Health IT Merges Clinical Insight, Better Workflow

Health IT vendors are helping to answer the call that healthcare facilities must work smarter. At RSNA 2007, vendors are showing increased functionality in their software, tools that improve workflow efficiency and offerings that assist with everything from scheduling to billing to electronic signature and reporting. Scalable solutions, improved networking capability, tighter integration and workstations that offer “one-stop shopping” are sharing the showtime limelight.

 

Advantech (Booth 3151) is showcasing its ARK-1000 series of compact, embedded computers. These small, powerful all-in-one fanless systems are designed for rugged and space-critical applications in automation control and wireless gateway applications. A solid sealed aluminum case provides vibration and water resistance, and also functions as a passive cooling solution.

The ARK-1000 series feature AMD Geode to Intel Core Duo processors, along with flexible storage and connectivity, from multiple gigabit Ethernet and COM ports to wireless connectivity and highly capable graphics sub-systems—all with flexible I/O configurations and long life product support. The ARK-1000 systems can be mounted inside machinery or other equipment. They also can be standalone, wall-mounted, DIN-rail mounted or VESA mounted. The series accepts a wide range of power supplies (DC power in) and comes in a footprint of only 7.44-by-1.61-by-5.37 inches.

The ARK-1370 offers four USB 2.0, one LVDS, one LAN port and two COM ports in a small, rugged unit powered by an AMD Geode processor. Wireless connectivity can be added via the PC card slot for PCMCIA or CardBus cards. It also supports a wide range of input voltages from 9 V DC to 35 V DC. The ARK-1370 Compact Embedded Computer is equipped with a solid state onboard CF card of up to 4 GB, so it easily passes 50 and 5 Grms shock and vibration tests.

Advantech is demonstrating its first network video solution, the DVG-1100, a single channel, full motion MPEG4 video server. Powered by a hardware MPEG4 encoder and a RISC processor, the DVG-1100 provides excellent video quality and stable performance. With mature development on the network infrastructure and more devices connected to the IP network, the DVG-1100 provides gateway functions to convert analog video signals to digital video streams over the IP network. These functions greatly expand the application range of the server into diverse vertical markets, making it quite simple to integrate video into networks with management applications.

Agfa HealthCare (Booth 4106) is demonstrating its ORBIS Clinical Information System (CIS). ORBIS Live is the heart of the ORBIS application architecture, and offers hospitals and healthcare facilities a broad platform for the industry-specific process structure of institutions. ORBIS Live is the foundation for any facility's electronic medical record and encompasses administrative processes including admission/transfer/discharge, order entry, results reporting, document management, and general and administrative admissions.

Orbis Care offers a complete Clinician Charting and Documentation module, aimed at optimally supporting the documentation requirements within the nursing departments.

Amicas (Booth 2853) is launching a new version of Vision Series RIS that introduces advanced work queues to optimize order entry and scheduling workflows, and advances in native HL7 integration capabilities, and advances in scalability for complex practices.

Insight Dashboards is a web-based business intelligence platform that provides access to customized, near real-time, easy-to-read graphical data for key performance metrics and indicators, including clinical and operational factors. Users can set customizable active alerts to notify users of reported data changes as they occur.

Amicas is displaying Vision Series Document Management, an enterprise document management solution providing electronic capture, storage, and management of every document in an ambulatory radiology business. Vision Series Document Management allows for retrieval, revisions, annotations, and distribution of documents on demand throughout the enterprise.

Vision Series Financials is a Windows-based system designed to automate revenue cycle management for radiology groups, imaging centers, multi-specialty practices, and billing services. With advanced automation tools such as document imaging and optical character recognition, Vision Series Financials is designed to automate the timely and accurate acquisition and population of data from multiple data sources and multiple locations. This revenue cycle management solution uses “CashFinder” technology to reveal uncollected revenue with the use of sophisticated work queues for denial management, working unpaid claims, and managing unpaid patient balances. Vision Series Financials also features graphical and statistical reporting capabilities to facilitate the monitoring and management of key performance business indicators.

Amirsys (Booth 1003) is showcasing STATdx, the first point-of-care, clinical decision support system for imaging. STATdx Expert Differential Diagnosis generates key differentials including common, less common, and rare, but important, diagnoses.  STATdx streamlines workflow by reducing the time required to research and complete a difficult imaging analysis. Its digital format ensures that radiologists can have access to on-demand reference tools wherever and whenever needed. STATdx is now PACS- and voice recognition-integrated, providing instant access within the radiologists’ workflow without separate login.
 

Aspyra (Booth 3307) is demonstrating its CyberRAD RIS which offers end-to-end solutions that automate processes at every point of patient and encounter workflow. Using a Windows platform, CyberRAD focuses on advanced scheduling, film management and electronic signature.

Carestream Health (Booth 2513) is showing its new Kodak Carestream RIS Standard Configuration and the latest version of Carestream RIS. The new standard configuration version is a fully featured RIS solution that equips small to medium-sized hospitals with increased productivity, more efficient patient scheduling and exam workflow and comprehensive reporting capabilities. This affordable RIS also delivers a rapid, cost-effective implementation, the company says. An optional mammography module includes specialized scheduling, patient communication and reporting capabilities. The RIS’ open architecture is highly scalable and supports web-based user access.

Carestream also is featuring its Kodak Carestream Digital Dashboard that now supports monitoring of Kodak Carestream RIS operations, following up previous versions that supported Carestream PACS and Kodak Carestream information management solutions.

The digital dashboard provides system administrators with a convenient way to proactively monitor equipment performance, storage utilization and user volumes as well as verify network communication of other vendor’s devices. Radiology and PACS administrators can use the digital dashboard from an existing laptop or desktop computer. A stoplight graphic display gives immediate feedback regarding the status of any monitored device.

The dashboard also makes it easy to track the number of concurrent users for a device, the number of read and unread imaging studies, as well as the status of other tasks. The dashboard’s graphic view equips administrators to identify and resolve potential problems, thereby reducing or avoiding system downtime and optimizing workflow. Maintenance checklists provide task details, reminders and a history of completed actions. Administrators also appreciate the dashboard’s ability to deliver summary reports on system efficiency, which allows them to adjust schedules, better distribute patient and system workloads and increase staff efficiency.

The dashboard also helps ensure the accuracy of patient information by providing statistics on patient ID conflicts, missing accession numbers and patient imaging studies that require backup. At one of the user test sites, for example, the digital dashboard identified a glitch that was causing some imaging studies to be missed during the facility’s backup process.

Disk capacity, database storage and processes are also continuously monitored. The dashboard alerts administrators when systems are about to experience a shortage. If, for example, a process is in trouble or a directory is almost full, administrators can take action before any users are negatively impacted. 

Cedara Software (Booth 1316) is highlighting its connectivity tools for the integration of a multitude of patient information and image sources into end-to-end healthcare enterprise information flow. Solutions range from high-quality analog video acquisition to EHR/HIS integration of radiology systems, including MergeBox Video, a streaming video acquisition device that enables capture from multiple sources of patient data and images, fully integrated into the RIS/PACS workflow. MergeBox provides an efficient way to capture legacy data, as well as integrate specialized imaging, such as endoscopy or cardiology imaging, into the existing RIS/PACS solution.

CoActiv Medical Business Solutions (Booth 5741) is introducing Exam-RIS, a fully web-based RIS tightly integrated with the CoActiv web-based enterprise Exam-PACS.  The new RIS includes single and multi-site scheduling, multi-site billing, document scanning, web-based dictation, transcription, exam report templating, custom management reports, and HL7 integration with HIS and billing, the company says.

CodeRyte (Booth 2576) is showcasing its computer-assisted coding solution and showing by customer example how it works. One CodeRyte customer, a medical billing and collections services company, implemented CodeRyte when its business continued to expand. Through natural language processing technology, CodeRyte identifies correct billing codes with statistical precision from clinical information in medical reports. Context and confidence anchor the technology, which easily recognizes subtle language nuances such as negation, context and time references in medical records.

Prior to CodeRyte, the customer relied on spreadsheets to manually track the work of eight full-time coders. After CodeRyte, the customer saved nearly $1,000 a month in overtime, reduced its full-time coding staff from eight to three, cut report turnaround time from six days to less than 24 hours, and has a medical necessity denial rate of less than 1 percent.

The number of records coders processed everyday increased considerably with CodeRyte’s technology. Coders went from 80 records an hour to nearly 130 per hour for records they reviewed.

Compressus (Booth 5924) is showcasing several product enhancements to the MEDxConnect system, which delivers optimized workflow management for enterprise interoperability. With a single login, the clinician is presented with one view of current and historical patient and study information. MEDxConnect offers an affordable, efficient solution for seamless connectivity and interoperability between disparate systems and disparate clinical processes common in multi-site, multi-enterprise, and multi-vendor environments.

Pertinent Pre-Fetching is an enhanced rules-based tool to access prior studies and data.  In addition to the requested data, Pertinent Pre-Fetching tools gives users a snapshot of all available data to ensure that critical information is not missed. MEDxConnect’s Optimized Diagnostic Workflow feature adds intelligent routing to the Virtual Worklist, based on physician work patterns and exam review throughput. This maintains maximum productivity in the exam review and reporting process, while reducing bandwidth issues, particularly in smaller or rural facilities.

Eclipsys (Booth 6959) is showcasing its integrated clinical, revenue cycle and access management software, clinical content and professional services that help healthcare organizations improve clinical, financial, operational and client satisfaction outcomes.

The company is highlighting its Diagnostic Imaging Solutions, featuring Sunrise Radiology, a fully scalable system that can be integrated with the Eclipsys Sunrise Clinical Manager for a robust imaging solution. The latest release of Sunrise Radiology offers enhancements to online scheduling by physicians, speech recognition, support for PACS-driven workflow with third-party PACS, additional flexibility and granularity in managing users’ rights and permissions, and improved performance and scalability.

Fujifilm Medical Systems USA (Booth 1129) is showing as a work in progress its expanded data model for Synapse PACS which will allow greater diagnostic efficiency through enhanced workflow and greater information access. Fuji also is demonstrating the tight integration of Empiric Systems Encompass.NET RIS functionality that provides hospitals and imaging centers with a customizable solution that is uniquely capable of meeting all of their imaging and information needs.

GE Healthcare (Booth 1729) is demonstrating its Centricity Radiology solution, which brings together GE’s Centricity PACS product with the Centricity RIS-IC (formerly known as IDX Imagecast). The system allows radiologists to manage workflow and leverage a common radiology information system across multiple locations. Additionally, clinicians have immediate access to significant clinical findings and associated images as well as tools for reducing errors inherent with manual data entry.

InSiteOne (Booth 8308) is launching a new generation of its services roadmap, InDex 5.

InSiteOne says InDex 5’s services will expand the tools to manage information for the life of clinical data, and will incorporate a revised set of web-enabled administration functions for reporting and configuration management across virtual storage assets. It is scheduled for availability in February 2008.

McKesson (Booth 2542) is showcasing its enterprise cardiology product offerings and Revenue Management Solutions. Horizon Cardiology 11.1 CVIS supports hemodynamic monitoring, cardiac catheterization, echocardiography, vascular, nuclear reporting and CPACS on a single platform. McKesson’s soon-to-be released ECG solution features multi-vendor interface capabilities. The Revenue Management Solutions business intelligence and reporting too provides access to billing and accounts receivable information.

Medicalis (Booth 4987) is highlighting the new Percipio Analytics product which allows data mining and analysis of orders and outcomes. Percipio Analytics is used to understand current ordering patterns, identify areas of cost or reimbursement improvement, and track the ongoing success of Percipio radiology decision support deployments.

Percipio Analytics is a flexible, in-memory data analysis technology that allows multi-dimensional manipulation of large sets of clinical data. Users can select dimensions, measures and other analysis criteria on-the-fly and immediately receive results. A graphical user interface allows users to view and aggregate data at an enterprise level as well as drill down to individual records.

Combined with Percipio decision support applications, healthcare organizations now have a means to benchmark existing processes, deploy decision support solutions to improve order appropriateness and quantifiably track performance and success metrics.

Merge Healthcare (Booth 1122) is showcasing its Fusion RIS MX solution. Fusion RIS MX 3.30 incorporates the top requests from the company’s recent User Group Meeting and contains additional capabilities such as improved fax service, external order ID tracking workflow and national provider number.

Key elements of the Fusion RIS MX solution include enterprise-wide licensing and scaleable design that is used successfully by customers with small volume, as well as some of the largest imaging center chains in the country; flexible scheduling options that allow customers to fine-tune scheduling workflow and optimize room utilization; embedded modules for applications such as document management and dictation, to facilitate seamless, paperless workflow; and billing capabilities tied tightly to the RIS workflow.

Neurostar Solutions (Booth 3582) is debuting its Virtual Practice Management (VPM) package for providers of offsite radiology reading. Developed to streamline business operations, VPM features include universal, cross-client order entry; order tracking and management; support of multiple reports, including preliminary, final and consults; permanent storage of orders and reports; and billing reports to track receivables by client.

Neurostar also is introducing a range of enhancements to its Virtual Radiology Network (VRN) platform. 
 

NovaRad Corporation (Booth 6537) is highlighting its NovaRIS 7.0 which offers tighter integration, enhanced image access, and scheduling/billing/process management for radiologists and administrative staff.

NovaRIS runs on the same open source platform as NovaPACS to ensure seamless integration between the two systems. Its open source, web-based platform is designed to ease maintenance. This latest version also is now available in Spanish and offers inpatient scheduling, a “quick order” wizard and increased menu customization options.

New with this latest version release is NovaCentral, an improved command center that enables NovaRad’s customer support team to remotely monitor in real time all of the critical functions of the customer’s RIS/PACS. This remote monitoring serves as a safeguard to ensure uptime and updates for optimal performance of the systems.

NovaRIS generates reports, measures profitability and facilities paperless management of patient records. Featuring the ability to filter workflow by modality and launch dictation from workflow, NovaRIS also contains specialized worklists and reports for stalled and cancelled procedures.

Philips Medical Systems (Booth 4129) is showcasing its XIRIS radiology information system, which facilitates collaboration across the medical enterprise. XIRIS automates tasks such as scheduling, organizing, reporting, tracking, dictating, transcribing and distributing detailed patient information into reports containing exam images. XIRIS is the first enterprise RIS designed to support the medical industry and management methodologies. XIRIS is a completely web-based application designed to manage patient registration, scheduling, exam tracking, staff and resource management, and the generation of reports and statistical information. XIRIS can be integrated into a new or existing center via its own HL7 Broker or DICOM Worklist Manager. It also shares information across multiple centers with Multi-center RIS-Backbone, available in a variety of formats to multi-center or enterprise models.

Philips Xcelera streamlines clinical workflow and improves efficiency throughout the cardiovascular continuum of care, the company says. It reconciles the multi-modality, multi-vendor flow of clinical information at various points-of-care, spanning early diagnosis, treatment, and follow-up. Xcelera puts Philips’ modalities and their respective clinical applications and analysis tools into a comprehensive patient-centric workspace. It also integrates with third-party information systems, including electronic medical records, order management, ECG management, and clinical documentation systems. Xcelera offers scalable solutions to address various configuration requirements and Philips Informatics legacy systems as well as accommodating future expansion. It can also leverage iSite as a long-term archive, shared with radiology, so that infrastructure as well as images can be shared throughout the enterprise. Xcelera provides HL7 connectivity meeting IHE profiles as well as storage of DICOM and DSR-TIFF imaging/service standards. It is scalable from small to large multi-site enterprises and its architecture is based on proven industry standards (supporting the latest database and operating system platforms from Microsoft, including clustering services). Xcelera provides instant (<2 seconds) review of original image quality/size at acquisition speeds up to 30fps (including biplane).

RADinfo Systems (Booth 4171) is launching DICOMmail, designed for sending DICOM-compliant images through email systems. DICOMmail comes with a basic RSVS viewer. It allows a user to send DICOM images through email by simply dragging-and-dropping files; converting JPEG, GIF and/or BMP images into DICOM format, if needed, and then clicking send. The consulting user can view the images in the basic RSVS viewer after easily downloading the DICOMmail application.

The DICOMmail Viewer is based on RADinfo Systems’ FDA-approved RSVS visualization technology. DICOMmail Send allows the user to drag and drop an image into the software for delivery to any email address. DICOMmail supports DICOM, jpeg, gif, and bitmap images.

RIS Concepts (Booth 5909) is introducing a range of advanced features to support rapid workflow. An advanced exam scheduling wizard for multi-site facilities searches across locations to select the first appointment available for a specific modality. Also new is an exclusive RIS Concepts RadSpeak feature that utilizes templates and macros to streamline web-based dictation. When accessed, RadSpeak presents the user with a range of exam report templates. Through verbal commands, the user simply selects standard paragraphs from the template to include in the report, makes any necessary changes and calls for a digital signature. Radiologists also can create an unlimited number of custom voice-controlled templates.

RIS Concepts also is introducing its RAD-RIS, a comprehensive RIS solution fine-tuned for the needs of radiologists reading for multiple facilities.

ScImage (Booth 2551) is displaying its PicomRIS, an IHE-compliant RIS that complements the company’s flagship web-based enterprise-wide PACS, PicomEnterprise. The solution is available as either a stand-alone RIS or fully integrated RIS/PACS and is ideal for small acute care facilities and outpatient imaging centers.

PicomRIS alone provides tools for exam ordering, scheduling, film tracking and billing. PicomRIS also offers solid management reporting tools to ensure high-performance business efficiency. Patient reporting can be accomplished using either the built-in transcriptionist module along with digital dictation or self-edited Dragon-based speech recognition for reporting. The standards-based system leverages DICOM and HL7 to satisfy IHE requirements for interoperability with any number of clinical information systems.

Adding PicomRIS to ScImage’s Enterprise Imaging Solution, PicomEnterprise, results in a fully integrated clinical and business workflow solution that enables enhanced workflow productivity and eliminates complex interfaces between third-party products. The single database solution provides a single point of entry for patient data and workflow management, virtually eliminating time spent toggling between applications and providing the user with a more consistent experience.

ScImage’s single database design places RIS and PACS on the same server, thereby reducing the hardware investment, integration fees and implementation time. This leads to seamless data exchange, shorter exam lifecycles and fewer errors because there is only one system to access for clinical and business workflow.

Siemens Medical Solutions (Booth 7713) is showcasing its syngo software platform, including RIS, PACS, post-processing and distribution. The applications under syngo are based on one architecture and common user interfaces, simplifying its use. This architecture is also known as Service Oriented Architecture or SOA. With a high level of integration, the applications are accessible and available from any workstation—anytime, anywhere.

Siemens is strengthening its focus on the portal approach and through web-based integrated syngo portals, offers fast and secure communication between departments and partners. syngo Portal Radiologist is structured for radiologists performing medical checks, reading images and signing off on reports. This structure displays the daily scheduled procedures and the relevant information for the user in their main task area, helping users work efficiently. This and other syngo portals are developed in close cooperation with care providers.

Siemens also is showing a new cardiology image management and reporting solution, syngo Dynamics version 6. The product integrates image and data management, post-processing and reporting.

Siemens is displaying the REMIND platform (Reliable Extraction and Meaningful Inference from Nonstructured Data), which includes data extraction, data combination and probabilistic inference. REMIND searches through all patient records analyzing information in unstructured and structured form. At RSNA, Siemens is showing two different applications based on REMIND:

• Soarian Quality Measures powered by REMIND represents a fundamentally new tool to support quality improvement. It replaces time-consuming manual chart reviews with highly accurate and automated chart abstraction of quality measures. Soarian Quality Measures combines all available patient data, including free text in clinicians’ notes, to capture a provider’s compliance with accepted practices to improve quality of care. Soarian Quality Measures currently supports in-patient quality measures as defined by the Centers for Medicare & Medicaid Services and the Joint Commission.
• REMIND Clinical Decision Support (CDS), a works-in-progress application which is under development in collaboration with MAASTRO (Maastricht Radiation Oncology), a leading radiation oncology treatment center in the Netherlands. REMIND CDS helps physicians personalize therapy plans by predicting therapy outcomes and side effects in lung cancer patients undergoing therapy. REMIND CDS can leverage all available electronic information in the patient record, including demographics, clinical factors, imaging information, treatment plans, delivered treatment, genomics and proteomics.

Siemens has partnered with NextGen Healthcare, a leading provider of practice management software and ambulatory electronic medical record solutions, to extend the value of its RIS/PACS, enabling a new and advanced level of interoperability between image management and practice management to meet the unique healthcare information technology needs of imaging centers and specialty/multi-specialty practices.

For practices that provide clinical services beyond diagnostic imaging, Siemens also provides NextGen’s image-enabled ambulatory electronic medical record, delivered with robust clinical content for specialties such as cardiology, orthopedics and obstetrics.

Siemens is displaying its Soarian Clinicals, which combines departmental solutions with core clinical information system components to provide a complete clinical information solution that meets the needs of the acute care hospital environment across the complete continuum of care. With a workflow engine that simultaneously pushes multiple tasks to multiple people, Soarian Clinicals makes information available when and where it’s needed. It presents clinicians with alerts and reminders and can help coordinate teamwork among clinicians. 

Soarian Cardiology combines the power of an extensive cardiology clinical repository, workflow management technology, and superior documentation and reporting tools. Soarian Cardiology can become part of a comprehensive cardiovascular information system, equipped to collect, store, organize, retrieve, and analyze cardiovascular information, and share it via the internet. 

 

Sony Electronics (Booth 2571) is showing its IPELA PCS-HG90 High-Definition, IP-based Visual Communication System. Just as HDTV enhances television color and clarity, high definition imagery used in the Sony IPELA visual communication system allows users to see details of a patient’s anatomy with four times the resolution of standard-definition technology. Used in hospitals, conference rooms and classrooms, the Sony IPELA system can improve hospital efficiency by connecting people and places around the world with the highest quality audio and video images.

With an advanced H.264 HD video codec and high-resolution and high frame rate of 1280 x 720 60P/30P, the Sony PCS-HG90 offers realistic and lifeline images even on large-screen displays. Additional features of the PCS-HG90 include a four site multi-point videoconferencing capability, site name display and ITU-T H.235 encryption.

Swearingen Software (Booth 6951) is releasing the RISynergy Results Viewer, a new feature that allows referring physicians to view transcription report results for their patients over the internet using just a standard web browser. The RISynergy Results Viewer’s flexibility allows physicians to receive critical information about their patients from any location.

TeraMedica (Booth 7109) is showcasing its new Evercore - SOAR platform as part of its ongoing commitment to solving interoperability challenges in the enterprise content management arena. The SOAR (Service Oriented Architecture Repository) platform was built using standard SOA methodology. It uses industry standard web services protocols which allow Evercore Clinical Information Manager (CIM) to operate as a SOA. The functionalities provided by the SOA were previously only available internally within Evercore or via more complex protocols such as DICOM or HL7. This platform allows hospitals and healthcare systems to choose the best-of-breed when shopping for modalities and departmental systems.

ThinAir Data (Booth 5528) is demonstrating TeleRIS, designed specifically for groups who manage multiple contracts and facilities. The common interface provides single sign-on capabilities for providers, regardless of location. TeleRIS is designed to help users automate workflows, meet service level agreements, automate reports and maximize professional resources.