Maine's health information exchange (HIE) today announced it is piloting what is said to be the nation's first statewide medical imaging archive, giving physicians access to patient X-rays, MRIs and other images regardless of their location.

Maine's statewide exchange, HealthInfoNet, currently serves a million of the state's 1.3 million residents in sharing some form of electronic medical record (EMR) information between healthcare providers. The new medical imagery archive will be hosted on a separate public cloud infrastructure, provided by Dell.

Todd Rogow, director of information technology at Maine's HealthInfoNet, said the five-month pilot will involve about 200TB of storage. Each year, Maine healthcare providers produce 1.8 million medical images, which represent 45TB of data. The images include X-rays, CT scans, MRIs and mammograms.

"The typical radiology image is 50MB in size. And, we're talking about bringing over all the archives," he said. The image archive will share data between 56 radiology imaging centers, which make up 80% of the state's volume, Rodow added.

Currently, medical images are stored in a number of disparate picture archiving and communication systems (PACS) within the hospitals. Today, when there's a need to share the images between non-affiliated hospitals and private physician practices, they're typically copied to CDs.

By consolidating these images into a single archive, HealthInfoNet estimates that Maine's providers stand to save $6 million over seven years through reduced storage and transport costs. It also greatly reduces system administration requirements at each hospital.

"When a patient has an X-ray or MRI at a facility outside the our system, it can take days for their doctor at Maine Medical Center, for example, to get a copy of that image," said Dr. Barry Blumenfeld, CIO at MaineHealth healthcare system, which supports the project and participated in its design.

"This new service will save time for our providers and their patients. With instant access to a patient's images, medical staff can treat them much faster and the patient won't have to take the time to pick up and deliver CDs," he said.

Dell hosts medical images in one of two public cloud storage facilities in Connecticut and Arizona. While it hosts medical images from other states, those mainly involve hospital groups and regional health information organizations (RHIOs), which represent a handful of providers who've signed up to exchange data.

In addition to leveraging HealthInfoNet, the image archiving service prepares Maine's providers for sharing images through the Nationwide Health Information Network Direct and open source Connect HIE systems. It also supports the development of Accountable Care Organizations and other shared-risk model care delivery structures.

Amy Landry, communications manager for HealthInfoNet, said 25 of the state's 39 hospitals and 182 of its 600 private physician practices currently use the exchange. This year, another nine hospitals are expected to join in and the state hopes to have all 39 hospitals signed up by the next of next year, she said. Over the next year or two, the state plans to bring in long-term care and mental healthcare facilities.

"For patient care, it's important to see a statewide picture of your patient," Landry said.

In many states, exchanges are limited to regional agreements between affiliated hospitals and private physician practices. Like any business, hospitals can feel proprietary about their patient information and resist sharing it with other facilities.

Maine has an advantage over other states in attaining agreements between healthcare providers to share information because of its relatively small population and mainly rural demographics, Landry said.

In 2005 and 2006, when HealthInfoNet was first being developed, healthcare providers had to agree to share information, Landry said.

"In other states, exchanges in general haven't been able to get off the ground because of that complication," she said.

Rogow agreed, saying his exchange's success hinged on organizations agreeing not to compete over patient data. Now that images are in the mix, Rogow sees the same politics resurfacing in other state exchanges. "The concern has come up, 'Oh, they get to see those images as well, but that's my patient,'" he said.

Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at @lucasmearian or subscribe to Lucas's RSS feed. His e-mail address is [email protected].

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