Vendor Neutral Archive (VNA) - White Paper

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About the "Vendor Neutral Archive" White Paper: For those who do not know what is Vendor Neutral Archive or VNA, the term is used by many vendors of PACS software to identify the core of their product--the component that is used to reliably manage, store, retrieve, and query medical images and related information. Unfortunately, there is no "official" definition of the functionality of a VNA. As such, Vendor Neutral Archive offerings vary from vendor to vendor. The result is confusion among users due to the lack of a baseline that permits a direct comparison of VNA functionality and features.

This white paper proposes a definition of a Vendor Neutral Archive (VNA) that identifies different architecture levels and their specific functionality. The various components which make up the core of a healthcare image and information management system will be discussed. It also provides the key advantages of a VNA compared with a proprietary solution. A checklist which can be used when evaluating and/or requesting a RFI/RFP for a VNA is included as an attachment.

NOTE: For the comfort of our non-technical readers, we have linked difficult terminology in the white paper to our health imaging Wiki, HubPedia, so you can enjoy reading and can get instant reference, definitions and brief detail of technical terms.

Excerpts from VNA (Vendor Neutral Archive) White Paper

It is somewhat unfortunate that the term Vendor Neutral Archive (VNA) has stuck as it does not really describe what a VNA is supposed to achieve. Ideally, a Vendor Neutral Archive is an archive developed on an open architecture that can be easily migrated and/or ported to interface to another vendor’s viewing, acquisition, and workflow engine to manage medical images and related information. Instead of “Vendor Neutral”, a better term would have been “Architecture Neutral”, “PACS Neutral,” “Content Neutral” or “Third-Party Neutral.” Keep in mind that each commercial archive is provided by a specific vendor (we are not considering open-source offerings, which may be the only truly vendor neutral solution). Therefore, the word neutral does not really make sense. However, the VNA acronym has become fixed in both the medical IT user and vendor culture, so we will not make any attempt to re-phrase the term.

What is the problem that a Vendor Neutral Archive intends to solve?
As of today, there are literally thousands of PACS installed and in operation worldwide. Most of these are working satisfactorily, and provide a more efficient and effective solution to manage medical images than was achieved with analog (film-based) solutions. However, PACS users are experiencing growth pains due to two issues: The first one is caused by needing to serve not just the radiology department but also other departments and specialties. These can include departments such as cardiology, radiation therapy, dentistry, as well as other “ologies” such as ophthalmology, endoscopy, and other specialties that use visible-light acquisition modalities. This expansion can be expected to see exponential growth when pathology converts its exams to digital images. As more departments seek access to PACS, the proper identification of patients and exams becomes an issue. Often, each department will have its own patient and exam requisition system, Accession Numbers may or may not be used for identification, and patient and exam IDs may be assigned by each department. There are also very different performance and storage requirements for each of the modalities in each of the departments.

The second PACS growth pain being experienced by users is when they change PACS vendors. This has proven to be a costly, lengthy effort for early adopters. In addition, important information such as image annotations, Key Images, and changes to studies are sometimes lost.

These are the major issues that a Vendor Neutral Archive addresses: Scalability beyond a department-level archive solution that delivers true data integrity for image data and related information; the capability to change PACS vendors without the need to migrate or convert image data and to create true independence from a specific storage solution, i.e., the hardware platform that a PACS vendor might force upon a prospective customer. This changes the role of the traditional PACS archive to one of a transient, easy replaceable component that stores only those images that need to be available for a limited amount of time (e.g., 3-6 months), while the Vendor Neutral Archive provides long term vendor neutral image and information management.

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Excerpts from VNA (Vendor Neutral Archive) RFI-RFP Checklist

  Yes No Future Date
Medical Device
Certifications:
The device is registered with the FDA as a Class 1 Medical Device, registration number: (provide)___________________, or alternatively registered as part of a 510(k) filing, provide registration (K) number:      
Vendor manufacturing/development facility is ISO certified      
Scalability:
The device must be scalable (i.e., support queries and retrievals without noticeable performance degradation) when the number of studies increases.      
Database/Image Manager:
The vendor shall provide user friendly access to usage statistics which includes-- but is not limited to--storage and retrieval rate based on institution, department, modality, and study description      
System administrator tools must allow for patient and study merge      
Tools should allow for changing any DICOM Attribute in the image header and database      
Query tools (SQL is acceptable) shall be provided to access the database for any searches that are needed to locate “lost exams” and perform any analysis (based on images stored) that an institution sees fit      
Changes in image headers should be able to propagate to all images in the respective Exam, Series, Study, and Patient level      
Life Cycle Management:
It shall be possible for images and related information to be deleted by a PACS administrator      
Images shall be able to be deleted based on configurable retention rules which shall include modality type, patient age, study date, and date of last retrieval      
DICOM Image Object Support:
Storage and retrieval of Enhanced DICOM objects such as--but not limited to-- the new multiframe MRI, CT, XA, and RF shall be supported      
A complete list of all supported Image Storage SOP Classes shall be provided    
The device shall be able to support dynamic conversion of new, Enhanced SOP Classes to the traditional SOP Classes based on the destination AE Title      
DICOM Non-Image Object Support:
Changes in window width/level, zoom, and pan shall be stored and retrieved as DICOM Presentation States      
Overlays, such as those that contain measurements and notes, as well as markers and shutters, shall be stored and retrieved as DICOM Presentation States      
Key images shall be stored and retrieved as DICOM Structured Reports      
Structured reports--such as to store CAD and measurements--shall be able to be stored and retrieved      
A complete list of supported Non-Image DICOM SOP Classes shall be provided      

Download VNA (Vendor Neutral Archive) RFI-RFP Checklist

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About the "Vendor Neutral Archive" White Paper Sponsor: This White Paper about Vendor Neutral Archive was sponsored by TeraMedica Healthcare Technology, a privately held company, was formed in 2001 to advance a research project initiated at the Mayo Clinic in Rochester, Minnesota. The challenge was to develop a clinical image archive that could accommodate the size of Mayo’s practice – one of the largest in the country – and provide access to images for clinicians wherever and whenever it was needed. TeraMedica developed the easy-to-use, robust, reliable solution that healthcare enterprises across the country have come to rely on. The TeraMedica Vendor Neutral (VNA) Hyper-Archive brings together silos of clinical content under one institutional infrastructure that works with hyper-intelligence, hyper-speed and hyper-sensitivity to lower the total cost of ownership. The TeraMedica Vendor Neutral Hyper-Archive creates a means to bring together silos of clinical content under one institutional infrastructure Please visit their site for further information on their Vendor Neutral Archive Solution at: http://www.teramedica.info