By Laurence Yudkovitch, Product Manager – Synapse VNA, TeraMedica Division of Fujifilm
The COVID-19 pandemic has upended most office environments across the globe, and healthcare is no exception. Much of the world is under social distancing and stay-at-home guidelines. To limit the spread of disease and conserve scarce personal protective equipment (PPE), many hospitals have closed outpatient departments and cancelled elective procedures and visits. Many providers have transitioned to telehealth, with doctors treating patients in the comfort and safety of their home. Along with EHRs and telemedicine portals, enterprise viewers make it easier to treat patients outside the walls of traditional healthcare environments.
Enterprise viewers, also known as universal viewers, provide any member of the care team access to a patient’s medical images. Typically, a clinician launches the viewer from the EHR while reviewing a patient’s chart to view images associated with the order, visit, or procedure. An enterprise viewer often can federate across multiple archives, meaning it can query a radiology PACS, CV PACS, or vendor-neutral archive (VNA).
The benefit of an enterprise viewer compared to a basic EHR viewer is the ability to provide access to the patient’s full medical imaging record. Enterprise viewers can display multiple images simultaneously, display patient photos, and stream patient-centric video or audio content. We will discuss some examples later, but the key point is that clinicians no longer need to wait for specialists to share files with them, which can be particularly challenging in these socially distant times when many offices are closed.
Modern enterprise viewers run on any HTML5 browser and can be accessed from any system without requiring special software or VPN connections. This translates into easy access both inside and outside the office. Synapse Mobility, for example, is a zero-download HTML5 application that runs on Chrome, Internet Explorer (IE), Firefox, and Safari. It supports Android and offers a dedicated iOS app that is perfect for iPhones and iPads frequently used in healthcare facilities. While the ability to diagnose an X-ray or CT while out for dinner may seem superfluous in normal times, it’s become more essential during the pandemic and will likely see continued demand as clinicians grow accustomed to the benefits of the technology.
Consider the following use cases, whether you’re still in-clinic or providing telehealth while social distancing:
- Wound care: A patient was recently admitted to the emergency department (ED) with third-degree burns on his abdomen. While at home, the physician reviews the patient’s prior images to see how the wound has changed since the initial admission.
- GI visit: A patient with irritable bowel disease (IBD), such as Crohn’s or colitis, schedules a telehealth visit due to continued abdominal pain 5 days after being discharged from the hospital with COVID-19. The specialist pulls up the patient’s most recent colonoscopy images along with the point-of-care ultrasound (POCUS) scan taken in the intensive care unit (ICU) to help determine the need for further testing.
- Transplant follow-up: A patient reports a rash on her neck 15 months post-transplant and submits photos through the EHR patient portal, sparking concern about possible GVH (graft vs. host). During the telehealth visit a week later, the transplant specialist and consulting dermatologist (who are in different offices) compare the patient-submitted photos with photos taken at discharge and observe the current state of the rash during the video consultation.
- Pediatric injury: A parent schedules an urgent visit after her child suffers an injury attempting a viral TikTok challenge. She uploads the video to the patient portal, which the pediatrician watches in the enterprise viewer before the telehealth visit.
- Orthopedic: A patient is scheduled for a 6-month follow-up after knee surgery to repair a torn meniscus. The surgeon brings up an MRI of the knee, an arthroscopic video from the surgery, and a gait study video taken by the physical therapist showing improvement and ongoing challenge areas.
One of the great benefits of Synapse Mobility is its built-in collaboration tools. From the Synapse Mobility platform, a clinician can invite others to join the session, making it great for consultations with colleagues and/or engaging family members remotely. Users can share audio/video in a HIPAA-compliant manner and obtain access to all the tools, including measurement and annotation.
Synapse Mobility is also a cacheless system in that it retrieves all content directly from the source archive (PACS, VNA, etc.) and streams it to the user. For IT, this means no extra storage is needed, and it can easily scale up by adding additional servers. For users, performance is similar to YouTube or Netflix, where the server does the heavy lifting and they can start browsing content immediately.
Social distancing has forced many of us to adopt new workflows and learn new tools. Although this disruption in routines has created some chaos, a positive aspect emerges as the technologies scale to support our new normal, and we learn better ways to care for patients. An enterprise viewer, such as Synapse Mobility, is one such tool that has demonstrated its value during the pandemic and should continue to be an integral part of a comprehensive enterprise imaging strategy going forward.