document something, and the resolution of these devices is as good as high-end digital cameras used to be. On the other side of that, you want access more quickly, because you have that device in your hand. So EHRs are evolving beyond what used to be a client to access on the computer; now, physicians are looking for apps on their phones for viewing the imaging and viewing the records. So it’s creating much more content and it is creating demand in the imaging community to view that content.

If you don’t have an enterprise imaging strategy, it’s going to be very difficult to connect the different imaging areas all the way through to the EHR and out to the mobile apps. Securely enabling access to the complete imaging record to the edge of the physician access demand, which is now the mobile devices, is very important to the enterprise imaging strategy. And for some physicians this includes the need to also capture content on these devices, making sure this content is associated with the right patient and securely added back to the VNA.

As a technology vendor, I’m sure you believe an enterprise imaging strategy should be a top priority with healthcare organizations. But tell me about the state of the industry – just how well are hospitals and health systems doing when it comes to actually deploying a comprehensive strategy? What are the challenges?

Every health system we are talking to knows that enterprise imaging is a direction they need to understand, and most systems recognize that they should have a VNA and understand how it fits into a broader storage strategy. The challenge we’re seeing is that most systems have trouble determining where to start; the key drivers are typically an departmental imaging application change, but if you don’t have that kind of driver taking place, it is not clear to most systems how to build that enterprise imaging strategy that begins with an entry-point project and can continue to expand year after year centralizing and securing more and more at risk imaging areas. That’s a big challenge, and a lot of that is due to a lack of understanding of governance. We know who manages PACS, we know who manages an EHR, but enterprise imaging is created across multiple areas of a health system and it’s not always easy to understand who will be the leader of enterprise imaging. Who will make the decisions around imaging retention and access? We are doing a lot of education right now to help customers understand how to build a strategy that starts with their priority areas of need, which may not be traditional, but includes a long term vision and the appropriate technology and governance to see it through.

What do hospital CIOs and senior executives say are their biggest drivers when it comes to enterprise imaging technology?

There’s a difference when you ask an IT professional and a clinical professional about what the driver is. When we talk to IT leaders, their focus is how to operate more efficiently and how to lower costs. When you go over to the clinical leadership, it’s more about how to provide a better outcome while providing better access for physicians to the medical record. All stakeholders are concerned with the larger goals surrounding security and risk mitigation.

It’s important in the governance of enterprise imaging--and this is something we are educating the market on--that you have IT leadership and physician leadership. We see that piece missing today. However,  I think the market will better understand that as we move forward into 2017 and share more and more enterprise imaging success stories.  

What do you see as some of the common mistakes organizations make when it comes to deploying an enterprise imaging strategy?

I think a lot of organizations start a strategy based on a specific scope of work, a specific need, and they don’t really think about the long-term strategy, or organizational impact and possibilities. We see projects that begin, say, with a PACS replacement in radiology, and they may put some of the framework in place, but they don’t plan out what their strategy is beyond that first entry point. I think having that long-term strategy before you take the first step is critical, and that’s something else we are educating customers about.

How does the Synapse portfolio of solutions enable or support an effective enterprise imaging strategy? What sets Synapse apart from competitive solutions?

We consider ourselves the most comprehensive enterprise imaging solution available today. There are lot of vendors that sell VNA and PACS.   There are a few vendors that only sell VNA or only sell enterprise viewer. But, we cover all areas of enterprise imaging with a portfolio of best of breed technologies, and we believe that really offers a unique option for customers to address this need.

If you look at it, our Synapse portfolio includes one of the market leaders in radiology PACS and Cardiology. We work closely with FUJIFILM SonoSite for point-of-care ultrasound along with our Endoscopy Division of FUJIFILM Medical Systems U.S.A., Inc.  And with the acquisition of TeraMedica, we have that organizational content management layer that can separate all the imaging applications from the physical storage equation. This allows IT to begin to eliminate silos and get the cost benefit of a centralized system.

We also have the strength of the enterprise viewer and its ability to integrate with the leading EHR vendors like Epic and Cerner, giving us that capability to provide a single view to physicians for all of the content within the VNA. The addition of TeraMedica, a pioneer in neutral VNA technology, which we still uniquely manage as an independent division, allows us to offer the most intelligent centralized core possible to grow your enterprise imaging strategy.

When considering the right long term partner for enterprise imaging, Fujifilm is pretty unique.  We offer the opportunity to combine all of the technology, plus utilize our experienced resources, our proven record of introducing continuous new innovations and the financial strength of a company like Fujifilm.

This text has been edited for space and clarity.