Clinical Information Systems

Regional health information organizations (RHIOs) may top the list of buzzwords in the clinical information systems category at HIMSS 2006. Vendors are launching multiple solutions to support, nurture and connect RHIOs. Moving down from the macro level, exhibitors are touting enhanced integration between the electronic medical record and imaging. Other tools to help healthcare operate better, smarter, safer and faster include closed loop medication systems and dashboards. PACS and RIS remain hot items. Look for new enhancements as well as niche solutions geared for the imaging center as well as cardiovascular information systems and new oncology information systems that support all facets of cancer care.

Agfa's HealthCare Business Group (booth #5633) is launching new products and services, including technologies for building an image-rich EHR. The company is displaying IMPAX RIS/PACS for outpatient or imaging centers, Heartlab cardiovascular information system solutions, its complete IT portfolio, Version 3.1 of its voice recognition system, iPlan scheduling system and the Enterprise Clinical Dashboard.

IMPAX for Outpatient or Imaging Centers provides a single point of access to integrate information and image management workflow and results distribution. New developments include embedded billing workflow and an integrated Mammography Tracking module.

Agfa's Heartlab solutions give cardiologists fast access to critical clinical image information from any workstation either within or outside of the hospital. The cardiology solution archives and manages data from multiple imaging modalities to provide an integrated cardiac record.

The company also is showing its complete Agfa portfolio of hospital-wide IT solutions and introducing a solution that allows for access to medical images and patient information through secure wireless technology, including laptop PCs and PDAs. The patented streaming technology with built-in encryption means that only the screen image has to be distributed allowing for image and information distribution to ultra-thin clients at the point of care or wherever clinicians are located.  

Version 3.1 of Agfa's voice recognition, dictation and reporting system allows physicians to dictate, edit and electronically sign reports to improve report turnaround time and decrease transcription costs. Productivity enhancements include the ability to insert fixed or customized data fields automatically.

iPlan is an easy and intuitive web-enabled scheduling system for use inside and outside the hospital. iPlan simplifies electronic scheduling and boosts productivity by allowing hospital staff and referring physicians outside the hospital to make and view appointments.

Agfa's Enterprise Clinical Dashboard provides web-accessible, single sign-on to disparate systems. The new Enterprise Clinical Dashboard increases productivity and improves patient care by presenting patient records and images from existing standalone systems through a single, unified web interface. This simplifies physician access to relevant patient information. Agfa's Enterprise Clinical Dashboard is built on an open, vendor-neutral architecture, supporting rapid deployment. Potential results include increased productivity, reduced operations cost and improved patient care.

Cedara Software Corp. (booth #7601) is demonstrating a macro-level approach to image management and radiology workflow for OEM/VARs to incorporate into their offerings.

Cedara's middleware architecture provides a comprehensive approach to system management throughout the healthcare enterprise. For OEM and VARs, this technology facilitates scalable, vendor independent multi-system integration and management that leverages existing equipment. Cedara is showcasing a real-world scenario to help optimize the operation of an imaging practice, using IHE integration profiles and underlying medical communications standards as a foundation. The scenario generates and gathers useful analysis data for future purchasing or process improvement decisions. Cedara's multi-faceted approach to image and data management is based on the Cedara OpenEyes development platform, extended structure from Cedara BluePrint and a new workflow engine.

Cisco Healthcare (booth #2513) is showing Cisco Connected Imaging that delivers advanced imaging services that help optimize image acquisition, transport, storage and security. Based on the Cisco Medical-Grade Network, Cisco Connected Imaging provides security, storage and server virtualization, IP voice and RFID capabilities.

DR Systems (booth #2001) is exhibiting enhanced EMR integration and RIS features. Its unified RIS/PACS platform provides a single-vendor solution for technologies such as web-based scheduling, document scanning, voice recognition, digital dictation, automated reporting, and output to billing systems. This fully integrated approach enables hospitals to avoid the costs, complications and frustrations of working with multiple vendors.

DR Systems recently announced single sign-on capability with third-party EMRs such as McKesson's HorizonWP Physician Portal, adding to the many interfaces the company has already created to third-party HIS and RIS vendors, using HL7, DICOM, and CCOW industry standards.

New features of the DR Systems RIS/PACS include:

• WebLaunch, for easy single sign-on integration capability with other HIS or EMR systems. Caregivers can log onto their HIS to access a patient's record and launch images with appropriate documents or notes and also hear an audio summary.
• Enhanced patient management tools for the RIS, including web-based scheduling for referring doctors, patient tracking, output to billing systems, film tracking and new management reports.
• Connectivity features for participation in regional health information organizations (RHIOs).
• Expanded web-based capabilities through DR's Web Dominator for complete remote reading, montage creation and transcription.
• Full integration of mammography PACS capabilities with new diagnostic reading tools.
• Improved integration of Barco's VOXAR, Vital Images Vitrea 2, Orthocrat's TraumaCad, MRS QAPlus and other third-party products.
   

Eclipsys (booth #3933) is showcasing the latest release of the Sunrise clinical suite, Sunrise 4.5 XA, which spans the entire healthcare enterprise with a single, integrated technology platform that connects all caregivers, administrators and processes across the continuum of care.

The Sunrise 4.5 XA advanced clinical suite delivers approximately 1,500 new or enhanced capabilities for documenting care, creating orders, reviewing test results and coding for maximum reimbursement - on a single clinical platform. This release builds upon the strengths of previous Sunrise releases on the XA platform, including the fully integrated capabilities of Eclipsys Sunrise Ambulatory Care Manager and Sunrise ED Manager solutions. Additionally in Sunrise 4.5 XA, Eclipsys delivers a truly integrated, end-to-end medication management solution. Because each solution in the Sunrise advanced clinical suite shares the same Health Data Repository, are customized for the workflows of specific clinical environments and utilize the same architecture - Eclipsys customers can link care providers, operations and the entire continuum of care to achieve unprecedented interoperability.

Emageon (booth #4233) is unveiling System Release 5.30.1 with new and improved administrative tools, enterprise workflow and open standards support.

Integrated Administrative Toolset provides Web Administration tools including a rules-based QC Workstation. Enhanced Enterprise Workflow tools manage exams and increase productivity. Native Volume Rendering with OpenGL graphics manipulate 3D volumes with real-time, high-quality ray-tracing.

Fujifilm Medical Systems USA (booth #1226) is showcasing Synapse web-based PACS that integrates multi-site, multi-information system and multi-reading group environments. Fuji is demonstrating its vision for the future of Synapse - Comprehension - a roadmap for expanding Synapse beyond the traditional boundaries of PACS into a comprehensive radiology management platform. Also, Fuji is showing Obliquus, a new Synapse component for integrated, diagnostic 3D visualization. Obliquus requires FDA 510(k) review and is not currently available in the U.S.

GE Healthcare (booth #1719) and IDX Systems Corp. (booth #4509) are highlighting their new integrated strategy at HIMSS 2006 and showing Centricity PACS, Centricity Pharmacy and Centricity Physician Mobile.

GE Healthcare Information Technologies is demonstrating the latest version of its Centricity PACS family of products. The Centricity PACS SE product is positioned to meet the unique needs of small to medium size hospitals. The Centricity RA 1000 diagnostic workstation provides the latest radiologist toolset plus the AW Suite application. The CA 1000 is a Centricity enterprise-wide solution that combines radiology and cardiology information in the same database, while providing cardiology specific tools.

Centricity Pharmacy enables productivity and quality of care improvements by managing pharmacy department end-to-end workflow. It interfaces to other information systems and devices to ensure the seamless movement of information between caregivers in the process of distributing medications. When the Pharmacy system is deployed with GE's Computerized Provider Order Entry (CPOE) and bar code-enabled Medication Administration Record (MAR) modules, it completes a closed-loop medication management suite that is designed to aid in the practice of evidence-based medicine while streamlining workflow. Centricity Pharmacy can be deployed with existing CPOE and electronic MAR solutions to help ensure consistent delivery of safe and efficient care within the institution.

Centricity Physician Office Mobile (Powered by PatientKeeper) offers a computing platform for physicians that extends the functionality of Centricity Physician Office to mobile devices such as PDAs and Smartphones. Centricity Physician Office Mobile allows physicians to access and manage their patient lists and schedules and to capture charges quickly and accurately - from any location. Physicians can wirelessly sync or cradle their devices to connect with Centricity Physician Office. Charges captured on the device are automatically submitted, reducing the lag time between service delivery and charge posting.

Guardian Technologies International, Inc. (booth #3616) is announcing what it calls "a breakthrough in image processing with the potential to improve the diagnostic characteristics of medical images which should result in easier and speedier diagnoses, decreased misreads and greater workflow efficiency for the diagnosing physician."

The technology, built on Guardian's 3i core imaging analysis engine, is able to detect and distinguish different types of organic compounds contained in images from a wide array of sources, including x-ray, CT and hyper spectral data types. Since the human body is made of organic compounds, the adaptation of the scientific principles behind Guardian's PinPoint threat detection technology to medical image analysis follows naturally. Guardian has discovered and implemented a method that identifies a unique signature within images - like a latent fingerprint that is unique to individual types of materials. The two dominant interactions in this process are the photoelectric and Compton effects. Guardian's software decodes the encoded signatures, making accurate identification of specific items within images possible.

Guardian has initiated research and development activities focused on the implementation of its new Intelligent Imaging Informatics (3i) technology in the following three healthcare related areas: Extended Visualization Imaging Tools, Multi-Modal Synthesis/Image Fusion and CAD.

Kodak's Health Group (booth #2313) is demonstrating the newest capabilities of its Kodak Carestream Information Management Solutions (IMS), Kodak Secure Email Services and Kodak Healthcare Solutions.

IMS equips healthcare IT staff to more efficiently manage information stored in systems across an enterprise, region or country. These scalable solutions help reduce expenses by providing intelligent, automated management tools and by equipping facilities with centralized management of decentralized storage systems.

Carestream Information Management Solutions and Carestream Radiology Solutions provide optimized image and information management across an enterprise, while simultaneously lowering total cost of ownership. Kodak is highlighting its ability to provide healthcare services across communities and regions and demonstrating KODAK Secure Email Services.

Kodak Healthcare Solution Services offers a family of workflow design and change management services designed to maximize profitability and improve efficiency for healthcare providers.

Kodak's Carestream Information Management Solutions include: Kodak Carestream Enterprise Information Management (EIM), Kodak Carestream Hosted Information Management (HIM) and Kodak Carestream Regional Information Management (RIM).

Carestream architecture can be scaled to meet the needs of small-to-large hospitals and medical practices as well as regional or national healthcare information systems - all within the same software framework. Since the same software architecture is featured in Kodak Carestream PACS, a healthcare facility that purchases Kodak's PACS can implement enterprise-wide management of other applications and storage systems with a software upgrade.

CARESTREAM RIM can extend clinical information life cycle management to an entire geographic region. CARESTREAM HIM offers business continuity and disaster recovery by hosting an organization's data remotely at a secure Kodak data center.

McKesson Corp. (booths #2137, 2543) is highlighting its comprehensive product portfolio which it says makes healthcare safer through advanced financial, administrative and clinical solutions combined with automation technologies. Featured solutions include Horizon Clinicals and McKesson Medication Safety Advantage.

McKesson's portfolio helps organizations to streamline workflow and digitize the patient record to enhance the safety, quality and efficiency of care. McKesson is showing solutions to automate virtually every aspect of healthcare delivery, from the hospital to outpatient settings, the physician office and into patients' homes.

Horizon Clinicals portfolio includes the Connecting Physicians offering, which leverages e-prescribing and online physician-patient communication solutions, proven points for jump-starting community-based electronic health records.

McKesson Medication Safety Advantage combines software, automation, packaging, distribution and consulting solutions to help providers prevent medication errors at every stage where they can occur.

Medical Information Technology (Meditech) (booth #5033) is displaying its new Scanning and Archiving product that enables healthcare organizations to move toward a paperless environment by storing all healthcare information on-line. This application provides customers with an organization-wide solution to their document scanning and imaging needs, enabling staff members to quickly scan documents into their system, review the quality of images, associate documents with patient records and incorporate the resulting digital documents directly into users' workflow. The Scanning and Archiving application enables customers to generate and maintain complete, secure, legal medical records.

The company is also launching its Oncology Management system.

Merge eMed (booth #7601), a Merge Healthcare company, is showcasing FUSION RIS, FUSION Matrix PACS and FUSION RIS/PACS MX.

FUSION RIS is a completely integrated business workflow solution, which includes navigation, worklist management, group practice deployment, integration capabilities and security features that have allowed clients to accelerate productivity from scheduling through billing, reporting and distribution of results. FUSION RIS offers several optional modules including: Embedded Document Management, Embedded Digital Dictation and Mammography Tracking. The optional Referring Practice Portal allows for instant online viewing of reports and images, as well as real-time patient status. Practice Analysis functionality enables users to analyze, report and make decisions with simple mouse clicks. Finally, customers can opt for a complete billing solution from scheduling to receivables management.

FUSION Matrix PACS allows radiologists to perform their jobs more effectively by efficiently displaying images, providing needed information clearly and facilitating results generation. The PACS incorporates smart client architecture, provides relevant clinical information at the radiologist's fingertips, facilitates easy peer communication while reading and enables efficient distributed workflow. A Learn Wizard optimizes viewing protocols and enables the user to start reading faster. New 64-bit processing enables radiologists to simultaneously load, view, compare and manipulate more images.

The FUSION RIS/PACS MX solution integrates information workflow from FUSION RIS and image visualization of FUSION Matrix PACS to unify RIS, PACS, dictation, document management, web-enabled distribution of clinical and business information and billing and practice analysis workflow.

NovaRad Corp. (booth #7341) is launching NovaRIS that tracks patient information, procedures, exam status, and reimbursements. The RIS is web-based for paperless-oriented management and designed to generate reports, analyze exams, measure profitability and even bill insurance companies. NovaRIS also maximizes productivity by tracking exact reimbursement costs, which insurance companies paid for what, and which procedures are currently making or losing money. It can even track the productivity of individual radiology techs.

NovaRIS features voice recognition and transcription and contains specialized worklists and interfaces for administrative assistants, technologists, radiologists, transcriptionists and billing specialists. Additional NovaRIS features include bar coding, HIPAA logging, HL7 interfaces, electronic signature for radiologists, audit trail and seamless integration with NovaPACS or other third-party PACS or HIS.

The NovaRIS companion product, NovaPACS, is an enterprise level, scalable, PACS solution that offers 3D imaging, fast image retrieval, full-feature viewer with intuitive interface, brokerless integration and all-inclusive support.

PACSGEAR (booth #155) is sharing PacsSCAN FORM and PacsSCAN Enterprise.

PacsSCAN form provides a software solution that allows users to fill out any form electronically and include it with patient images at the point of diagnosis. Existing forms can be imported and customized by defining pull-downs, text areas, check boxes and auto-fill fields with RIS data. Users can draw free hand using any standard PC or handheld tablet.

PacsSCAN Enterprise scans and electronically stores both clinical and non-clinical patient documents, such as insurance and financial information. Patient information is available anytime and any place with security controls to limit access and ensure patient confidentiality. Additional enhancements include expanded inbound/outbound fax support and electronic order entry.

Philips Medical Systems (booth #5017) is demonstrating Xtenity and iSite PACS.

The company is highlighting Xtenity's ability to interoperate with its medical equipment, monitors and software, showcasing the benefits of having access to the electronic health record (EHR) throughout the patient care cycle, using a suite of integrated products. Specifically, Philips is showing Xtenity's integration with Philips IntelliVue monitors, iSite PACS and SpeechMagic. Xtenity includes an enterprise data repository, inpatient, ambulatory, registration, scheduling, ADT and revenue cycle management on a single platform. Xtenity's E-Health solutions include the Patient Portal and the Provider Portal, allowing organizations to leverage the power of the web and extend their services to patients and throughout the healthcare community.

Philips' specialty module addresses the needs specific to individual clinical specialties. Xtenity RIS, the first specialty module from the Xtenity portfolio, manages images and data for radiology departments. Philips is showing the enterprise-ready RIS as an integrated solution with Philips iSite PACS. Integration of the RIS, HIS and the PACS expands the radiologists' reporting capabilities, improving relationships with referring physicians and allows them to provide more patient-centric care.

Philips iSite PACS, acquired when Philips purchased Stentor, Inc., can be sold with a "pay-per-study" business model that enables customers to purchase PACS services without a major software or infrastructure investment. Specifically, Philips is showcasing iSite Enterprise, iSite Enterprise integrated with Xtenity Enterprise, iSite Radiology integrated with Xtenity RIS and third-party integrations via the iSite Platform API (application protocol interface).

Raintree Systems Inc. (booth #523) is featuring its Raintree dash board that provides a convenient, centralized area that automatically navigates an end-user to different program areas while performing daily tasks. Raintree has designed dash boards for clerical staff members, clinical personnel and providers. A dash board automatically navigates users to program areas, automatically displays a list of follow-up to do items, automatically opens an assessment record for each scheduled patient, automatically lists current medications and other diagnostic tests, automatically updates demographics, intake information and patient alerts and automatically lists patients ready to be seen. The system also creates a chart note and supports electronic signatures.

Siemens Medical Solutions (booth #1237) is showing off its Soarian portfolio of solutions and syngo suite. Both lines support Siemens' Care Without Boundaries theme, which emphasizes proactive integrated patient care throughout the enterprise.

The new generation of Soarian solutions enable healthcare enterprises to transcend information solutions. At HIMSS, Siemens is demonstrating how IT solutions with a workflow orientation can manage not just transactions and data, but also the process of healthcare delivery and the interactions between members of the healthcare community. Soarian's workflow technology reduces manual process steps; monitors, tracks, and escalates processes automatically; and orchestrates clinical best practices - throughout the enterprise or at the clinical departmental level.

Siemens is focusing on clinical and departmental optimization and demonstrating its emphasis on patient safety and closed-loop medication processing by combining CPOE, Siemens Pharmacy information system, and Med Administration Check, which uses bar code technology to alert nurses to potential medication administration errors. Additionally, Siemens is leveraging its recent alliance with RxHub to address medication reconciliation. The company also is highlighting its new INVISION Bed Management solution.

Siemens is demonstrating RIS/PACS integration with broader enterprise solutions as an essential stepping stone to building an EHR across acute care and ambulatory care settings. The syngo Suite offers complete integration of HIS, RIS, PACS and post-processing, and supports end-to-end radiologic workflow.

In support of the RHIO movement, Siemens is showing Soarian Community Access, which connects all partners in the healthcare community, enhances patient communication via a secure online exchange, and empowers patients to maintain a personal health record. Additionally, the Soarian Clinician Portal provides clinicians with reliable access to information through a secure, roles-based, personalized portal. The Portal enables authorized users to seamlessly access information including patient scheduling, images, results, email, financial information and professional education and reference materials. Finally, the Siemens/NextGen Healthcare partnership helps providers optimize patient flow across acute and ambulatory settings.

Siemens is showing how its financial solutions and revenue cycle services enhance financial operations and enable customers to achieve proven results at hospitals across the country.

Also, the company is sharing IT innovations including the latest Soarian departmental solutions - Soarian Oncology, Soarian Operating Room, and Soarian Emergency Department - as works in progress in the Emerging Solutions area of the booth.  

The syngo Suite unites image acquisition, RIS, PACS and post-processing with the clinical and administrative cycles addressed by Soarian.

The syngo Suite includes:

• syngo Imaging: Siemens' radiology PACS, which is scalable to meet the image volume needs of large academic medical settings to smaller diagnostic imaging centers. The solution features specialized workplaces; Smart Select, a navigational tool; dynamic loading and intelligent layout enhancements to speed image reading; tight integration of all components; and advanced post-processing functions.

• syngo Workflow: Drives the complete radiological workflow from order entry to image and report distribution. More efficient radiological diagnoses and interpretation are supported via new integrated (works in progress) referring physician and radiologist portals that combine the traditional information located in a HIS, RIS and PACS into a single user interface and workspace.
   
• syngo Dynamic:  A multi-modality, dynamic image review, diagnosis and archiving system that is pending FDA 510(k) approval, enables evidence-based reporting to help improve the efficiency of clinical procedures for cardiology, general imaging and OB/GYN. The solution is scalable for imaging clinics, hospitals and multi-facility health enterprises and features optional interfacing to clinical or hospital information systems.

Varian Medical Systems (booth #3412) is highlighting its Varian's MedOncology information management system that combines the benefits of a comprehensive electronic health record (EHR) with guideline-driven care, workflow management, and decision support.  It also incorporates other clinical operations such as pharmacy, billing, lab, clinical trials, and communication with external healthcare providers.

It was designed to mimic the paper chart and incorporates a powerful chemotherapy ordering system that automates drug ordering and interfaces with the pharmacy, turning cumbersome multistep processes into simple ones.

Varian's MedOncology tool draws from a robust relational database that can generate more than 600 different types of reports to give clinicians access to virtually any type of data about each patient's treatment. In addition, the system has interfaces for connecting with more than 60 different vendor systems and lab devices.