Modern radiology workflow requires consumption, choreography, and orchestration of content from multiple disparate information systems that do not natively “talk to each other.” Without optimal integration and interoperability amongst these systems, humans are required to serve as “integrating agents:” this frequently results in inefficiency and error because humans are not good as a integrating agent.
Examples of practical integration strategies that have been used successfully are web viewer EHR integration, single sign-on, RIS vs PACS driven workflow).
Advanced integration strategies, include using vendor APIs, state aggregation, SOA, and IHE.
Interopability is not just about single logon but should address the integration of the different software tools on a granular scale.
IT should move from choreography to orchestration. Instead of just providing a static edge environment, a more versatile system should be available which is loosely coupled using a middle (bus) layer and move towards a service oriented architecture. A component based architecture that supports composite applications and orchestrates these applications into complex workflows.
SOA is, according to dr. Chang, not going to work in healthcare although everyone else is doing it since healthcare IT groups will not make the effort to go for SOA. However, applications can be implemented to mimic a similar environment collecting and combining all available data in the hospital that can go into a dashboard. In this action, normalization of medical data is essential.
Image Sharing—A Fond Farewell to CDs
We are currently moving from sharing data on CDs to Sharing healthcare information in the cloud. Although it is solving part of the problems with CDs a major concern becomes security and confidentiality when moving to network sharing. Some proprietary enviroments are available but the industry should move to the available standards. The IHE XD profiles should be used when applicable.
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