Charles Stockham, PhD, DeJarnette Research Systems Inc., discussed “Storage Gateway that Facilitates Cross-Enterprise Document Sharing” during the Imaging Informatics in the Enterprise session during SIIM 2007 in Providence, RI, on Friday. His firm is working on two large database projects in Quebec and London. Without standards, data is stored in a proprietary format, patient updates made in the RIS are not necessarily applied to the archive, and image manipulations often are stored in proprietary format as well. “Proprietary interfaces lead to stranded data,” Stockham said.

A standards-based approach allows for a gateway to inexpensive off-site storage and the more sophisticated storage solutions now available are easier to use with standards-based data. Standards also allow for the disaster recovery planning required by HIPAA.

Stockham recently returned from meetings in London about the regional database that will be part of the country’s National Health Service. They discussed workflow issues and their needs, which include:

• Web-based regional access;
• Intelligent pre-fetch by the archive;
• Auto-routing with orders;
• Report status notifications (alert all parties with a vested interest in the results);
• Region-wide worklist for local coverage balance; and
• Referring clinician order list.

Dr. Ruth Dayhoff of the Department of Veterans Affairs, discussed a new telereader application for a national teleretinal imaging network. The project was piloted last August and already increased the screening rate from 46 percent to 71 percent. Readers were trained as equipment was installed across the country. Many veterans weren’t getting screened because of the inconvenience so the VA set up more than 159 image acquisition sites and 58 reading sites. Images are transferred from the acquisition sites to the reading sites. Dayhoff said that the VA has received overwhelmingly positive feedback from both patients and ophthalmologists.