Vendor Neutral Archive (VNA): An Essential Guide
March 9, 2022
What is a Vendor Neutral Archive?
Vendor Neutral Archive (VNA) is a medical imaging technology designed to store medical images and clinically related files in a standard format utilizing a standard interface so as to provide vendor-neutral access to authorized healthcare professionals, irrespective of proprietary image-generating system used.
Before moving to the details, you can watch the video below to understand the basics of the system.
Uses of a Vendor Neutral Archive
Vendor neutral archive is used for consolidating, standardizing, and archiving medical images and data transmitted from different Picture Archiving and Communications Systems (PACS) into a central, interoperable, highly accessible digital storehouse. By this centralized design, Vendor Neutral Archive eliminates the need for siloed storage groups attributed to individual PACS systems.
Thanks to the streamlined archiving of PACS data storage, Vendor Neutral Archive offer healthcare providers several benefits – from improved clinical and data workflow management, seamless integration with multi-vendor imaging applications, easy access to (and efficient control of) image data – that work together towards ensuring consistent, responsive patient care.
Before addressing the benefits (which will be discussed in detail further in this article), it is essential to first understand the importance of a VNA’s function.
Why a Vendor Neutral Archive is Important
A Vendor Neutral Archive is crucial in the effective provision of value-based healthcare as it organizes unstructured data for usage at the point of treatment.
For healthcare providers, the opportunities for implementation of VNAs are diverse and auspicious. Built for high-caliber interoperability, a Vendor Neutral Archive — as well as an Imaging EMR — can seamlessly integrate medical data to act as an interdepartmental enterprise archive, whether pertaining to radiology, cardiology, or other medical specializations.
The significant contributions of a VNA-enabled health system are apparent, yet another key consideration point in determining a comprehensive lens on understanding VNA solutions is the examination of their intentional day-to-day operation and how they function.
Vendor Neutral Archive administers a unified viewing experience independent of the source of the pictures, reducing the number of medical systems on which physicians must be fluent, reducing mistakes, saving time, and lowering training expenses.
Vendor Neutral Archive Advantages
There are five main advantages in successfully adopting a Vendor Neutral Archive solution most healthcare providers can expect to experience:
- Notable Cost Savings
- Enhanced Interoperability and Data Exchange
- Consolidated Storage Architecture/Uncomplicated Data Viewing
- Lifecycle Management/Better Technology Support Management
- Reliable Data Security and Protection
The above advantages pertain to the implementation of a standard VNA system; however, RamSoft’s revolutionary Imaging EMR solution, OmegaAI, provides additional incomparable benefits that can help further a healthcare organization’s medical imaging operations, consistently translating into responsive, holistic, 360° patient care experiences.
Though considered one of the most specialized technologies, VNAs and other radiology EMR software systems have played a transformative role in the digitization of medical imaging.
Within the healthcare setting, there are various PACS data storage and archive applications available on the market. To ameliorate connectivity and compatibility issues between various vendor-specific PACS systems, the VNA was devised. As suggested by its name, the Vendor Neutral Archive is constructed to inherently operate independently from the unique parameters of all vendors’ medical imaging equipment.
How a Vendor Neutral Archive Works
Medical images are frequently stored in DICOM® formats. While DICOM is known as a globally recognized communication standard, in the face of the increasingly widespread trend in usage of medical imaging technology, DICOM also presents as a file extension type within other care arenas.
Since disparate syntaxes within DICOM are used by distinct PACS vendors, it makes for a notable element of difficulty in successfully configuring data between vendor system environments. VNA mitigates incompatibility by deconstructing the data from the original PACS before migrating it to the new system while ensuring to the correct syntax is leveraged and allowing for a smooth data integration. Vendor Neutral Archive sits between image formats and PACS and employ algorithms to query the incoming data to promptly conduct these tasks. Additionally, the system alters the tags correlated with DICOM in favor of fostering compatibility.
Moreover, VNAs need to interface with data via electronic health records (EHRs), electronic medical records (EMRs), clinical reports, and other HL7 standard compliant digital sources.
Vendor Neutral Archive Architecture
Now, let’s take a look at the Vendor Neutral Archive architecture. As mentioned above, VNA architecture can vary between vendors too. Yet typically the actual VNA component is “middleware”, which represents an array of services. The majority of Vendor Neutral Archive provides a range of services for interacting with multiple image sources, inclusive of PACS, modalities, and other related applications. 
VNA systems provide access to services focused on the management of:
- Image archive workflow – Determine how the VNA processes image data
- Image storage infrastructure – Oversee how image data is handled specifically within the VNA’s infrastructure (i.e., correctly allocating appropriate media storage avenues for data, facilitating consistent data migration between media modes, supporting consistent cloud service interactions, etc.)
Fundamental elements of a Vendor Neutral Archive’s architecture include:
Multi-tenant architecture
| The VNA should have a developed multi-tenancy architecture that allows users to manage internal organizational data independently from metadata and storage.
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| Asynchronous hub and spoke model | When necessary, the VNA should operate as a disconnected intermittent and low bandwidth [DIL] connection type model. Users should have local access to clinical information at remote sites with limited connectivity, and the VNA should provide dynamic synchronisation as soon as the connection is re-established.
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| Superior high-availability and business-continuity capability within a scalable framework | For cloud-based deployments, this architecture is required. Internally and through load-balanced distribution, VM deployments, clustered data center(s), even inclusive of dual data centre implementations, the VNA solution should exhibit high-availability capabilities. As traffic loads increase across the organisation and new content sources feed into the system, the VNA must operate as if it were adding appliances to manage the new or peak loads in a N+1 architecture all the while working to ensure capacity of scaling up and out and preparing for infrastructure obsolescence.
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Key Features of a Vendor Neutral Archive
The main features that contribute to making a VNA such a powerful solution are:
Image Lifecycle Management (ILM): Operating as an open loop process, this data retention tool dictates how medical images are acquired, transmitted, and stored (or discarded) over time. This data curation is based according to the predetermined business value of medical image and clinical reports files and how that value varies over time. To put it another way, a strong ILM framework takes into account not only the desired data lifestyle, but also the data attributes required for effective data management.
Security: Great VNAs should incorporate industry and policy compliant security layers that work to mitigate and eliminate any security significant gaps (e.g., URL-enabled linking of image data to EMR/HER systems). A VNA unifies access points and procedures, allowing for more efficient access management and auditing.
Hanging Protocols: It is essential that a Vendor Neutral Archive aids in meeting the requirements of external systems, allowing items like hanging protocols to function. In facilitating the easy operation of hanging protocols, the VNA can actively safeguard against operational business continuity threats such as hardware and/or software failures or natural disasters.
Image Object Change Management (IOCM): In a VNA, IOCM assures data integrity between systems by defining how one system can transmit local modifications to other systems that process copies of the same imaging objects in their own local systems. This usually entails study merges and deletions, and medical image expungements.
Disaster Recovery: Should disaster strike either by way of an act of God, downtime, or a system failure, a Vendor Neutral Archive can be an organization’s most essential business continuity asset. Operating as an on-premises or cloud-based system, a VNA can effectively maintain files located in various facilities as well as individual data centers. Working with a zero-footprint or DICOM compliant viewer, a VNA may also perform as a backup image viewer. Additionally, a database affected by a disaster event may be rebuilt with a VNA leveraging indexed metadata via a DICOM header.
Tag Morphing: Key for a VNA’s functionality, tag morphing involves the alteration of one or multiple data attributes — most specifically to the healthcare use case, DICOM data elements. This can be executed either “statically” (i.e., the completion of a singular mapping), or “dynamically” (i.e., the completion of several mappings), each customized to a specific recipient. In essence, any non-DICOM data sent can be standardized for easy consumption by the recipient or destination side. In the global worklist environment, tag morphing is a viable method for dealing with metadata processing discrepancies characteristic of many existing PACS systems.
Centralized Integration Point: Providing a single outward point of connectivity, a Vendor Neutral Archive can remove the need for management and integration support for environments involving multiple PACS systems. Many larger-scale organizations leveraging this centralization functionality to address a demand-distressed PACS often report improved performance. The image management of a VNA is built to operate at a higher scale than that of a PACS. Organizations endeavoring enterprise imaging will discover that a VNA can be pivotal as a single point of integration into a HIE or for enterprise analytics (in contrast to several independent clinical systems integrating to supply data to these linking solutions).
Non-DICOM Content: Another prerequisite for a VNA’s operation is ensuring the apt processing of non-DICOM file formats (e.g., PDF, XML, etc.). Various PACS can at times convert bulky or sizeable clinical file types into the DICOM format by way of “encapsulation”. For example, a scanned document may be stored as a PDF which the PACS system will then encapsulate into a DICOM PDF object and endow it with the satisfactory metadata needed for easy identification and management, treating it as an image file. Therefore, it is a paramount for VNAs to be equipped to support these encapsulated DICOM files along with the sufficient DICOM “header” means of metadata indexing and query and retrieval support.
OmegaAI: Features Beyond a VNA
Designed to provide a competitive edge in speed, scalability, and ease of use, RamSoft’s OmegaAI, the world's first Imaging EMR, can easily consolidate various systems — including VNAs! — to bolster efficient, effective democratized healthcare. OmegaAI's unique features consist of a universal worklist, a zero-footprint viewer, a patient portal, a real-time business intelligence & visualization app and so much more!
Here’s a quick snapshot:
 | Enterprise Master Patient Index (eMPI) Identify patients and match and link their medical records to a unique identifier. |
 | Seamless Consolidation & Interconnectivity OmegaAI uses a cloud-native, serverless platform endowing it with medical imaging interoperability to seamlessly integrate with any of the latest in-market or legacy systems. |
 | 360° Patient Records Empower quicker clinical decision-making with data-aggregated comprehensive patient records. |
 | Advanced Workflow Automation Increase productivity and reduce turnaround times by easily automating and customizing workflows based on patient and study demographics and much more. |
 | Optimized Image Viewing OmegaAI’s Image Viewer offers seamless integration of existing viewers for a worry-free user experience while saving time on staff retraining and new system orientation. |
Implementations & Considerations of a Vendor Neutral Archive
Healthcare organizations seeking to implement a VNA solution, particularly those aiming to achieve faster, empowered care, need to carefully evaluate their needs and how a VNA should effectively operate within their health ecosystem. A solid investment in thoughtful due diligence in examining pivotal consideration points will go a long way in ensuring a successful Vendor Neutral Archive implementation.
Sidebar: Healthcare organizations endeavoring improved patient autonomy and democratized healthcare are increasingly looking to implement Imaging EMR platforms . Imaging EMRs offer data and systems consolidation that extends beyond that of VNAs — learn more HERE.
Considering VNA Implementation
The initial step towards implementing the right VNA solution should involve a careful review of the organizational need of a platform, its workflow and workload capacity, as well as there should be an understanding of the scope and range of medical image archive consolidation required. Presently, there are five VNA classifications:
 | Departmental VNA Ideal for a clinical scenario where only a singular department is provisioning a VNA with the medical images; if the images and other objects (reports, documents, JPEGs, waveforms) are in DICOM format and VNA “neutrality” is desired in migration facilitation and porting data to EMRs. Automated synchronization of changes in PACS and subsequent changes in VNA is a paramount feature. |
 | Multi-departmental VNA Ideal for a multiple-department feed VNA setup. Key identifier cross-referencing or unique source identification prefixing (e.g., non-unique accession number and patient numbers) must be enabled with this VNA.
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 | Multi-specialty VNA Similar to the Multi-department VNA use case; however, this VNA case is geared towards serving a setup involving several specific medical specialties (e.g., ophthalmology, dermatology, endoscopy, etc.) that utilize both encounter-based and order-based workflows while processing non-DICOM objects.
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 | Enterprise VNA Characteristic of servicing a metropolitan area with a small-scale integrated delivery network (IDN), this scenario involves a VNA needing to service multiple sites (e.g., 1–15). Other more advanced VNA’s are even capable of servicing entire countries! Tag morphing is vital for this use case.
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 | Corporate VNA Ideal where the consolidation of all medical images generated from a large healthcare conglomerate (e.g., Kaiser, Tenet) into a single location is required. For those interested in endeavoring their own “cloud solution”, this VNA type could be a possible choice. The VNA features that are best served in this use case are scalability, high availability, and redundancy. Also, in the face of the increased risk of hacking via the higher number of data access points inherent in this scenario, security must be a prime consideration.
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NOTE: A bottom-up method, i.e. gradually adding new features, could be possible for a departmental, multi-departmental, and specialty use case. A top-down approach is more beneficial for enterprise and corporate VNA installations.
Preparing a Strategy for VNA Implementation
Once the preliminary homework has been completed for VNA solution implementation, the next thing to establish is an effective strategy incorporating key VNA system actionables. Though every healthcare organization may have different requirements for VNA adoption, we’ve included in the checklist below top sweeping noteworthy items:
| Keep in mind the delivery model | Cloud-enabled flexibility allows for smooth integration and easier data access. Highlight the VNA solutions with a strong HIPAA compliance track record. |
| Develop VNA operations policies | Essential for addressing organizational archive expansion and resource organization, these policies can help to provide clarification on the prioritizations of implementations while facilitating realistic project timeline assignments. |
| Explore innovation | As unstructured medical data continues to increase, organizations need appropriate VNA solutions that help improve their data processing by way of harnessing leading-edge technology. |
| Establish IT goals | Self-service option tools can ensure departments not part of the initial VNA rollout will have access to shared data in the interim until full-scale implementation has been completed. |
| Determine best practices for archiving | Keeping business needs as well as benefits to end users and patients in mind, it is advantageous to organizations to confirm their needs and priorities related to archiving practices, which ensures calls for experimentation and adjustments can easily be actioned. |
| Ascertain connectivity with other existing IT infrastructure | The technological scope of VNAs goes well beyond image viewing to integration with EHRs, mobile applications, and content management systems. Ensuring seamless integration with present IT tools endows users with “anytime, anywhere” data access translating to a more dynamic user experience. |
For healthcare providers seeking to utilize a medical imaging software solution with an integrated Vendor Neutral Archive, studying key implementation learnings from other organizations is tremendously valuable in garnering a firsthand perspective on strategy and execution.
Other essential considerations for planning a VNA solution implementation include the common factors of cost, security (HIPAA compliance, etc.), and support.
VNA vs. PACS
Medical imaging technology is at the pinnacle of innovation development—swelling the medical imaging software market with numerous solutions for healthcare providers to choose from. Many of these medical imaging solutions – whether VNA or PACS – must need to effectively handle and store growing volumes of increasingly higher resolution images.
All these varieties of VNA or PACS solutions on the market begs the question, “What do medical imaging professionals and clinicians actually need?”.
- VNA – Unlike the PACS, medical images received from several devices and locations can be viewed and stored in an integrative manner. To put it simply: images can be stored in standard format using a standard interface, enabling access via any workstation, regardless of vendor. VNAs are built to ensure long-term data storage and archiving facilitating cross-vendor migration without risk of imaging data loss.
- PACS – Designed for a focus on workflow improvement, a PACS’s key three functions include storage, archiving and backup, and retrieval. A PACS offers all-round access to and storage of medical images and data (e.g., MRI and CT scans, ultrasound, digital x-rays). Typically restricted to operate under a single-system-single-department basis, PACS is not ideal for interdepartmental collaboration.
Keen to explore more about the differences between a VNA and a PACS? Or...how about discovering how a VNA and PACS compares to an Imaging EMR?
Questions for Us?
Whether regarding RamSoft’s innovative medical imaging software solutions or wishing to reach out to our team of experts, we’re excited to learn more about you and what you’re looking for in transforming your healthcare enterprise! Connect with us today and let’s get the conversation started.
