Paul R. Hart BA, Presenter: Employee, TeraMedica, Inc

Based on the evidence, the paper concludes: - VNA and XDS technologies are complementary - Even so, it is possible to have most but not all of the same benefits from a single implementation of each solution, but…. - The size and nature of the projects matter and can determine the appropriateness of a single or combined solution.

Building on the vast experience of PACS, RIS and HIS enabled by the now almost universal adoption of DICOM and HL7, as well as the growing number of IHE profiles in medical institutions over the last quarter century, the march toward the widespread establishment of the full-blown Electronic Medical Record (EMR) is continuing at a pace. Key among the drivers bringing about these changes since the turn of the millennium, and increasingly over the last 3-5 years, have been the Vendor Neutral Archive (VNA) and Cross-Enterprise Document Sharing (XDS) and XDS for images (XDS-i). 

Three health IT project implementations are presented: - VNA-only solution - XDS-only solution - combined VNA-XDS solution VNA and XDS/XDS-i are compared to ascertain if one technology is better able to meet the needs of medical institutions to make all patient data available to clinicians at multiple points of access.

The paper identifies and addresses a series of questions that arise from the proposition that a combined or shared archive can help produce improved clinical outcomes, including: - Are VNA and XDS alternatives, or are they complementary? - If they are alternatives, why adopt one solution in preference to the other? - If complementary, in what ways? - If implementing one solution, is the other necessary? - Which functions belong uniquely to one and which to the other? - Would it be possible to pick the best features of each and make a hybrid solution? - If an enterprise implements both technologies as a combined solution, is it necessary to make one of them the primary service?

Hart, P, VNA and XDS - An Appraisal of Two Different Approaches to the Problem of How to Make all Patient Data Available at Multiple Points of Access within and across Institutions  .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013770.html