Back to Basics

5 years into my VNA experience the one thing I can say is that, the KISS principle applies.  The only way to easily maintain your system, after it is up and running, is if the build is very orderly from the beginning.  To that end, it cannot be stressed enough that sticking to the basics of system design and deployment is critical.  One way this is achieved is by utilizing well thought-out naming conventions and time-proven, standardized processes.

Before the first system is brought online the team should focus (obsessively so) on the naming conventions.  These naming conventions need to be easily identifiable and baked into every nook and cranny of your system; from AE titles all the way to network shares.  Typical things that one should consider including in naming conventions are: site name, the type of system and the function.  Bearing in mind that AE titles are limited to 16 characters, it is important that the names be easily and consistently identifiable.  During troubleshooting situations, the VNA team will be looking for these names in the logs, so ease of use is paramount.  An example might be HOSA_FS_R_AE standing for hospital A, Fuji Synapse, Radiology, AE title.  The last two characters could be changed to DB for database, ST for storage or any other internal component related to each particular system.  Once the naming convention is set it needs to be passionately enforced as there is often enticement to loosen the standard to fit this site or that site.   Although there might be a circumstance that truly requires it, under 99% of situations you should not give in to this temptation!  Consistency in troubleshooting and training of new VNA team members are only two, of the many, reasons as to why uniformity is key during name convention decisions.

Similar to the idea of constancy in naming conventions is the creation of standard operating procedures.  The team needs to create a checklist for regularly occurring actions, such as: adding systems to VNA, testing new VNA releases, starting and finishing data migrations and verifying during PACS upgrades.  Each of these line-item tasks needs to be simple, straight forward, and DOCUMENTED.  There are many tools available in the VNA and there may be a temptation to get fancy with tag mapping / morphing, adding in sophisticated routing rules or any one of the myriad of features and functionalities that are available.  While these features are useful, remember that customization is the antithesis of supportability.  The team should determine what features and functions to use, and site 100 should be configured similarly to site 1.  This is not to say that there are no circumstances under which customizations should be used, however, they should be build-necessary customizations and not simply because one wants to play with all the cool tools in the toolbox.

There is a myriad of things to consider when planning and architecting a VNA, of which, naming conventions and SOPs are but two.  And, while this idea of a back-to-basics approach is neither new, nor specific to VNA design, it is an intelligent and proven method to utilize when laying the foundation upon which to build your Enterprise Imaging system.