Getting Ready for The Next Step in Security Standards
What does the Common Security Framework mean for HealthIT vendors and users?
Medical device manufacturers have implemented a variety of IT security standards in recent years. HIPAA requirements are well established, and a new round of standards will address the need for greater security across healthcare organizations’ rapidly expanding networks.
The International Electrotechnical Commission (IEC) has drafted a global standard—expected to be formalized in October 2010—that describes the roles, responsibilities and activities of the health organization and the medical device manufacturer so that a risk management approach is used when medical devices are added to the institution’s IT network. The draft standard is referred to as IEC 80001-1, “Application of risk management for IT networks incorporating medical devices.”
The Health Information Trust Alliance (HITRUST) believes information security should be a core pillar of, rather than an obstacle to, the broad adoption of health information systems and exchanges. In pursuit of this goal, they led the development of a Common Security Framework (CSF) that they claim “can be used by any and all organizations that create, access, store or exchange personal health and financial information.”
The CSF is described as “an information security framework that harmonizes the requirements of existing standards and regulations, including federal (HIPAA, HITECH), third party (PCI, COBIT) and government (NIST, FTC). As a framework, the CSF provides organizations with the needed structure, detail and clarity relating to information security tailored to the healthcare industry.”
This new information security framework is a relatively new effort to clarify choices so that healthcare provider organizations and medical device manufacturers can ensure that appropriate physical, technical and administrative safeguards are in place. If this initiative is able to achieve its vision, it can serve as a valuable resource throughout the healthcare community.
Jess Edwards, CIPP | Global Director, Privacy & Product Security, Carestream Health
Robin Wible talks about service in Memorial’s DRX installations.
Note to reader: This is the second in a series of interviews with Robin Wible, Director of Imaging at Memorial Hospital (York, PA), who recently completed the purchase and installation of a DRX-1.
“Service has been very good, very responsive, in fact we do quarterly reports for radiation safety, and my chief technologist had a lot of good things to say about the DRX-1—about the uptime, and the service, and the quality, and also the reduction in radiation. We have a radiology school here and the director of the school came over one day and was really impressed with the technology. She thought the Carestream product was really unique and was very impressed. We looked at the traditional products too, but we liked the Carestream sales team and the product and we just took it from there.
Many individuals from Memorial Hospital have been very open in giving their feedback of the CARESTREAM DRX System. Their extended comments can be found here.
What’s important about service to you? Have you ever had a memorable service experience?
Robin Wible, Director of Imaging, Memorial Hospital
The End-to-End PACS Workflow… Will Have to Wait
Nadim Daher, Frost & Sullivan
Today 3D/4D post-processing is, by all measures, a very common step in the radiology reading workflow, one that is performed on more than 30% of imaging studies across modalities. Given these high figures, it is striking how slowly advanced visualization is making its way into the PACS workflow.
The Standards bodies, including NEMA’s DICOM Workgroup 23 and the National Cancer Institute’s Cancer Biomedical Informatics Grid (caBIG) eXtensible Imaging Platform (XIP), are making a concerted effort to push forward an integrated medical imaging software platform. This ideal standard would allow advanced visualization applications to be seamlessly plugged into the software architecture, making it possible for a radiologist to freely move between applications for each study. But, with the exception of a few vendors, we’re simply not there yet.
For the IT vendors, offering the advanced visualization application through PACS means speeding up the migration of more of their thick-client scanner workstation software onto their PACS platform. However, as they start to overcome the technological barriers associated with this migration, it is the internal political challenges that start to kick in between the ‘PACS group’, the ‘Scanner group’ and the ‘Workstation group.’ For whichever reason that is, the fact of the matter is these vendors have mostly been busy re-writing the clinical applications from scratch.
As for most other PACS vendors who are still playing catch-up with advanced visualization, bringing the application onto their PACS is being done in one of several ways. One such method is to incorporate the SDKs and algorithms offered by a number of small advanced visualization vendors on the basis of an OEM software license. They are essentially purchasing the technology from third-party vendors, incorporating it to the PACS, and re-branding it as their own.
PACS vendors are also trying to work out tighter integration deals with the well-established independent advanced visualization vendors, which can add tremendous value through the clinical depth they have developed over the years. But incidentally, such vendors would never agree to disclose all of their source code and have their brand name be absent from the end-product… until they get that “offer they can’t refuse,” that is!
And then there are a select few PACS vendors who have done it right from the start, making 3D an intrinsic component of the PACS - by design and from the ground up. Considering the native 3D capabilities its PACS system has had for more than three years, and the breadth and depth of the specialty clinical applications it has built upon it since then, the CARESTREAM PACS is clearly leading this pack.
What has been your experience with the integration of advanced visualization and PACS systems?
Post contributed by Nadim Michel Daher – Senior Industry Analyst – Medical Imaging and Imaging Informatics – Frost & Sullivan / author of the most recent study publication on the “2010 North American Advanced (3D/4D) Visualization and Clinical Applications for Medical Imaging Markets”
Updates as they’re happening – Live from AHRA!
Photo courtesy of AHRA
Helen Darling, President of National Business Group on Health, opened this year’s AHRA conference today with some sobering but much needed information on the state of healthcare in America. In detailing the potentially disastrous consequences that will come from healthcare costs that are increasing at exponential rates because Americans are using more services than ever before—-it’s clear that medical imaging and healthcare IT suppliers can help in the fight to control and lower costs by encouraging healthcare institutions to implement aggressive quality improvement plans that can result in significant savings.
With 10% of US healthcare costs being spent on diagnostic imaging—-an area of care that is critical to improved patient care and outcomes but is overused at some facilities—genuine collaboration between suppliers and healthcare providers to lower radiology costs and improve productivity can help save precious healthcare dollars.
With workers forgoing pay raises to fund healthcare, and where the national average for healthcare spending by a family of four has surpassed $18,000 per year, aggressive plans to improve the productivity of radiology services while continuing to raise the standard of patient care provided can make a much needed contribution to the monumental challenge Americans face in improving healthcare for generations to come at a price we can all afford.
Did you attend this morning’s keynote speaker? What was your perspective?
AHRA will be featuring this as well as other updates of the annual meeting on the organization’s blog. Likewise, we’ll continue to reflect upon what we’re learning throughout the week here and on our other online channels.
What is it? We have a winner!
Yes, with dozens of entries from radiologists, technologists, administrators and students, we do have a winner (but it was none of these who guessed it!). Instead, our congratulations (and our coffee mug) go to Boyce Thompson (who works in an airport) and has seen similar images go through the detector.
And (drum roll, please) it is a box of cereal!
Thank you for your interest, your comments, and your guesses, and please stay tuned to this channel for the next “What is it?” contest.
Do you have interesting images that might stump the radiology community? If you’d consider allowing us to publish them we’d love to hear from you!
What do you want to know about wireless digital imaging?
The AHRA Annual Meeting is right around the corner, and we’re looking forward to meeting new people from the radiology community at our Wireless Headquarters. We hope to see you there!
To kick off the excitement, Carestream Health will be hosting a Wireless Rally on Monday evening. The educational event will feature a panel discussion, including participants from the Mayo Clinic, Rochester, MN, Memorial Hospital, York, Pennsylvania, Heartland Health, St. Joseph Missouri and Memorial Medical Center, Springfield, Illinois. Our guests will be discussing their experiences with wireless digital imaging, and will be answering questions from attendees.
We understand that not everyone will be able to attend, but it is important to us that we answer your questions! Leave a comment here to let us know what you would like to ask our panel. We’ll raise the most commonly asked questions and report back with panelist response.
Continue to follow us online for live updates from the Wireless Headquarters!
Vote wireless in 2010!
Even in Washington D.C., site of the 38th annual American Healthcare Radiology Administrators (AHRA) Annual Meeting, there’s one thing everyone can agree on: everyone wants to join the “wireless party.”
Wireless digital imaging solutions can boost OR, ER and staff productivity and deliver enhanced patient comfort. Tethers—which can be both inconvenient and unsanitary—are eliminated. Stop by Carestream Health’s booth at AHRA (#810) and find out just how easy and affordable it is to adopt wireless DR solutions for x-ray rooms, automated suites and mobile x-ray systems.
Here’s what some of our customers are saying about their decision to go wireless in 2010!
- “The new DRX-Evolution can perform every imaging exam we perform because of the unique wireless DRX-1 detectors. This single system has everything we need for a highly productive, diverse imaging workflow,” reports Mark Sevcik, Operations and Development Director, Radiology Consultants Associated
- “Our dual-detector DRX-1 system is located in a busy outpatient clinic that serves 10 orthopedic surgeons and general practitioners. Our productivity has doubled and patient wait times are greatly reduced. This wireless detector also offers the positioning flexibility required by complex orthopedic exams,” notes Mike Foley, Director of Radiology, Tufts Medical Center
- “Converting our GE mobile CR system to the DRX-1 detector allowed us to double productivity, improve image quality and provide better patient care. The line and tube companion image is extremely helpful for critically ill and injured patients, and our physicians and surgeons appreciate the ability to review images in just a few seconds,” notes Robin A Wible, CNMT, Director of Imaging, Memorial Hospital
- Installing a DRX-1 detector in our mobile x-ray system has been a great benefit for spine, total joint and other surgical procedures. It reduces imaging time by 10-15 minutes for each patient and the clarity of the image is outstanding,” said Dr. Dean Natchtigall, M.D., orthopedic surgeon, Memorial Hospital
- “Carestream Health’s family of products based on the DRX-1 detector equips us to gain higher quality and faster image access at a very reasonable price. It will also enable us to offer better care, especially for patients in our emergency room, surgical suite and ICU units,” said Larry Kirschner, Heartland Regional Medical Center’s Director of Radiology
- “We have installed our Carestream DRX detector in one of our analog rooms (previously CR only), and the techs love it – almost more than the dual detector DR rooms! It’s the same user interface as our Carestream CR, so staff training and buy-in was easy. We are awaiting our new GE AMX-4 portable and then will retrofit with a DRX detector for use in our PICU. Can’t wait! Thanks for sharing your experience with this product – we agree with your positive results. And for us, it’s in a pediatric environment – our providers like the image quality.” commented Bonnie Wold, Gillette Children’s Specialty Healthcare
What do you think about wireless DR?
New image challenge! What is it?
Radiology challenge image—this one is even harder than the last one (which nobody guessed correctly!).
Step up to it, radiologists, technologists, RAs, MDs, PAs – guess the subject of this educational x-ray quiz and we’ll send you an Everything Rad coffee mug—definitely a status symbol on any desk or table. Competition will be a little stiffer on this contest, too—so be warned—we’re also inviting Aunt Minnie and RadRounds readers to weigh in with their best guess. Good luck!
(Sorry, employees of Carestream Health—and their agencies—are prohibited from entering—go back to work!)
Harnessing the data stampede: Moving to shared workflow
Rounding the clinical data "herd" presents unique challenges and opportunities
The healthcare industry is facing a stampede of data in the form of both images and information. In a prior post, we discussed how multiple storage silos and dedicated departmental solutions create a “herd effect” that is difficult to control. Modern clinical data management solutions help healthcare providers share data, and that’s important. But the next step—a shared workflow—promises to achieve even greater overall efficiency and cost savings.
With a shared workflow, a dispersed group of clinicians and healthcare staff can function as though they are all sitting in the same room at the same time using a single system and user interface.
The basics for achieving this virtual community include:
- A global patient worklist that allows radiologists to read exams captured at any location from any on-site or remote workstation. This eliminates bottlenecks in workflow and eliminates the need for radiologists to travel to specific locations just to read that site’s exams.
- A consolidated patient portfolio that includes data from different departments, hospitals and other healthcare providers, and is delivered through a single user interface.
- Advanced techniques that facilitate the interconnection of incompatible DICOM devices so that information is both available and accurate.
A shared workflow not only rounds up the required data, it equips healthcare providers to harness its collective power. This next-generation workflow improves productivity for individuals and groups while trimming the cost of managing, storing and sharing data.
Are you able to share patient data easily across multiple locations? Have you achieved a consolidated workflow that serves multiple sites?
- Elad Benjamin, General Manager, Carestream Health
How long should mammograms be kept?
Today we’re dealing with a confusing topic with significant clinical, technical and legal ramifications. Specific retention requirements—like screening conventions themselves—vary widely by country as well as locally at the province/state level.
In general, retention of prior film and digital images falls into two very different camps: one puts responsibility on the healthcare facility to retain the images and make them available for a set number of years. Countries such as the U.S., Canada and many European countries mandate this. The other places the onus on the woman being screened to store and retrieve prior images, as in Mexico, South America and India.
For this discussion, we’ll focus on U.S. requirements since they are among the more confusing. For starters, U.S. facilities providing mammography must follow the Mammography Quality Standards Act (MQSA). This law mandates that mammograms be retained for a period of not less than five years and, in some cases, at least 10 years if no additional mammograms of the patient are performed at the facility. But remember, individual state laws may require even longer retention and are equally important to follow.
Many facilities end up retaining prior films for the life of the patient (or longer). This might be due to litigation concerns that could result from missed cancers, lack of understanding of state requirements or the fear of quality inspections. Many are instructed (or choose) to retain film indefinitely, rather than risk making a mistake that could put themselves or their organization at risk. This can result in a huge amount of wasted storage and resource usage that could be avoided—especially since many older mammographic images have been rendered virtually “undiagnostic” by technology advances over the last 10 years.
When organizations transition to digital imaging, this issue is further compounded by questions regarding the digitization of prior images. It’s important to understand that digitized images of prior film mammograms can be extremely useful and can be used for comparison purposes, but cannot be used to fulfill retention requirements as the FDA mandates that the original film mammogram must remain archived and available.
With all of this in mind, my guidance is to always understand your local and state laws regarding retention of prior mammography images. It’s also essential to have a sound strategy for digitizing analog images that aligns with your workflow, patient needs and country and local mammography quality standards laws. This knowledge, and planning, will serve you and your patients well—and just might help you avoid storing “ancient” films longer than you need.
How does your organization/facility deal with this issue?
- Anne Richards, Clinical Development Manager, Women’s Health
