By Kurt Woock

It’s 9:30 at night, and a patient is wheeled into the emergency department. Having been in an accident, he has external wounds and possibly head trauma. The physician orders a number of imaging exams, but first she needs to document the patient’s external wounds with a camera. Someone goes to a cabinet and grabs the point-and-shoot. After taking the pictures, someone takes the memory card to a file room and uploads the data to a computer. Next, they either print it out and run it down to the patient’s folder or dump the images into a file on the server with cryptic titles like 06062013_2159.jpg. Together, these steps represent an inefficiency in the way non-DICOM information is captured, stored, and delivered. “There’s no patient context data,” said Nathan Gurgel, product manager at TeraMedica. “It’s named whatever the camera names them; you’re relying on the person to remember all that patient information and be able to do that all immediately.” TeraMedica’s Evercore Connext Mobile product seeks to replace that workflow with something better.

Nathan Gurgel-TeraMedica Nathan Gurgel, Product Manager, TeraMedica

The answer lies in mobile devices. Gurgel said he has heard of people exchanging images on personal thumb drives or using text messages because, frankly, it’s efficient and convenient and there isn’t a good alternative. “Right now, in some departments, when you’re talking about things like visible light images, there isn’t even a departmental solution,” he said. Do-it-yourself solutions are not the right answer, but it’s not entirely off base to turn to the iPhone. By harnessing the familiarity of mobile devices, TeraMedica offers a product that is easy to implement.

So what does Connext Mobile do? “We looked to create a seamless capture of non-DICOM data, capturing it in a worklist driven fashion to get that data into the vendor neutral archive (VNA) and distribute it throughout the enterprise via the EMR. When we talk about VNA, we talk about breaking down silos, centralized repository, distributing the data effectively—this basically checks all those boxes.” Upon its release, Connext Mobile was focused on non-DICOM images, but the company plans to increase the capability to include video, audio, and text capture in future iterations.

Capturing non-DICOM information, such as visible light images, was never the problem. Providing mechanisms to immediately embed the information in a clinical context and securely deliver it to clinicians who need it is the hurdle that Connext clears. “We actually tie the information that’s being captured to the patient encounter,” Gurgel said. “We not only index the data by the patient, but we tie it to the visit that was being done.” TeraMedica works with clients to customize the way non-DICOM images are stored, providing tags, or labels, to give an added layer of meta-data to the information. These organizational tools let users go back and search for what they need rather than look for needles in a digital haystack.

The non-DICOM images can be accessed through the facility’s EMR. Users will see a link. “When they click it, it will link to our Univision product,” Gurgel said. Univision is a lightweight reference viewer. “It distributes non-DICOM and DICOM on a single screen. Users get complete patient history with one click.”

TeraMedica is readying the product for a mid-May launch. As of now, only iOS (Apple) devices support the software.

“A value we provide is being able to handle data in its native format without adding a layer to it,” Gurgel said. “What benefit is there in taking a jpeg and translate it into a DICOM object if the ability to capture and distribute natively exists?” The new product expands TeraMedica’s Evercore Connext tool suite by providing broader clinical non-DICOM data capture and distribution capabilities, based on standards including XDS and HL7. It also allows users to leverage the power of the VNA by consolidating all clinical content from multiple hospital departments into a single repository. This enables enterprise access despite vendor variations and also fulfills meaningful use criteria.