Vendor Neutral Archives (VNA) are gaining attention in Medical Imaging. VNA's hold promise of true neutrality and most vendors are rushing to bring product to market. This rush, coupled with the immaturity of the technology, has created ambiguity and confusion for early adopters. Many vendors are simply rebranding legacy third party DICOM archives as a VNA solution. Others are providing a full archive solution that accommodates all data types and stores data in native formats. Understanding the difference between the various solutions and archiving methodology is paramount to those who are considering procurement and adoption of a VNA solution.
The value of a VNA offers more than simply archiving DICOM studies. Buyers must perform due diligence in researching vendors solutions as they vary greatly in architecture, methodology, performance and cost. The first and foremost question you must answer is, "What is our need?" This presents a challenge as customers typically have been locked into a vendor solution for so long that it is hard to look at the enterprise with new eyes. One must, however, look carefully at all areas of service beyond radiology and cardiology. Images are acquired across the enterprise in many formats other than DICOM that belong in the patient record and are often held in silos without the availability of PACS, CVIS or other department-specific solutions. A VNA spans these various solutions and consolidates data in one environment.
VNA's, in addition, should be capable of providing the next level of storage management and information dissemination. These include the foundations of the next generation of imaging architecture. Some key components of archiving include:
- WebServices for header/database index publication
- Certified Hardware Virtualization
- Hardware agnostic implementation option
- ILM (image lifecycle management)
- Routing / Prefetch rules
- Data Normalization tools
- Native DICOM and Non DICOM object archival in native format.
- Single Patient Record across all disciplines
- Single integration point for image enablement for all archiving clinical systems
There are by my definition three categories of VNA solutions: True VNA, Hybrid VNA and DICOM VNA. There is a place for all three within the VNA space as each need is individual and unique. Some adopters may not need a full VNA to accomplish strategic goals and facility needs, while others may require a more robust and complete archiving solution. As you begin the discovery process consider these three categories as you review vendor solutions and consider what type will meet your specific requirements.
True VNA
A true VNA is not only an all in one solution but offers the ability to fully utilize non DICOM objects without manipulation or intervention. A true VNA provides an embedded and supported universal viewer that is capable of displaying DICOM and non DICOM objects within a single application without wrapping or encapsulating the object simply to archive the object and make it useful with current technology.
True VNA's typically offer the following abilities:
- WebServices for header/database index publication
- Certified Hardware Virtualization
- Hardware agnostic implementation option
- ILM (image lifecycle management)
- Routing / Prefetch rules
- Data Normalization tools
- Native DICOM and Non DICOM object archival in native format.
- Single Patient Record across all disciplines
- Single integration point for image enablement for all archiving clinical systems
- Unified fully integrated image viewer for Dicom and Non Dicom objects
PACS and CVIS are by default architected to archive image data forever. With many facilities reaching 50+TB, the datacenter has become a graveyard of images that haven’t been accessed in many years.
A True VNA will provide you with a one stop shop for all archiving needs and dissemination of all image data to EMR and HIE exchanges by default. They will provide Viewer support or access to the data if a third party viewer is warranted by your analysis. A True VNA will work to archive all data types.
Hybrid VNA
A Hybrid VNA offers the core infrastructure of a True VNA but does not include a few items that tie the entire package together. These abilities typically include:
- WebServices for header/database index publication
- Certified Hardware Virtualization
- Hardware agnostic implementation option
- ILM (image lifecycle management)
- Routing / Prefetch rules
- Data Normalization tools
- Native DICOM and Non DICOM object archival in native format.
- Single Patient Record across all disciplines
A Hybrid VNA is lacking in a unified viewer, it allows you, the customer, to choose best of breed when selecting a viewer for your enterprise. It provides the viewer a Direct Access Link (DAL) to the object storage location. Hybrids are capable of storing non DICOM objects but typically by default do not provide an ability to utilize the non DICOM object unless the chosen third party viewer is capable of displaying that file type. Consider this a finger pointing session between the clinical application system and the third party unified viewer. The VNA vendor will simply provide storage and access to the object.
DICOM Archive VNA
DICOM VNA's are simply third party DICOM archives with a new name or branding often referred to as PNA or PACS Neutral Archives. They offer the ability to store and archive images from multiple DICOM systems but usually lack the ability to store non DICOM data without wrapping or encapsulation. They often also usually lack ILM and WebServices to publish the data to an HIE. There are many vendors in this space touting VNA, but really they are simply rebranding their existing products.
It is important to understand that many archiving systems use proprietary objects or TIFF formats for image and data storage. This category of VNA vendors recommend that these objects be wrapped or encapsulated in a DICOM Wrapper. This renders the object unusable by the clinical archiving system. It solves the ability to disseminate the object but destroys the ability for the archiving system to utilize the object because it lacks the ability to retrieve that object once stored.
Proceed with Caution
VNA is shaping up to be the next transformation in healthcare IT as the industry moves from a silo based architecture to a more open dynamic architecture in which data is disseminated outside of the enterprise. The complex world of VNA requires that you the client, engage a non biased party to perform an analysis of your enterprise and help you define your needs and future goals for an archive architecture.
VNA selection should be more intricate than a clinical systems selection since replacement would mean the migration of all clinical image data from one VNA to another. Choose your VNA partner for a long term relationship. Knowing what type of VNA will meet your needs is a critical step in the selection process.
Are you and your current clinical systems ready for this wave?
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