Clinicians have one word for what they want from your next generation enterprise imaging solutions. Context. A recent study in the Journal of Digital Imaging suggests that nearly 60% of radiology orders have no mention of important chronic conditions, calling it “an alarming lack of communication” that “may negatively impact interpretation quality.” Imaging orders such as “chest pain” or “lower abdominal pain,” for example, are essentially context free, giving clinicians little information to work with. Access to a complete clinical history behind those orders can help clinicians provide richer input for more accurate diagnoses and more effective care plans, along with results of the imaging study.

1. INNOVATION IN ENTERPRISE IMAGING:
CLINICAL CONTEXT IS WHAT’S NEXT

2. More complete information,
more complete care
Clinicians have one word for what they want from
your next generation enterprise imaging solutions.
Context. A recent study in the Journal of Digital
Imaging1
suggests that nearly 60% of radiology
orders have no mention of important chronic condi-
tions, calling it “an alarming lack of communication”
that “may negatively impact interpretation quality.”
Imaging orders such as “chest pain” or “lower
abdominal pain,” for example, are essentially con-
text free, giving clinicians little information to work
with. Access to a complete clinical history behind
those orders can help clinicians provide richer input
for more accurate diagnoses and more effective care
plans, along with results of the imaging study.
Current imaging solutions
fall short on context
First generation enterprise imaging systems excel
at the manipulation and visualization of DICOM and
other images in a myriad of ways. But support for
non-DICOM patient data is often limited to other
image formats such as JPEG, TIFF, BMP, and PDF.
Whether you call them vendor neutral archives
(VNA), deconstructed PACS, or Application Indepen-
dent Clinical Archives (AICA)2
, these systems offer
little access to important information in unstruc-
tured physician notes and patient history. And they
provide limited visibility to relevant structured data
such as problem lists and diagnoses; failing to
present a complete patient record to clinicians.
The future of patient-centric imaging requires
enterprise-imaging solutions to support a true
longitudinal record of the patient – not just
image data types.
Delivering context within
next-generation imaging solutions
To work with data beyond DICOM, additional tech-
nology is needed. This technology, often acquired
from multiple vendors, includes one or more of:
n Database management system
n Middleware or enterprise service bus
n Interface engine – to perform the healthcare
interfacing work typical ESB solutions cannot
n XDS registry/repository
n Master patient index
n Master provider directory or provider registry
Managing the expanding requirements for clinical
data to provide true patient context is challenging
for solutions built using products acquired from
multiple vendors. In addition, their overall complex-
ity and resulting fragility of the code base has led
to long implementation times, unnecessarily large
deployment profiles, and poor upgrade paths.
Innovation in Enterprise Imaging: Clinical Context is What’s Next Page 1
60%of radiology orders have no
mention of important chronic conditions,
“An alarming lack of communication” –
Journal of Digital Imaging.
1
Piotr Obara, Merlijn Sevenster, Adam Travis, Yuechen Qian, Charles Westin, Paul J Chang Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology 2015, 28 (3): 272-82
2
“What is an Application-Independent Clinical Archive and Why Do Providers Need Them?” IDC Community, Judy Hanover, Aug 2014

3. Instead, InterSystems suggests creating enterprise
imaging solutions on the foundation of a unified
health informatics platform. A platform such as
InterSystems HealthShare® provides the technology
required to support aggregation and sharing of the
contextual information radiologists need, while also
handling the traditional needs of enterprise imaging
solutions in a single, unified product. The remainder
of this paper presents background on HealthShare
and highlights its most relevant capabilities for
developing next-generation imaging solutions.
Innovation in Enterprise Imaging: Clinical Context is What’s Next Page 2
The future of patient-centric
imaging requires enterprise-imaging
solutions to support a true
longitudinal record of the patient.

4. Innovation in Enterprise Imaging: Clinical Context is What’s Next Page 3

5. Imaging developers using the HealthShare
platform can take advantage of the same
technology that powers the most robust health
information exchange solution on the market.
HealthShare is ranked by KLAS as the top EMR-
agnostic HIE platform and presents an opportunity
for enterprise imaging solutions to drive true
information exchange capabilities.3
With an imaging solution built on HealthShare,
clinicians can have an accurate presentation of
existing diagnoses, doctor’s notes, wearables data,
and even genomic information prior to reading a
study. At the same time, enterprise imaging vendors
benefit from easier, more streamlined deployments,
the ability to rapidly evolve and extend the solution,
and the increased system reliability, performance,
and scalability expected from solutions built on
InterSystems technology. It begins with the following
key capabilities.
The Data Model
Data is at the heart of any healthcare application
and it comes in many forms – including records,
images, events, and documents, in structured and
unstructured formats. Our health informatics
platform includes powerful, multi-model (document,
graph, relational and key-value) database technolo-
gy that enables applications to efficiently store and
retrieve all types of healthcare data within a
common and consistent environment. This is the
same data technology used in applications that
power over two thirds of the medical records within
the U.S.HealthShare aggregates and harmonizes
data from multiple sources. Its comprehensive data
model enables enterprise imaging applications
to consume and store discrete data of all types,
including patient data, images, financial claims,
and even genomics data. By leveraging HealthShare
as part of an enterprise imaging infrastructure, the
imaging solution can move beyond just being an XDS
registry/repository to creating a truly holistic virtual
patient record on demand.
Interoperability by Design
For enterprise imaging solutions to provide clinical
context effectively, interoperability is required. Yet
many VNAs and enterprise PACS systems rank poorly
in KLAS analysis for interoperability. For solution
providers who choose to use HealthShare as part
of their enterprise imaging environment, advanced
interoperability capabilities are core to the platform.
This is the same technology that has been ranked
#1 or #2 by KLAS for the past 10 years4
. HealthShare
brings next-generation health service bus capabili-
ties to an enterprise imaging solution, allowing the
imaging platform to speak X12 and FHIR® as easily as
it speaks DICOM today. HealthShare also positions
enterprise imaging platforms for an API-driven future
with powerful JSON and REST capabilities.
Consent and Patient Index
HealthShare includes tightly coupled consent and
patient identification capabilities that are driven off
the underlying data model. For next generation
enterprise imaging solutions, this simplifies one of
the most challenging aspects of solution architec-
ture – managing and controlling comprehensive
patient records created from many different sources.
Without robust consent and patient index capabil-
ities to ensure that only the right clinician accesses
the right information, it is impossible to fulfill the
mission of a vendor neutral archive.
HealthShare Consent Services enable granular
control and data segmentation of a patient’s record.
Different consent profiles can apply for different
facilities, clinician groups, patients, or even types
of data.
Innovation in Enterprise Imaging: Clinical Context is What’s Next Page 4
With an imaging solution built on
HealthShare, clinicians can have
an accurate presentation of patient
health status prior to reading a study.
HealthShare Technology for Enterprise Imaging Vendors
1
KLAS, Health Information Exchange Market Segment Analysis, 2016
4
Integration Engines KLAS, May 2015 Report

6. Innovation in Enterprise Imaging: Clinical Context is What’s Next Page 5
Business Process and Workflow Management
HealthShare includes powerful built-in support for
long-running guaranteed business processes as
well as coordinated human workflow. Easy-to-use
graphical tools for rules and business process
management quickly automate processes and
information flow. HealthShare’s business process
management tools support any needed workflows,
from sophisticated fetch and pre-sort routings to
work lists of nearly any complexity.
Mobile Ready Development
Modern imaging applications have to be focused on
the user experience. Users demand fast and easy
access to the information and services they need in
the form they want. Our health informatics platform
includes the front-end frameworks and back-end
services you need to easily create modern mobile as
well as responsive web applications for healthcare.
HealthShare brings together the data, analytics
(working with unstructured as well as structured
data), and business services needed to power a
solution; publishes these services using efficient and
secure REST and Web Services; and delivers a sleek
and personalized user experience via mobile and
responsive HTML5 frameworks.
Real-Time Healthcare Analytics
As a development environment, HealthShare
includes multiple analytics options to provide rich
insight, from integrated real-time analytics to
sophisticated healthcare business intelligence.
Traditionally, analytics is used with structured data
to “slice and dice” numbers. But this traditional
approach also involves creating and maintaining
a data warehouse, which can only provide a
retrospective view of information.
HealthShare includes embeddable software that
makes it easy to enhance transactional applications
to provide real-time analytics, giving users insights
exactly when and where they need they them. No
data warehouse is required. Application developers
can rapidly build interactive dashboards that are
graphical displays of key performance indicators.
Since these dashboards are embedded within trans-
actional applications, HealthShare makes it easy for
users to access vital information.
HealthShare also offers unique technology to
analyze unstructured data. When the robust
analytics available in HealthShare are combined
with unstructured data analysis technology, new
insights can emerge from a truly holistic view of all
your data. This can be critically useful when mining
the text-heavy data sources of transcription reports.
Health Insight
HealthShare offers a unique analytics environment
called Health Insight. Health Insight contains a
complete analytics data model, infrastructure, and
starter sets to add meaningful health analytics to
any enterprise imaging solution. It also can deliver
current, credible data to extend and optimize invest-
ments in existing analytics solutions.
Cloud, Premise or Hybrid
Enterprise imaging solutions may need to be
deployed on premise for major academic medical
institutions, for example, in the cloud for smaller
hospitals or physician groups, or in a hybrid model
combining both options. HealthShare offers
deployment models to meet any of these needs
while delivering scalability, elasticity, reliability,
and rapid value to your clients.
Deploying technology should be a business decision,
not a technical one. InterSystems offers templates
and features that make it easy to deploy, provision,
monitor, and manage applications built on
HealthShare in any environment.
HealthShare’s natural language
processing technology is a must-have
for mining the text-heavy data sources
of transcription reports.
Without robust consent and patient index
capabilities it is impossible to fulfill the
mission of a vendor neutral archive.

7. Partner with InterSystems
HealthShare takes the challenge out of creating
connected, information-rich, non-stop enterprise
imaging solutions. It removes the complexity from
data management, mobile and web access,
interoperability and integration, healthcare
analytics, and other common tasks so that you
can focus on the unique value and content of a
next generation solution.
InterSystems understands application developers.
The company was started by software engineers
with a passion for technology and applying it to the
problems of healthcare. InterSystems knows what
it takes to develop and successfully deploy software.
Whether you are a healthcare startup, a Fortune
500 company, or a healthcare system developing
new solutions, InterSystems can deliver the
technology, knowledge, and support to help you
bring your vision to life.
Over 80% of our business is with long-term partners.
Companies like Epic, GE Healthcare, 3M Health Care,
Ricoh, and Roche Diagnostics have made a strategic
commitment to InterSystems. Our record for
success and customer service is second to none
in the healthcare software industry.
To learn more
Take advantage of InterSystems’ unequalled
healthcare technology experience and record of
customer success. Contact us now to learn how we
can help your enterprise imaging solutions succeed:
n info@InterSystems.com
n 1-800-753-2571 or +1-617-621-0600.
Visit InterSystems.com/contact for a link to the
number of your local office.
Innovation in Enterprise Imaging: Clinical Context is What’s Next Page 6
HealthShare takes the challenge out of
creating connected, information-rich,
non-stop enterprise imaging solutions.

8. InterSystems.com
© copyright 2016 InterSystems Corporation. All rights reserved. 11-16