The capabilities of today’s imaging systems are improving rapidly. At the same time, their size is shrinking almost as quickly. As a result, more imaging technology is able to be used beyond the traditional radiology center. While this is fantastic for physicians and their ability to diagnose certain health conditions more effectively, the sheer quantity of images being stored is massive. That can be an overwhelming concern for doctors and hospitals.
 
Fortunately, while imaging technology manufacturers focus on greater visual capabilities and smaller form sizes, there are companies working on addressing the image management challenges. These companies can work with imaging system OEMs to provide them with cloud-based storage solutions that offer their customers security and the ability to view images anywhere and anytime. One such company, Ambra Health has a solution for image management that can be used by the hospitals with systems they already have in place or by device manufacturers looking to enhance their offering with an image management package. I had the opportunity to speak with Ambra Health’s chief product officer, Ed Marshall, recently about the challenges of dealing with the sheer volume created by today’s imaging systems, the advantages his company’s solution offers, and what the challenges ahead are going to be in this space.
 
Sean Fenske: What is the imaging management solution you offer? Can you briefly describe it?
Ed Marshall: Ambra’s cloud-based image management suite provides a healthcare facility with the software, services, and support needed to address its image management needs. As our healthcare system moves toward higher interoperability, rapid image sharing and storage has become a priority across all medical specialties and facilities.
 
Redundant imaging exams due to missing data can place patient health at risk and raise costs for facilities. Whether a healthcare professional is in radiology, cardiology, neurology, or another sub-specialty, determining how to manage medical imaging and combine key patient data is a key concern. By partnering with Ambra, an interoperable landscape that allows for easy image exchange, anytime and anywhere diagnostic viewing and scalable storage is possible.
 
Fenske: Is your system format/company agnostic? Is it compatible across all imaging systems?
Marshall: Yes, Ambra is an agnostic, API-first platform. It can be leveraged as a stand-alone solution for imaging, or it can be layered onto other picture archive and communication systems (PACS). Developers can access the full power of Ambra through our comprehensive and fully documented APIs. They gain full control in managing image attributes, PHIs, user, role and group settings, study and patient information, orders and routing, HL7 commands, and more. It’s an end-to-end customization platform that enables users to connect Ambra with their healthcare systems, build custom integrations, or even develop in-house administration tools to tailor Ambra to their specific administration and workflow needs.
 
Fenske: Why is an imaging management solution important? What are the challenges it addresses?
Marshall: From reducing the time for staff to burn and mail a CD to eliminating manual data entry, cloud image management platforms like Ambra improve physician and administrative productivity and patient satisfaction. Ambra cloud image management ensures that imaging is always at the physician’s fingertips, so that when something comes up during non-clinical hours, critical information is always just a few clicks away.
 
The new reform rules promote the limiting of medical procedures and tests unless very necessary. Teamwork between providers and coordination among various points—from imaging centers, primary care physicians, and hospital surgical units—is absolutely critical. Missing medical images that lead to rescans is no longer a feasible option. Medical imaging must be available in real-time, either via PACS or via integrated electronic medical records.
 
Fenske: What value does your solution bring to medical device makers? In other words, why would they want to work with you as their imaging management solution (instead of perhaps providing their own)?
Marshall: Ambra can easily connect imaging modalities through a powerful gateway to transfer studies from DICOM modalities and PACS, as well as RIS via HL7, all using the cloud. Unique protocols ensure the highest degree of reliability possible for study uploads.
 
Ambra can also take the burden of disaster recovery and archiving management off device manufacturers by consolidating multiple imaging systems with one flexible, customizable, and low maintenance cloud storage platform. The ability to reliably retrieve a backup copy of imaging data that might be otherwise lost due to hardware/software or network failures is no longer just good practice, but a federally mandated requirement. Using cloud storage solutions as a backup method provides instant access to secondary versions of medical images and priors if primary data becomes unavailable.
 
Fenske: How do you address security in your system?
Marshall: One of the most secure methods of storing patient data in the cloud is our split-merge technology. This technology anonymizes image studies by removing protected health information from the imaging data. The protected health information is then separately encrypted and stored, creating an Internet-safe image study. The Ambra suite is HIPAA compliant and the Ambra diagnostic viewer is FDA Class II compliant and has 510(k) clearance.
 
Fenske: With more doctors seeking to review images wherever they are (in an office, hospital, on the go, etc.), how does your solution address that?
Marshall: Our 510(k)-cleared viewer is Class II compliant per FDA regulation 892.2050, and can be easily integrated with single sign-on into the patient jacket of leading electronic health record (EHR) systems or health information exchanges (HIE). Because it’s a next generation HTML5, zero-footprint diagnostic viewer, it’s mobile-friendly too. Browser-based and mobile accessibility puts critical information essential to quality patient care right at physicians’ fingertips. Using the Ambra HTML5 zero-footprint diagnostic viewer, physicians can access patient images from any PC, Mac, or tablet and perform measurements, make annotations, compare images, and more. Real-time image viewing is particularly critical in emergency situations. For example, instead of rushing into the office to view an image, medical personnel can make a preliminary diagnosis right from home. In larger institutions, mobile viewers allow multiple doctors to view the same studies simultaneously, which is especially useful for collaboration across networks. Viewing imaging on a mobile device can also be used as an interactive tool when meeting with patients. Tablets facilitate a collaborative approach based on visuals and can enable care providers to explain procedures in a more comprehensive manner. 
 
Fenske: What’s next for this type of solution? What can we expect in imaging management in the near and long term futures?
Marshall: Imaging is moving beyond DICOM to non-DICOM imaging like still-frame images, videos, and even mobile phone pictures captured during emergency situations. Image-enabling EMRs with non-DICOM imaging, storing large video-clips, and viewing across devices will all become a key part of any enterprise imaging strategy.
 
Fenske: Any other comments or thoughts you’d like to share?
Marshall: With providers wrapping up their electronic health record (EHR) system rollouts, imaging is fast becoming the next large dataset to manage and optimize as part of a holistic patient record. For instance, New England Baptist Health (NEBH) leverages the Ambra platform to allow physicians to access patient medical imaging from anywhere, anytime—whether it’s during clinic hours with the patient, getting a consult from a colleague during a virtual session, or in the OR in the hospital when performing the procedure.