Outside Interest in Maine’s Image Repository

For a larger feature on enterprise imaging that I’ve been working on, I touched base with Todd Rogow, director of information technology at HealthInfoNet, Maine’s statewide health information exchange, to see how the statewide image repository that jumpstarted in May was shaping up. And from the interest that other states are showing in this model, it appears to be going quite well in Maine.Maine’s image repository is a central cloud archive spread across three data centers that houses the full study and report for radiology and cardiology images. Currently, five hospitals are involved in the pilot, which is expected to come to conclusion by early 2013 after all participating organizations agree that their requirements have been successfully delivered, says Rogow.  For now, there are no costs to participate in the pilot, but each site is responsible for making staff resources available to participate for testing and validation of the image workflow, features, and technical architecture, says Rogow. Depending on the PACS software currently deployed, a participating organization may need to purchase additional software to allow for the separation of the digital archive function and integration.  Some lessons Rogow has been learning from the pilot are it is difficult fitting imaging in among all of the competing priorities of meaningful use and ICD-10. Also larger health systems that already have well-established regional PACS for their geographic area are much more complex to onboard to the statewide repository. “We’ve found it much easier to work through the technology side of this solution for those [generally smaller] hospitals that have a standalone solution just because it is not as complex,” says Rogow.

Todd RogowHowever, smaller organizations have their own complexities when it comes to bringing them onboard as they tend to have a smaller IT staff. HealthInfoNet leverages their existing support structures, and is now positioning itself to hire additional account managers to handle onboarding and issue resolution for these smaller customers.HealthInfoNet also offers an added bonus for its customers—onsite storage up to five years. “For large hospital systems, they’re concerned about performance, so just to address that up front, we said that with our partnership with Dell [the Round Rock, Texas-based company that is providing the repository infrastructure] we’ll put at no cost to them hardware within their data center onsite, continue to grow that structure, in order to maintain whatever their volumes are over a five-year period just as a safeguard,” says Rogow. “Accessing data is so critical, and it needs to be done in a timely manner, so that is part of the solution we are deploying.”The statewide approach for an image repository was many years in the making, getting its start as a stakeholder workgroup led by Jerry Edson, former CIO of Maine Medical Center and healthcare consultant for HealthInfoNet. He brought together the major healthcare players to come up with a common imaging approach to provide several efficiencies:

• group purchasing for the lower service costs
• reducing the internal costs of handling CDs
• central disaster recovery to transition organizations from tape to digital backup
• limiting physician liability by allowing access to all relevant prior images

HealthInfoNet is only offering a five-year contract option for customers with additional years for renewal. This was done intentionally to benefit the participating organizations to both provide substantial savings and to control their future costs in these operations, says Rogow.   

Several states have expressed an interest in HealthInfoNet’s imaging model and will be clued in at various levels through its pilot project. These states could eventually tap into Dell’s customer pricing for their own image repositories. “HIEs are looking at other lines of business to be sustainable and to keep the exchange side of the equation going in their state,” says Rogow. “They see this as a very good service that can almost stand on its own two feet. It has savings for the hospital; they can get rid of a lot of hardware, the handling costs and employee time, so there is some hard savings here. It’s very clear-cut from a business scenario.”

With regards to future functionality and next steps, Rogow thinks the image repository would be ideal to store and manage sleep studies, which are very large video files that take up a lot of space. He’s working with Dell to determine future capabilities and make changes to the product roadmap.