From my involvement in a couple current engagements, a key dilemma facing anyone considering an enterprise image archive is the question of architecture, and is it possible to “reach the pinnacle” of a truly vendor-neutral, patient centric solution that can receive input from multiple service areas, and provide accessibility to a number of applications?
I am reminded of some recent computer technology battles that might well be bell weathers for healthcare image archiving. One example is the 802.11 N Wireless standard. In the words of Wikipedia, “…market demand has led the Wi-Fi Alliance to begin certifying products before amendments to the 802.11 standard are completed.” In other words, in the zeal for faster networking, people are willing to gamble on hardware in the hope that it can meet the eventual final standard.
Another good example is the Blu-Ray versus HD DVD format war. Some elements of consumers were willing to pluck down large sums of money to be pioneers before one or the other became the de facto standard. In this case, Blu-Ray won. And what about all those who bet on HD DVD? At least one retailer is capitalizing on it – Best Buy is offering gift cards to help clear out HD DVD inventory, and trade-ins to convert to Blu-Ray. Smart retailing!
The “lesson-learned” for healthcare imaging: Is there a horse race brewing in terms of enterprise image archival? A lot is made over industry standards efforts such as HL7, DICOM, and IHE as the answer to an enterprise archive. In a perfect world, everyone will interpret the standard and vendor A’s device will easily interoperate with vendor B’s device. Unfortunately, it’s not a perfect world, and vendors still strive for some competitive advantage. Hence, in DICOM there are fields that can support proprietary data! So, is the industry really behind the standards, or merely giving lip service to them and looking for any chance they can to gain a competitive advantage? In the case of an enterprise archive, there are those that would propose force-fitting everything into DICOM, so a non-DICOM object would be handled by enveloping it in a DICOM wrapper.
At the opposite end of the spectrum are those who subscribe to a patient-centric service oriented architecture (SOA). The SOA concept has broad IT appeal in terms of interoperability, and might be considered as a mechanism to supplant standards, and enable different services to cope within the environment. Those that would subscribe to this approach argue that the objective is to create a “vendor-neutral” solution that can interoperate in multiple services. This sounds like a great answer, but, where is the incentive to make it work? Is it market pressure alone that will force vendors toward solutions that interoperate? Will competitiveness get in the way such that proprietary hooks preclude true interoperability?
What is the answer? I am sure there are multiple viewpoints. Having raised this issue, I would like to propose this as a forum for sharing ideas – from both users and vendors, with the objective of educating those for whom this is a concern. I welcome your comments. What do you think? Should the enterprise archive wait and be driven by standards? Or, is SOA an alternative that will win out from market pressure just as Blu-Ray has?
I welcome your thoughts!
