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Handhelds and Governance

Handhelds and Governance

By Jef Williams

By Jef WilliamsThe proliferation of handheld imaging devices continues to expand. These small medical imaging devices are most often used as bedside or point-of-care ultrasound (POCUS) in diagnosing or treating patients. They are affordable to the point that many clinicians have purchased them outside of the normal procurement process. And, while being an effective tool in aiding clinicians, they bring some unique challenges to organizations related to image management, integration and determining how they fit into the patient record. It is important that the governing body or committee that oversees the enterprise imaging strategy take steps to frame this disruptive technology within the parameters of its overarching goals.

These devices typically come with their own storage or archive platform in the cloud. As images are acquired, they are stored in the vendor’s hosted environment where users have access to image manipulation and viewing tools. While this brings a level of simplicity in deployment, it creates challenges for organizations that want to integrate these images into the larger imaging archive model. If images are stored both in the cloud and locally, there needs to be robust integration to ensure that all copies of these images, wherever they reside, are kept in sync. If the goal is ultimately having all imaging available via a single enterprise viewer, these images should also be available to that viewer. If the primary storage of these images remains in the cloud, one must ensure there are good image management policies and auditing capabilities in place.

The role these images play in the complete patient record will determine how to integrate these images to the EHR. The vendors provide strong integration points and many organizations have found a key stream of revenue by doing so. To store these images in context allows organizations to bill for the imaging done by these devices. More importantly, having these images available to clinicians through the EHR simplifies their access at the point of care.

Disruptive technology like this is good for our organizations. It challenges the status quo and tests our strategic planning. As is the case with handheld devices, some of these disruptions are entering our ecosystem outside of our prescribed processes and we must have the agility to respond. I began seeing these phone-driven ultrasound probes at the Consumer Electronics Show (CES) long before they made their appearance at the most popular health care conventions. It indicates that new technology is emerging as a consumer-driven solution and its introduction in the care environment will not follow standard procurement models.

This is where governance is critical to an enterprise approach to imaging. The goal should not be to dissuade the adoption of disruptive technology but rather to enable it in a way to meet the objectives of a fully image-enabled patient record. There are ways to solve the challenges associated with new, affordable and widely adopted platforms and each organization must solve it uniquely based on its existing technology landscape. But without strong governance, it will be entirely reactive and likely ineffective.

Jef Williams, MBA, PMP, CIIP, is a managing partner at Paragon Consulting Partners.

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