EMix

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eMix, which stands for Electronic Medical Information Exchange, is a cloud computing-based technology for secure sharing of medical imaging studies and reports between disparate healthcare facilities and physicians. [1] eMix was developed to address a challenge in medical imaging: How to exchange medical imaging data between proprietary information technology (IT) systems that do not "talk to each other", [1] [2] [3] The service also provides an alternative to legacy solutions typically used for sharing medical imaging data. [1] [2] [3] Examples of such legacy methods include:

Cloud computing form of Internet-based computing that provides shared computer processing resources and data to computers and other devices on demand

Cloud computing is the on-demand availability of computer system resources, especially data storage and computing power, without direct active management by the user. The term is generally used to describe data centers available to many users over the Internet. Large clouds, predominant today, often have functions distributed over multiple locations from central servers. If the connection to the user is relatively close, it may be designated an edge server.

Medical imaging technique and process of creating visual representations of the interior of a body

Medical imaging is the technique and process of creating visual representations of the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging.

Information technology (IT) is the use of computers to store, retrieve, transmit, and manipulate data, or information, often in the context of a business or other enterprise. IT is considered to be a subset of information and communications technology (ICT). An information technology system is generally an information system, a communications system or, more specifically speaking, a computer system – including all hardware, software and peripheral equipment – operated by a limited group of users.

Contents

eMix was one of the first cloud-based systems for accomplishing these tasks. [1] [2]

Cloud-based services are likely to help facilitate the trend toward universal access to medical imaging and other electronic medical information. For example, members of health information exchanges (HIEs) can use a service such as eMix to share radiology data even when those members have mutually incompatible IT systems. The service also makes it possible for a healthcare institution to include radiology data obtained from out-of-network facilities or physicians in the institution's PACS, radiology information system (RIS), healthcare information system (HIS), or electronic medical record (EMR). Finally, it is a logical system for patients to use when adding medical imaging information to their personal health record (PHR). [4]

Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community or hospital system. In practice the term HIE may also refer to the organization that facilitates the exchange.

A personal health record (PHR) is a health record where health data and other information related to the care of a patient is maintained by the patient. This stands in contrast to the more widely used electronic medical record, which is operated by institutions and contains data entered by clinicians to support insurance claims. The intention of a PHR is to provide a complete and accurate summary of an individual's medical history which is accessible online. The health data on a PHR might include patient-reported outcome data, lab results, and data from devices such as wireless electronic weighing scales or from a smartphone.

A potential advantage of using a cloud-based system is affordability. Healthcare institutions, physician offices, and patients need no special infrastructure to use such a system—they only need a computer connected via broadband to the Internet. They don't need to acquire special hardware or software, and can pay for the service on a subscription basis, much like phone service. [3] [5]

In telecommunications, broadband is wide bandwidth data transmission which transports multiple signals and traffic types. The medium can be coaxial cable, optical fiber, radio or twisted pair.

History

The cloud-based service is a business venture of DR Systems, an independent provider of enterprise imaging and information management systems for hospitals, integrated healthcare networks and diagnostic imaging centers, [2] [6] eMix debuted in beta phase in late 2009. During this period, it was successfully tested by three medical facilities in Montana on behalf of Image Movement of Montana, an organization of 30 medical institutions in Montana that formed to seek more efficient ways of sharing medical imaging data, [4] [6] The three IMOM members implemented eMix on a clinical basis in December 2009, becoming the first facilities in the nation to exchange data with the system, [3] [4] [6] Other IMOM facilities have since tested and implemented eMix, as well. [7] eMix was launched as a commercially available product in early 2010. Besides the IMOM facilities, eMix is currently being used by healthcare providers in Florida, California, Texas, Washington, Alaska, Tennessee, Arkansas, and South Dakota. [7] European eMix service is scheduled to debut in European countries in the Fall of 2010. [8]

Information management (IM) concerns a cycle of organizational activity: the acquisition of information from one or more sources, the custodianship and the distribution of that information to those who need it, and its ultimate disposition through archiving or deletion.

Management

DR System's Chairman of the Board is Murray Reicher, M.D., a board-certified diagnostic radiologist and company co-founder. The company's President and Chief Executive Officer is Richard Porritt. The General Manager for eMix is Florent Saint-Clair. [8]

Workflow

Workflow using eMix takes place as follows:

See also


Related Research Articles

Picture archiving and communication system

A picture archiving and communication system (PACS) is a medical imaging technology which provides economical storage and convenient access to images from multiple modalities. Electronic images and reports are transmitted digitally via PACS; this eliminates the need to manually file, retrieve, or transport film jackets, the folders used to store and protect X-ray film. The universal format for PACS image storage and transfer is DICOM. Non-image data, such as scanned documents, may be incorporated using consumer industry standard formats like PDF, once encapsulated in DICOM. A PACS consists of four major components: The imaging modalities such as X-ray plain film (PF), computed tomography (CT) and magnetic resonance imaging (MRI), a secured network for the transmission of patient information, workstations for interpreting and reviewing images, and archives for the storage and retrieval of images and reports. Combined with available and emerging web technology, PACS has the ability to deliver timely and efficient access to images, interpretations, and related data. PACS reduces the physical and time barriers associated with traditional film-based image retrieval, distribution, and display.

Digital Imaging and Communications in Medicine (DICOM) is the standard for the communication and management of medical imaging information and related data. DICOM is most commonly used for storing and transmitting medical images enabling the integration of medical imaging devices such as scanners, servers, workstations, printers, network hardware, and picture archiving and communication systems (PACS) from multiple manufacturers. It has been widely adopted by hospitals, and is making inroads into smaller applications like dentists' and doctors' offices.

Health informatics discipline at the intersection of information science, computer science, and health care

Health informatics is information engineering applied to the field of health care, essentially the management and use of patient healthcare information. It is a multidisciplinary field that uses health information technology (HIT) to improve health care via any combination of higher quality, higher efficiency, and new opportunities. The disciplines involved include information science, computer science, social science, behavioral science, management science, and others. The NLM defines health informatics as "the interdisciplinary study of the design, development, adoption and application of IT-based innovations in healthcare services delivery, management and planning". It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and bio-medicine. Health informatics tools include computers, clinical guidelines, formal medical terminologies, and information and communication systems, among others. It is applied to the areas of nursing, clinical medicine, dentistry, pharmacy, public health, occupational therapy, physical therapy, biomedical research, and alternative medicine, all of which are designed to improve the overall of effectiveness of patient care delivery by ensuring that the data generated is of a high quality.

GE Healthcare company

GE Healthcare is an American multinational conglomerate incorporated in New York and headquartered in Chicago, Illinois. As of 2017, the company is a manufacturer and distributor of diagnostic imaging agents and radiopharmaceuticals for imaging modalities that are used in medical imaging procedures. The company offers dyes that are used in magnetic-resonance-imaging procedures. GE Healthcare also manufactures medical diagnostic equipment including CT image machines. Further, it develops Health technology for medical imaging and information technologies, medical diagnostics, patient monitoring systems, disease research, drug discovery, and biopharmaceutical manufacturing. The company was incorporated in 1994 and operates in more than 100 countries. GE Healthcare operates as a subsidiary of General Electric.

A hospital information system (HIS) is an element of health informatics that focuses mainly on the administrational needs of hospitals. In many implementations, an HIS is a comprehensive, integrated information system designed to manage all the aspects of a hospital's operation, such as medical, administrative, financial, and legal issues and the corresponding processing of services. Hospital information system is also known as hospital management software (HMS) or hospital management system.

Electronic health record a program used to document a patients medical history on a computer

An electronic health record (EHR), or electronic medical record (EMR), is the systematized collection of patient and population electronically-stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.

Teleradiology transmission of radiological patient images

Teleradiology is the transmission of radiological patient images, such as x-rays, CTs, and MRIs, from one location to another for the purposes of sharing studies with other radiologists and physicians. Teleradiology is a growth technology given that imaging procedures are growing approximately 15% annually against an increase of only 2% in the radiologist population.

A Regional Health Information Organization, also called a Health Information Exchange Organization, is a multistakeholder organization created to facilitate a health information exchange (HIE) – the transfer of healthcare information electronically across organizations – among stakeholders of that region's healthcare system. The ultimate objective is to improve the safety, quality, and efficiency of healthcare as well as access to healthcare through the efficient application of health information technology. RHIOs are also intended to support secondary use of clinical data for research as well as institution/provider quality assessment and improvement. RHIO stakeholders include smaller clinics, hospitals, medical societies, major employers and payers.

JPIP is a compression streamlining protocol that works with JPEG 2000 to produce an image using the least bandwidth required. It can be very useful for medical and environmental awareness purposes, among others, and many implementations of it are currently being produced, including the HiRISE camera's pictures, among others.

The American College of Radiology (ACR), founded in 1923, is a professional medical society representing more than 38,000 diagnostic radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians and medical physicists. The ACR is centered on six core functional areas: membership value, quality and safety, advocacy, economics, research, and education.

VistA Imaging is an FDA-listed Image Management system used in the Department of Veterans Affairs healthcare facilities nationwide. It is one of the most widely used image management systems in routine healthcare use, and is used to manage many different varieties of images associated with a patient's medical record.

BHIE is an acronym for Bidirectional Health Information Exchange, a series of communications protocols developed by the Department of Veterans Affairs. It is used to exchange healthcare information between Department of Veterans Affairs healthcare facilities nationwide and between VA healthcare facilities and Department of Defense healthcare facilities.

Imaging informatics, also known as radiology informatics or medical imaging informatics, is a subspecialty of biomedical informatics that aims to improve the efficiency, accuracy, usability and reliability of medical imaging services within the healthcare enterprise. It is devoted to the study of how information about and contained within medical images is retrieved, analyzed, enhanced, and exchanged throughout the medical enterprise.

VistA electronic medical record system developed and used within the U.S. Veterans Health Administration

The Veterans Information Systems and Technology Architecture (VISTA) is the nationwide veterans clinical and business information system of the U.S. Department of Veterans Affairs. VISTA consists of 180 applications for clinical, financial, and administrative functions all integrated within a single database, providing single, authoritative source of data for all veteran-related care and services. The U.S. Congress mandates the VA keep the veterans health record in a single, authoritative, lifelong database, which is VISTA.

Medical image sharing

Medical image sharing is the electronic exchange of medical images between hospitals, physicians and patients. Rather than using traditional media, such as a CD or DVD, and either shipping it out or having patients carry it with them, technology now allows for the sharing of these images using the cloud. The primary format for images is DICOM. Typically, non-image data such as reports may be attached in standard formats like PDF during the sending process. Additionally, there are standards in the industry, such as IHE Cross Enterprise Document Sharing for Imaging (XDS-I), for managing the sharing of documents between healthcare enterprises. A typical architecture involved in setup is a locally installed server, which sits behind the firewall, allowing secure transmissions with outside facilities. In 2009, the Radiological Society of North America launched the "Image Share" project, with the goal of giving patients control of their imaging histories by allowing them to manage these records as they would online banking or shopping.

Life Image is the world's largest healthcare network for exchanging clinical and operational information, including medical images. Founded in 2008, Life Image has spent the past 10 years innovating an interoperable network ecosystem, that connects hospitals, pharmaceuticals, medical device and telemedicine companies, individual physicians, and patients with medical imaging machines, storage databases, and electronic health records (EHRs). Today, the Life Image network connects over 1,500 facilities in the United States and over 50,000 clinics globally, including 8 of the top 10 U.S. hospitals.

Ambra Health, is a software company that provides solutions for medical image sharing of DICOM and non-DICOM data between patients, physicians, and hospitals. As of 2016, the company has raised over $45 million for developing its cloud platform.

Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records. The US Congress included a formula of both incentives and penalties for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the, American Recovery and Reinvestment Act of 2009.

References

  1. 1 2 3 4 Phillips, J (2010). "Will Cloud Computing Blow Over?", Imaging Technology News, Jan./Feb. 2010.
  2. 1 2 3 4 McBride, R (2010). "DR Systems Spins Off eMix to Provide Online Exchange for Medical Images", Xconomy, 6 April 2010. Retrieved on 9 July 2010.
  3. 1 2 3 4 5 Reicher, M (2010). "Safe and Sound: Providing Security for Exchanging Medical Records", RT-Image, 18 January 2010.
  4. 1 2 3 Cadet, J (2010). "Cloud Computing: The Forecast for Image Management", Health Imaging & IT, 24 March 2010. Retrieved on 9 July 2010.
  5. ↑ Tang K (2009). "Cloud Computing Drives Design of New Imaging Management Platform", Diagnostic Imaging, 30 November 2009. Retrieved on 9 July 2010.
  6. 1 2 3 Merrill, M (2010). "Montana Providers Use Cloud Computing to Share Radiology Data", Healthcare IT News, 4 January 2010. Retrieved on 9 July 2010.
  7. 1 2 HIMSS10 NewsWire (2010). "eMix Presents Cloud Technology for Image Sharing", Healthcare IT News, 23 February 2010. Retrieved on 12 July 2010.
  8. 1 2 biowire (2010). "eMix Signs First European Distributor Agreement, Will Exhibit at German Radiology Congress", Business Wire, 3 May 2010. Retrieved on 12 July 2010.
  9. ↑ Vaughn C (2009). "Facilities Use Cloud Computing to Share Radiology Images", HealthLeaders, 15 December 2009. Retrieved on 9 July 2010.
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