Essentially, a VNA is tooled for data migration (a “backend” system) and a PACS facilitates data capturing, arranging, archiving, and sharing of medical image files (the “front-end”). Where PACS is intended to enhance workflow with attention to storage and retrieval, VNAs are geared towards long-term backup and archiving, sans vendor proprietary constraints.
To provide a comprehensive understanding of this topic, this article will review the definitions for PACS and VNA each, followed by an examination of a comparative analysis of the differences between these two medical imaging solutions:
What is a PACS?
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What is a VNA?
A Vendor Neutral Archive (VNA) is a technology used predominantly in medical imaging that stores medical image files and clinically relevant information in a standard format via a standard interface, allowing authorized healthcare practitioners vendor-neutral access regardless of the proprietary image-generating system employed.
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The Differences between PACS and VNAs
Necessitating the use of VNAs is a combination of the limitations of PACS systems as well as the rising demand for a mechanism to view unstructured data expediently across an interconnected delivery network. For organizations undertaking enterprise imaging, it is good practice to consider these key differences between PACS and VNA systems:
Provided below is a snapshot of the features PACS and VNAs each offer:
GUIDE FOR PACS
GUIDE FOR VNA
Basic features include:
Though may be varied across vendors, common features include:
• Web accessibility
• Interface designed for optimal intuitive user experience
• Modification of patient, study, and image data
• Accidental data deletion recovery
• Query and retrieval
• Login and security management for IT
• Storage capacity
• External data support (e.g., DICOM, non-DICOM hardware and universal viewers, etc.)
• DICOM compatibility and file processing
• Vendor-neutral storage
• Digitization and CD burning options
• Dual-site configuration for protection against failures occurring in one system (e.g., between two data centers)
Advanced features include:
• RIS/EMR integration
• Dictation, transcription, and voice recognition
• Study lifecycle management
• Auto-routing for DICOM
• Image viewing and sharing
While both PACS and VNA solutions are used prolifically among healthcare providers, each can address the specific needs of various user environments. Enterprise-scale organizations and hospitals can leverage the VNA’s innate interoperability to seamlessly interconnect with and exchange data between multiple departments and their existing PACS systems.
On the other hand, smaller medical imaging facilities (such as x-ray clinics) that do not operate with different departments can ordinarily be sufficiently serviced by a PACS.
Capabilities and Limitations
To help understand more deeply the differences between what a PACS and VNA may offer in terms of their capabilities and limitations, we’ve included a snapshot comparison outlining key points for each:
The main function of PACS is to store medical images and data and make them available for end-users.
By definition, it is a medical archiving system that stores and makes medical images and data available for end-users while following industry-accepted standards and formats.
PACS is required for the display and manipulation of SOP class/DICOM objects.
VNA can store all SOP classes/DICOM objects as well as display and manipulate these by way of preserving standard formats.
In general, there are “blind spots” regarding interoperability in PACS systems.
VNA enable consistent file readability despite organizations switching vendors. Additionally, they facilitate agile data sharing in organizations utilizing multiple PACS systems.
PACS can store radiology SOP Classes.
Enterprise VNA’s can store all department’s SOP Classes. Also, there are radiology VNAs.
Data migration tends to be more difficult for PACS systems.
VNAs are optimized and designed for data migration.
Single point of integration is an issue for PACS systems.
VNAs can offer a single point of integration for all PACS and other hospitals/healthcare systems (RIS, EHR, HIS, etc.) connected to a network, thereby “solving the problem” of PACS.
Pertaining to Image Lifecycle Management (ILM), VNAs support auto-delete functionality which can be utilized upon the legal retention period expiration of applicable data. VNAs are built to support locally customizable rule-based purging (culling) criteria and utilize storage tiers towards maximizing archiving capacity and data viability for the long-term.
Typically, there is no single point of access offered in a PACS system. Information is siloed; physicians need to access multiple departmental workstations/systems individually to view a patient’s data, which proves times consuming for users. However, some current in-market PACS solutions, such as RamSoft’s PowerServer™ PACS, can provide a single point of access.
VNAs consolidate every system and department to enable a unified viewing experience, no matter where images originate from.
Vendors add their own tags (into their own software); however, these tags are generally unreadable across other vendor-specific PACS platforms. There is a proprietary DICOM viewer dependence with a PACS system. Hospitals are unable to employ DICOM readers of their choosing since only a native tool included with the PACS can ensure proper image processing.
VNAs standardize DICOM tags for inter-system compatibility.
VNAs operate in compliance to new and legacy data transmission and retrieval industry-specific standards (FHIR, HL7, etc.), including those related to enterprise imaging.
VNAs provide versatility in processing a vast spectrum of file types including DICOM, non-DICOM, multimedia, XML, PDF, raw data generated by modalities, etc.
PACS systems are built specifically for radiology workflows.
VNAs are a better option for encounter-based imaging, as patient encounter is prime in current medical imaging environment.
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Evaluating pricing between implementing a PACS versus a VNA solution is dependent upon whether a healthcare organization is planning a “PACS first” or a “VNA first” approach.
Enterprises planning the conventional approach to radiology – PACS first – face a ballpark estimated investment of between $5K–$100K* (contingent on facility size) on implementation, setup, and training alone. Consequently, this would directly impact any budget lines related to “inpatient and outpatient non-capital non-labor” costs.
Additionally, depending on the organization, consideration of other applicable project-relevant costs should be made such as investment in new on-premises hardware, where some vendor estimates can run around the $20K+ mark.
On the other hand, without the costly burden of physical servers and storage hardware, cloud based PACS solutions offer a significantly less investment!
A VNA first architecture generally applies for larger-scale organizations and enterprises with multi-system departmental networks operating complex workflows. Though considered a pricier investment (the greatest drawback for VNA implementation!) this approach can yield in a remarkable PACS footprint reduction and curtailed maintenance costs (~15–20% annually of PACS licensing expense**).
At RamSoft, we offer two fair pricing models that grant healthcare providers the flexibility to select what works best for their organizations while ensuring best value of investment.
Cloud Model: A top customer preference, cost is determined on a minimum monthly volume, with tiers increasing incrementally per hundred studies. Software support and hosting service i.e., servers, backups, and networking in the data center, are bundled in the cost per study***.
Subscription Model: Ideal for customers using on-premises servers or third-party data centers, this model also operates under a minimum monthly study volume; however, as the monthly study volume grows, your licensing fee is upgraded accordingly. Software support is bundled in the cost per study.
**Source: HealthTech Hot Spot
***This pricing is available only for PowerServer™ products.
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