VNA Initiative – Top 5 Univiewer Considerations

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Jef WilliamsBy Jef Williams

June 2013—Medical imaging is again being asked to evolve rapidly based on new demands, new sources, new technology, and new delivery models of care.  Medical imaging executives are being bombarded about the nature, requirements, and benefits of vendor neutral archiving (VNA) and its associated technology – the Univiewer.  As you consider VNA technology you must also determine Univiewers as a supporting solution for managing enterprise medical imaging both near and long term.

Let’s consider the top five reasons to implement a Univiewer solution prior to your VNA or a supplementation to a VNA effort and how it will add value to your enterprise medical imaging initiatives:



Large communities of providers and referrers who are operating multiple viewers can achieve significant advantages.  By replacing the rabble of viewers with a single federated solution, you will gain early user buy-in, satisfaction, and more importantly a community of advocates for your imaging strategy.  This should lead to increased revenue from the referring community as their satisfaction is immediately, and tangibly, improved.


Current VNA projects are being estimated by larger healthcare entities to take around 8-12 months from inception to rollout. In my experience assisting organizations in streamlining their activities through the business plan, vendor selection, and implementation, I’ve realized that often the value of the VNA is not communicated sufficiently to gain organizational buy-in.  Healthcare is dealing with so many changes and impending deadlines around Meaningful Use, ICD-10, ACOs, and HIEs that a new initiative must contain robust communication and buy-in components for it to be successful. .  As John Kotter writes in his landmark book Leading Change, “running a transformation effort without serious attention to short-term wins is extremely risky.”1  Your VNA/Univiewer project will take time, a lot of capital, and a dedication of resources.  This amount of investment deserves a clear strategy that includes communication of early wins.  Deploying a Univiewer will give you a significant win across all stakeholders. IT will become a chief supporter as this option will reduce complexity in supporting the portfolio of viewers and users will appreciate a simplified way to access image data.


Charting your environment, both existing and “to-be,” is imperative to a successful Univiewer solution.  Key questions and concerns must be addressed around image caches, clinical systems, and adoption of an MPI prior selecting the appropriate vendor.  Several available market solutions provide a comprehensive set of feature functionality that allows organizations to mitigate issues around image ingestion from external entities, matching patient demographics when no MPI exists, and even providing diagnostic quality images and toolsets.  Choosing intelligently means two things:  1. Know your environment – make sure you are aware of the systems, the structure of support, the long term strategy, the business (M&A) strategy, and downtime and business continuation strategies; and 2. Know your options – take the time to learn what each vendor offers in the market.  There are as many different flavors as there are vendors.  Resist the urge to choose from an existing vendor and take some time to research.


Older systems and those that have been leveraged to manage incremental increases and terabytes of data are scaled to their limits and are starting to sputter with issues around uptime and ongoing performance.  Many of the biggest sufferers are the largest and most complex provider networks in the country.  Coupled with this endemic reality is the fact that most downtime solutions really don’t satisfy the key users: the radiologists.  An option is to pursue a viewer implementation prior to VNA, thus adopting a downtime solution that provides a better environment for the radiologists.  With many univiewers now presenting image data in diagnostic quality and associated toolsets, this solution can be built to allow departments to stay up and running while the clinical system is remediated and brought back live.


Keep in mind the goal is not to adopt a viewer without a VNA.  This solution has its limits.  Most viewers cannot aggregate all image data, and this solution is still dependent upon departmental clinical systems for its horsepower.  By adopting a VNA the users will experience an exponential improvement in performance once the VNA becomes the horsepower for the accessing and viewing of image data.  But by first integrating a Univiewer, this transition to a live VNA will be largely seamless for your user community.


1. Kotter  J. Leading Change. Cambridge: Harvard Business School Press, 1996.

Jef Williams is Vice President at Ascendian Healthcare Consulting and a frequent speaker and writer on healthcare technology topics and Enterprise Imaging solutions.  You can contact him .

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