The value of information has never been higher than it is today. WalMart may best embody the competitive advantage of information management in the way it has leveraged precise inventory workflow management and past performance information to become the largest retailer in history. Also consider the current stock market success story, Google, which derives its value from its service as an index and manager of digital content—at heart, a Digital Asset Management portal.
Real-world experience with DAM over the last five years clearly demonstrates the cost savings and increased productivity for users of the technology. However, DAM has experienced slower-than-expected growth, in part because of the perception that DAM limits access, rather than the reality—that it expands access. Effective strategies for implementing and using DAM are emerging, particularly in various vertical markets. Within verticals—regardless of differing needs and challenges—the demand for simplified, universal access drives adoption.
Target: Medical Records
Problem: Limited access and control of images and records.
Solution: Create a portal for patients to upload and control access to their images.
DAM can significantly improve quality of life by increasing access to medical records and images while addressing the needs of physicians and patients. The DAM team at i3Archive, Inc., had developed a database of more than one million digital mammography images called the National Digital Medical Archive, or NDMA. NDMA uses two IBM eServer xSeries systems as a grid, with EXP300 Storage units, and data indexed using IBM's DB2 Universal Database. Access is provided between member hospitals across the country, allowing resident physicians to review their patient's year-to-year images—thus improving the level of care the patients receive. Despite the success of this system, i3Archive saw a need for enhancing this database.
Cancer patients frequently see two or more doctors and specialists during their treatment, perhaps at several outpatient clinics or medical facilities. Past and current digital mammographs and images are essential for such treatment, meaning that patients would have to obtain copies from their previous provider every time they went to a new physician or clinic. This also made it difficult to change doctors or care facilities.
By incorporating a new, secure, patient portal to the NDMA, called MyNDMA, i3Archive was able to greatly increase the portability of a patient's records. Now, patients can upload their records to the site and provide their current physician or specialist with access to their images. Patients also now have greater freedom of choice in selecting and changing their doctor, rather than having to remain with a given practitioner, simply because that's where the records are.
Target: Medical Imaging
Problem: Provide remote access to images cost-effectively.
Solution: Leasing with low per-study fee structure.
Despite the benefits, the costs of even entry-level DAM solutions are a significant barrier to entry, tailored as they are for a large enterprise. In particular, rural and smaller facilities find upfront equipment costs and per-user licensing a challenge within their capital budgets. Yet these facilities could often benefit most from having remote access to information with a DAM solution. (Smaller facilities may not have a full-time radiologist, for example, and their current specialist may actually reside some distance from the facility.) Despite this value, the use of DAM with medical imaging to replace conventional film-based technologies has been slow because of the cost.
One company that responded to this need is NovaRad of American Fork, Utah. NovaRad developed its NovaPACS imaging system specifically for smaller sites and rural hospitals. Rather than sell the system outright, it leases the system, charging a monthly fee based on the number of studies performed, rather than on a per-user basis.
In this way, the monthly outlay is about the same as or less than a film-based system that takes into account the cost of film each month. Now, though, there's a significant improvement with faster patient diagnoses—whether in-house or remote, which is a feature of NovaPACS. In turn, NovaPACS also eliminates the cost of storing an ever-growing mass of film that must be housed in controlled conditions for seven to ten years or longer, depending on the jurisdiction and internal policies—a cost and use of space that would be at a premium at smaller hospitals.
Interestingly enough, this lease and per-use licensing plan has drawn considerable interest from larger and urban hospitals on a departmental level or even system-wide. There, the interest is again driven by a desire to preserve capital budgets for other uses.