Defining Enterprise Imaging and Implementation Program – Part 1

In today's healthcare landscape, images are captured and stored in a range of traditional and emerging settings. There is a myriad of ways to obtain clinical multimedia, be it with mobile devices, scope cameras, ultrasound, or one of the many other modalities at the point of care. 

However, inconsistencies in an organization's image capture and storage workflows can reduce the value/seamless incorporation of electronic health records (EHRs). Because images represent valuable care information, proper management and widespread accessibility to clinical imaging and multimedia content are vital to improving patient care and realizing the full potential of EHRs. 

Enterprise Imaging can be defined as a "set of strategies, initiatives, and workflows implemented throughout a healthcare system to routinely and optimally capture, index, manage, store, distribute, exchange and analyze all clinical imaging/multimedia content to enhance the electronic health record." 

In this two-part article, we will discuss the value of Enterprise Imaging initiatives in improving clinical and informatics leadership and outline seven of its key elements associated with health enterprise imaging and multimedia content. 

The key components we will discuss to optimize an Enterprise Imaging program are: 

  1. Governance

  2. Enterprise Imaging Strategy

  3. Enterprise Imaging Platform (Infrastructure)

  4. Clinical Images and Multimedia Content

  5. EHR Enterprise Viewer

  6. Image Exchange services

  7. Image Analytics



Effective, engaged governance is crucial to creating a successful EI  implementation strategy. Defined by HIMSS-SIIM collaborative workgroup as, "the decision-making body, framework, and process to oversee and develop strategies for the enterprise imaging program, technology, information, clinical use, and available financial resources," EI governance should be addressed early in the process of EI strategy formulation. 

The utmost responsibility of EI governance bodies is to join a wide range of stakeholders, including clinical, administrative, and IT departments, to develop a roadmap for implementation. Why? In the initial phase of Enterprise Imaging, different departments typically monitor and control their imaging operations, data governance, IT support personnel, and technological infrastructure on an individual level. Without establishing cross-department information or infrastructure sharing, an organization risks staff resistance to IT changes, and challenges are likely to arise across fragmented service lines. 

Employing an effective governance group, composed of constructive stakeholders, executives, and sponsorship teams, will not only improve the oversight of imaging activities and service lines but ultimately streamline EI initiatives.

Enterprise Imaging Strategy

A beginning EI strategy should align the decisions vetted through governance with the necessary EI infrastructure and services. While clinicians and their specified workflows should be prioritized in EI projects, it is vital to view and tailor strategies from an enterprise-wide scope and consider the potential challenges for non-traditional imaging environments, such as dermatology and ophthalmology specialties. 

For example, many of today's organizations have applications/technologies that can either not be integrated with the EHR to see an image or are not suitable for the EI platform. An EI strategy will not only help stakeholders clarify which applications, storage, and viewers do not fit with long-term enterprise plans, but also make apparent where capital or operational funding must be allocated to best support the EI platform. 

Because IT support may need to be restructured away from a departmental approach to support EI implementation, organizations must begin creating strategies surrounding the requirements, scope, and outcomes of EI integration. 

Enterprise Imaging Infrastructure

By providing the infrastructure, modalities, devices, and integration points on which strategies can be based, the EI platform can help providers meet critical performance objectives, and further, elevate the connection between people and data. How? Implementing an effective EI platform can, for starters, increase efficiency in the diagnostic process. 

With a standardized, universal reading and reporting experience through a global worklist, the traditional, time-consuming need to move between sites or systems is eliminated, and subspecialist reading can be expedited. Standards-based interfaces and communications will connect, enable, and support image acquisition workflows across "previously fragmented" departments and modalities. This ability to streamline data will enhance operational efficiency and optimize performance workflows regardless of bandwidth. 

Further, EI platforms can improve data quality, patient care, and reduce unnecessary costs. For providers and patients alike, the real-time sharing of information can increase the access and comprehensibility of relevant patient data. A single imaging record lets clinicians, patients, and specialists collaborate efficiently, and promote more accurate diagnosis and earlier commencement of treatment. 

In regards to the EI platform and electronic health records, the EHR can use order information to index and track imaging procedures. For encounters-based imaging procedures, the enterprise imaging platform can either 1) utilize an image availability notification to report "voluntary" imaging results or 2)request the EHR to develop an order and associate it directly with the imaging results. With this cross-department transparency and heightened accessibility to media-content, both encounters and order-based imaging workflows can be notified, indexed, and made available in the EHR with clinically relevant descriptors. 


Thus far, we've discussed how governance, strategy, and infrastructure are critical components that, if leveraged correctly, can drastically ease the implementation of Enterprise Imaging initiatives across departments and workflows of a healthcare organization. Check out part two of this article to learn more about other key components, including clinical images and multimedia content, EHR Enterprise Viewer, image exchange services, and image analytics. 

ImageMoverMD offers a suite of solutions to healthcare organizations hoping to integrate, develop, or enhance their enterprise imaging strategies and workflows. Contact us to learn more about how ImageMoverMD can transform your image management.