Journal of Digital Imaging

, Volume 32, Issue 2, pp 211–220 | Cite as

Implementation and Benefits of a Vendor-Neutral Archive and Enterprise-Imaging Management System in an Integrated Delivery Network

  • Chen Sirota-CohenEmail author
  • Beverly Rosipko
  • Daniel Forsberg
  • Jeffrey L. Sunshine


The use of digital imaging has substantially grown in recent decades, in traditional services, new specialties, and departments. The need to share these data among departments and caregivers necessitated central archiving systems that are able to communicate with various viewing applications and electronic medical records. This promoted the development of modern vendor neutral archive (VNA) systems. The need to aggregate and share imaging data from various departments promoted the development of enterprise-imaging (EI) solutions that replace departmental silos of data with central healthcare enterprise databases. To describe the implementation process of a VNA-EI solution in a large health system and its outcomes. We review the background of VNA and EI solutions development and describe the characteristics and advantages of such systems. We then describe our experience in implementation of these solutions in a large integrated healthcare delivery network in northeast Ohio. We then present the process, challenges, costs, advantages, and outcomes of such implementation. The VNA and EI solution was launched in December 2015 and is still ongoing. It currently includes 54 radiology and 26 cardiology sites affiliated with the University Hospitals health system. This process was associated with more than 10% cost savings, 30% reduction in storage costs, superior support for disaster recovery, and 80% decrease in unscheduled outages. All these were achieved despite a 120% increase in archive retrieval needs and a 40% growth in image production. Implementation of a VNA and EI solution was successful and resulted in numerous measurable and qualitative improvements in a large and growing health system.


Medical informatics Radiology information systems Diagnostic imaging Patient-centered care 


Compliance with Ethical Standards

Conflict of Interest

DF is an employee of Sectra AB, Linköping, Sweden. All other authors declare no conflict of interests.


  1. 1.
    Marceau C. What Is A Picture Archiving And Communication System (PACS)? In: Duerinckx AJ, ed. 1st Intl Conf and Workshop on Picture Archiving and Communication Systems. Vol 318. International Society for Optics and Photonics; 1982, pp 24–31. doi:
  2. 2.
    Cox JR, Blaine GJ, Hill RL, Jost RG. Study Of A Distributed Picture Archiving And Communication System For Radiology; In: Duerinckx AJ, ed. 1st Intl Conf and Workshop on Picture Archiving and Communication Systems.Vol 318. International Society for Optics and Photonics; 1982, pp 133–142. doi:
  3. 3.
    DICOM Standard. Available at: Accessed April 18, 2018
  4. 4.
    Integrating the Healthcare Enterprise. Available at: Accessed April 18, 2018
  5. 5.
    Thomas JD: The DICOM image formatting standard: its role in echocardiography and angiography. Int J Card Imaging 14(1+):1–6, 1998. CrossRefGoogle Scholar
  6. 6.
    Silva AF D, Costa C, Abrantes P, Gama V, Den Boer A. Cardiology-oriented PACS. In: Horii SC, Blaine GJ, eds. Medical Imaging 1998: PACS Design and Evaluation: Engineering and Clinical Issues.Vol 3339. International Society for Optics and Photonics; 1998, pp 248–256. doi:
  7. 7.
    Thrall JH: Directions in radiology for the next millennium. AJR Am J Roentgenol 171(6):1459–1462, 1998. CrossRefGoogle Scholar
  8. 8.
    Ratib O, Ligier Y, Bandon D, Valentino D: Update on digital image management and PACS. Abdom Imaging 25(4):333–340.
  9. 9.
    Ratib O, Swiernik M, McCoy JM: From PACS to integrated EMR. Comput Med Imaging Graph 27(2–3):207–215, 2003. CrossRefGoogle Scholar
  10. 10.
    Cao P, Hashiba M, Akazawa K, Yamakawa T, Matsuto T: An integrated medical image database and retrieval system using a web application server. Int J Med Inform 71(1):51–55, 2003. CrossRefGoogle Scholar
  11. 11.
    Huang HK: Enterprise PACS and image distribution. Comput Med Imaging Graph 27(2–3):241–253, 2003. CrossRefGoogle Scholar
  12. 12.
    Bandon D, Lovis C, Geissbühler A, Vallée J-P: Enterprise-wide PACS: beyond radiology, an architecture to manage all medical images. Acad Radiol 12(8):1000–1009, 2005. CrossRefGoogle Scholar
  13. 13.
    DeJarnette WT. What is a Vendor Neutral Archive? White Paper Series. 2009. Available at: Accessed April 18, 2018
  14. 14.
    Agarwal TK, Sanjeev: Vendor neutral archive in PACS. Indian J Radiol Imaging 22(4):242–245, 2012. CrossRefGoogle Scholar
  15. 15.
    Bellon E, Feron M, Deprez T, Reynders R, Van den Bosch B: Trends in PACS architecture. Eur J Radiol 78(2):199–204, 2011. CrossRefGoogle Scholar
  16. 16.
    Roth CJ, Lannum LM, Persons KR: A Foundation for Enterprise Imaging: HIMSS-SIIM Collaborative White Paper. J Digit Imaging 29(5):530–538, 2016. CrossRefGoogle Scholar
  17. 17.
    Vest JR, Kaushal R, Silver MD, Hentel K, Kern LM. Health information exchange and the frequency of repeat medical imaging. Am J Manag Care 20(11 Spec No 17):eSP16–24, 2014. Available at: Accessed April 19, 2018

Copyright information

© Society for Imaging Informatics in Medicine 2018

Authors and Affiliations

  1. 1.Department of RadiologyUniversity Hospitals Cleveland Medical CenterClevelandUSA
  2. 2.Sectra ABLinköpingSweden

Personalised recommendations