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Similar to instrument integration, image management systems also transfer data to EMRs but are more highly specialized. Specifically designed to handle digital images, these independent software programs run outside of the EMR, bringing all diagnostic imaging together, even from instruments of different companies. Any computer screen, tablet or other device in the office can view the image, freeing up the diagnostic instrument itself for use by another practitioner. Benefits include improved office efficiency, overall time savings for both patient and doctor and better patient education.

There are a multitude of examples of the variety of ways optometrists are electronically managing images. (See chart below for a list of available image management systems.) Carl Zeiss Meditec recently received FDA clearance for version 3.0 of its Forum Eye Care Data Management system, which enables eyecare practitioners to centrally store diagnostic data from various ophthalmic DICOM instruments, including the new family of Cirrus HD-OCT and Cirrus photo instruments, and integrate with other DICOM software systems.

Topcon’s Synergy Ophthalmic Data Management System integrates images and reports from Topcon and more than 135 other manufacturers’ systems into a single, secure, digital environment.

To integrate his diagnostic imagery, such as retinal photography, Robert A. Hoffman, OD, uses iScape, which stores pictures on a computer for easy access by the OfficeMate program he uses. He’s in the process of setting up a system that will store the images directly in the program. “When I get it set up I can access them from anywhere,” he said.

 
 Vision Care of Maine linked six doctors, 41 staff members, seven locations and two surgical centers to its NextGen EMR using Cabinet’s SAFE.
Merge Eye Care PACS is a standalone application that supports the DICOM OPT (OCT) standard and video and works with an EMR to integrate all diagnostic devices and clinical applications, enabling ECPs to review all of their patient’s images and diagnostic reports side-by-side from anywhere.

Vision Care of Maine linked its NextGen EMR to Cabinet’s SAFE (Shared Access Filing Environment) to store all patient images and related documents. With six doctors, 41 staff members, seven locations and two surgical centers, Vision Care of Maine can access any image from any of its locations within a 250-mile radius, according to Andrew Durkovich, CFO, CIO, CMO.

While the benefits can be substantial, there are some concerns regarding image management systems, and cost is one of them. “Regarding instrument integration, and most applicable with images, ask the EMR vendor if there are any additional charges to integrate with devices or if there’s third party software that’s required,” said Chris Moore, CEO, Integrity EMR. “Many EMR vendors market that they can integrate with diagnostic devices but only offer that interface through certain third-party software solutions.”

Moore also warned that as with basic instrument integration, image management is also challenged when communicating with the cloud. “One of the challenges that EMR companies have not figured out is how to get particular imaging data up and down off the cloud in an efficient manner, so optometrists need to ask their EMR vendor if they are storing those images on the cloud or if they are storing them somewhere else,” he said. “You need to be concerned with how much bandwidth is required and how fast the images will come down off the cloud. Some EMR systems compress the image to deliver more quickly, but the image isn’t high quality.”

One system that links with the cloud is the EMA Ophthalmology EMR system from Modernizing Medicine, Inc., which recently integrated Sonomed Escalon’s AXIS image management software to provide cloud-based image management. ■