Moving into the limelight - Healthcare Content Management System as primary system for medical data management

Medical data tend to live in the shadow world of IT subsystems – on isolated workstations or in format- or department-specific IT systems. While the disadvantages of these structures – such as cost inefficiencies or gaping holes in patient safety – are well known there has not been a convincing solution for comprehensive medical data management. One explanation is a widespread apprehension to elevate such a solution to the rank of a primary IT system. But once you have overcome this mental block and accept the Healthcare Content Management System (HCM) as second primary system next to the HIS, you are well prepared for any future challenges the healthcare system might hold in store.

A look at workflows in patient care illustrates how exactly the HCM fits in and the tangible value it offers. In a modern healthcare setting with its complex cross-department and cross-facility data streams all clinical patient data have to be stored in a single place in order to ensure seamless and safe care. The financial advantages of such a consolidated solution can only be estimated due to the lack of comparative data. In view of the fact however that the use of digital patient records in medical controlling decreases the search times per case from 42 minutes to 9 minutes * indicates the cost-saving potential of consolidated healthcare data. Imagine all clinical and care staff being able to pull the necessary information from one single system rather than having to log on to different IT systems or, even worse, change work stations.

One reason why such a unified system has never been developed is the fact that consolidating heterogeneous data such as image date, documents, functional data and videos turned out to be very difficult since each data form and format has its very specific requirements with regard to display and processing functionality. Moreover, and this is not trivial at all: in order for an HCM to use data for medical decision making, and this is the raison d’être of such a system, it has to comply with the medical device directive. Simply tying formats together is not sufficient to make clinical data useable and useful.

HCM: Learning from experience is the first step towards innovation

When looking for a primary medical data management systems the HIS seems to be the obvious choice since it contains more data than any other system. The major drawback: the HIS focuses on patient administration and medical process support, such as request management, scheduling, or reporting of services and diagnoses. The HIS is not geared towards archiving, display and post-processing of medical data in different formats. The conventional DMS won’t do either since it does not comply with the medical device directive. Moreover it does not sufficiently support the specific clinical workflows and in most cases does not provide a ‘medical grade’ viewer. 

Thus the most promising candidate to assume the role of an HCM is the PACS with its excellent functionality regarding the structured display of patient exams, its outstanding post-processing and reading options, hanging protocols and compliant and audit-safe archiving. But a PACS reaches its limitations the moment it leaves the DICOM data orbit and has to integrate data from medical technology devices and their subsystems.

As one of the leading PACS providers VISUS has long aimed to make the PACS advantages available to the workflows of other medical disciplines. Based on the functional and process know-how from radiology VISUS created two IT solutions for the management of medical data outside of radiology: JiveX Integrated Imaging to integrate functional data from medical technology devices and JiveX Medical Archive to integrate all medical data, including documents (also from HIS). This entailed the development and programming of gateways which transfer data in any format from subsystems to a leading system such as an HCM. Integration capabilities with the HIS are crucial: Firstly, in order to be able to move data from the HIS to the HCM, secondly in order to transfer medical data back to the HIS and make them available for administrative processes, for example in medical controlling.

PACS und Healthcare Content Management system: one root, two systems

In the meantime, these solutions have evolved into a single system that is modular, flexible and intelligent – a system in its own right, a product onto its own next to the core business „PACS“. The VISUS HCM offers all the advantages the PACS has developed over the years, plus the specific workflow elements for handling a wide variety of medical data.

Case in point: the viewing function. The VISUS HCM offers a unified viewer for all medical data, from the CT scan through ECG to the physician’s letter. It uses the tried and tested concepts applied in radiology, such as hanging protocols. At the same time, the viewer was carried to the next level to provide specialized functions for different objects, such as measuring devices for wound images or ECGs, etc. A further component VISUS moved from the PACS to the HCM world is archiving – compliant, audit-proof and equipped with an intelligent rights management concept. The core difference between a conventional PACS and the HCM is the expansion of standards: the HCM archiving function not only supports DICOM but all other relevant HL7, PDF and IHE formats. Thus all medical data within a system can be archived and managed based on standards. This is the precondition for manufacturer-neutral data consolidation and management which in turn enables data exchange across facilities. 

In short, the VISUS HCM is a system that does much more than consolidating different archives: it integrates subsystems and provides a solution for their archiving needs. It is partner of the HIS – the two systems complement each other. The bi-directional data exchange capability will finally pave the way for lean clinical processes. And last but not least, the VISUS HCM is XDS-enabled, i.e. it can exchange data across facilities. In view of ‘patient cubby holes’, patient records and other planned regulatory requirements this capability generates immense added value in modern data management.