Executive Overview of Corporate Symposium Hosted at RSNA 2021

Expert Panelist include:

Ken Buechele, VP of information technology at Bronson Healthcare
Claude Hooton, president and CEO of Nucleus Health
Kyle Henson, senior director of enterprise imaging at Solis Mammography
Archie Mayani, chief product officer at Change Healthcare for enterprise imaging

Each of our panelists focused on the challenges they faced in Enterprise Imaging and the influence cloud-native innovation had in advancing their Imaging strategies.

Perspectives from the Experts

Nucleus health is a nighthawk teleradiology company with 85 radiologists that read about a million and a half studies a night. Claude Hotton’s strategy was to focus on three critical areas: speed, performance for the radiologists and scalability to grow a company. He focused on giving radiologists the performance needed without buying new hardware. Cloud allowed them to do that.

Bronson Healthcare is a mid-sized healthcare provider in southwest Michigan with about 8500 employees and four hospitals. The goal for Bronson was to look at a current enterprise imaging system and envision where to take the current architecture in the next 3, 5 and 7 years using a shared governance model between stakeholders and IT. They needed to solve the storage issues of an aging data center. The goal was to migrate or move the data center to shrink the footprint.

Kyle Henson, a former PACS administrator of a large IDN enterprise imaging department with more than 70 hospitals was a sceptic of cloud at first. He had to solve the problem of never-ending upgrades with a solution that was as fast as on-prem, secure, and most importantly, offer the latest patches and versions. He had to personally research cloud computing to understand cloud-native technology and why it is different. It was designed solely to utilize the elasticity or the additional resources that cloud offers moving data differently and smarter.

Advantages the panelists are seeing with cloud-native

Nucleus Health is seeing the performance levels their radiologists need. Everyone has PACS features figured out; but, with Change Healthcare’s cloud-native solution they offer innovation with client site rendering and server-side streaming for the performance of timely reading.

Bronson Healthcare initially need to solve for a storage issue at an aging data facility. They required the cloud to be the same or faster for retrieval of images. In pulling some of the older images from on premise archive, it could be a minute or more. Now, it is 5 seconds, on the high end. The increased efficiency is a dramatically noticeable result for Bronson clinicians.

Security and the Cloud

Hospitals are not able to staff the necessary security engineers to meet their imagining needs. So, the question is… can an outside partner who has greater access to the latest resources to better secure the environment. Bronson Healthcare’s data environment had some physical risks – 60-year-old building and sat on the edge of a flood plain. The more information they could put in different places creates a safety net. However, the costs to pay for the redundancy were unaffordable.

From a large IDN perspective, Kyle Henson spoke to having 600 PACS servers and needing to implement Microsoft updates just to stay secure. If one was missed, the systems became vulnerable. They had a fire wall to block the vulnerabilities, but it became outdated. They needed multilayer security for protocols throughout the enterprise. He too suggested that looking to outside the hospital environment to utilize resources to become most secure. He recommended a multi-tenant environment with one application and the encrypted data gets shared only with the customer.

Taking security one step further, Archie Mayani added to look at application that are using best practice standard of SOC2 or HITRUST certified. That is an additional layer of security.

What to consider when migrating to the cloud?

Ken Buechele identified that they are building the foundation for cloud and taking the incremental approach to build in stages. They have identified the business opportunities, the business value and cost effectiveness. They will move the most consumption aspects first and the rest later.

Claude Hooten suggested from a teleradiology perspective that a cloud-native solution offers the ability to go without a secure workstation. Radiologists can log into a secure environment anywhere they want to go. There would be no need to keep updating PCs for security reasons. Outsourcing the data center is a critical piece and is an economical, highly secure, infinitely scalable, and valuable.

Kyle Henson suggestion bringing in the clinical partners to make sure they are part of the decision-making process. Prove to them that they technology works, and you will have a higher adoption rate.

This is a change management process, and education is key. This is a different technology that they will need to understand – the two most important things are speed and security. Time to first image is critical.

Archie Mayani summarized what truly cloud-native offers: reliability, uptime, speed, and innovation. The system allows real time updates, so you don’t have to wait for the next upgrade. Obviously, speed is related to performance. As with the case with Nucleus Health reading 1.5 million images in a night. Speed is necessary. Gaining greater innovation with democratization of the data. We can centralize it and democratize it to build some of the coolest algorithms whether it’s machine learning or AI models.

What should customer look for when evaluating different vendors?

Archie Mayani suggested having customers share their strategic roadmap and organizational goals. The right vendor will sit down and partner on how to meet and solve for those goals. Additionally, ask for ROI calculator on the technology. Make sure it indexes on your goals. Make sure the vendor can innovate with you to meet the goals of the radiologists.

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