Image & Information Management: Workflow, Integration & Beyond
The message at McCormick Place was loud and clear. PACS continues to evolve to meet radiology's most pressing challenges. The hot items this year included integrated advanced visualization, digital mammography solutions and enterprise systems that transcend radiology and incorporate cardiology and beyond. The small hospital/imaging center and replacement markets also earned their fair share of the spotlight. Vendors also touted value propositions, aiming to ease the sting of the Deficit Reducation Act (DRA) that take effect this month and declining reimbursement.
Going with the flow
The latest vendor offerings promise improved workflow and deeper integrations. Many new systems incorporate the next level of advanced visualization tools, enabling radiologists to employ 3D and remain at a PACS workstation, which represents a workflow plus. Embedded advanced visualization tools overcome the limits of dedicated 3D workstations and distributes advanced visualization to all workspots throughout the enterprise.
Advanced visualization applications weren't the only new offerings. DMIST results are out, and the first CR mammo system is on the market. Digital mammo has turned the corner, and sales are skyrocketing.
Both advanced visualization and digital mammography bring similar challenges. That is, radiologists need a cohesive work environment — not separate workstations, says Brad Levin, vice president of marketing for Dynamic Imaging. Several vendors aim to simplify the intricate challenges of storing and recalling digital mammography images with new PACS workstations approved for interpretation of current and prior studies and incorporate embedded CAD and multi-modality imaging viewing.
Enterprise top of mind
Another buzzword heard loud and clear around McCormick Place was enterprise imaging. Sites are looking for a single solution for cardiology and radiology archiving and distribution, says Ed Heere, president of CoActiv Medical Business Solutions "The lines between imaging departments — radiology and cardiology — are blurring," concurs ScImage National Sales Director Richard Taylor. For example, both cardiologists and radiologists need to view static and dynamic images, a trend that will strengthen as cardiac CT and MR grow.
Other vendors, including McKesson and PACSGear, pointed to the bigger picture — image-enabled care — and the need to integrate all types of images including non-DICOM ENT, bronchoscopy and pathology images. An enterprise solution that wraps in DICOM and non-DICOM images could be ideally positioned to meet the storage, IT and financial needs of the enterprise.
While vendors touted the 'enterprise,' they also honed in on the little guy. PACS has penetrated the majority of large and mid-sized hospitals, but many smaller sites, imaging centers and specialty practices are eyeing digital image management solutions. "PACS/RIS is migrating to the masses — imaging centers and community hospitals," notes Tim Law, president of NovaRad. These sites do have unique needs, which may include older, non-DICOM modalities, a barebones or non-existent IT staff and an ultra-tight budget.
Scaling systems for smaller practices
SourceMed and Dynamic Imaging point to the validity of web-based solutions that can grow with the smaller site as its clinical and technical needs evolve. "A web-based solution can scale from one to two to multiple distributed facilities," Dynamic Imaging's Levin points out.
The Deficit Reduction Act and declining reimbursement could be a positive for some PACS vendors, says Tim Kulbago, chief strategy officer, for Merge Healthcare. That's because hospitals and imaging centers will increase their reliance on technology to counteract dropping reimbursement. Imaging centers may grow their business by investing in new tools designed to improve relationships with referring physicians, predicts Aine Cryts, AMICAS marketing communications manager.
The show floor was peppered with new advanced workflow solutions, designed to minimize disruptions to radiologists, streamline communication and mine data to facilitate optimization of staff and modality resources. The other half of this trend is consulting services. According to Kulbago, more sites are requesting practice analysis services to help grow their businesses.
Cost sensitivity
Another effect of the belt-tightening? Some sites are evaluating less expensive PACS. Sites in the replacement market should analyze their service contract to make sure it remains viable and determine if the installed PACS meets current and anticipated future needs such as digital mammography, says Vijay Ramanathan, president and CEO of RamSoft, Inc.
It was possible to get beyond the here and now at RSNA '06. Visitors to GE Healthcare's Science and Technology Pavilion were propelled into the future. GE shared a prototype Graffiti PACS that can bypass the mouse and allow users to scribble commands. Other works-in-progress incorporated touchscreen technology enabling multiple users to interact with the entire patient record including images and patient data like cholesterol levels.
The show floor also featured a host of related solutions, ranging from new RIS solutions to next-generation speech recognition offerings, furniture and peripherals such as digitizers and CD burners.
Agfa HealthCare launched functional extensions for digital mammography reading and reporting applications for IMPAX PACS and its business consulting group and shared IMPAX Data Center. The company also demonstrated IMPAX Clinical Applications. Finally, Agfa shared information about a potential wireless integration of IMPAX with Ascom and discussed a new alliance with Vocada, Inc. centered on improved distribution of clinical results.
AMICAS debuted RadStream, announced Vision Reach and launched Vision Series PACS Version 5.0. RadStream is designed to integrate disparate RIS and PACS environments, boost soft-copy reading and automate communication and documentation of positive results. Vision Reach facilitates end-to-end radiology practice in a filmless and paperless radiology operation and integrates the radiology report with key images to create a single ìmulti-mediaî report for referring physicians.
BRIT Systems announced the release of 3D imaging tools native to the company's Roentgen Files PACS and available on any BRIT Vision workstation. Improved MPRs, MIPs, volume rendering and basic 3D imaging tools, along with more efficient viewing tools, are now native applications on properly configured BRIT Vision workstations. The company also showed new administrative and reporting tools, such as ìtwo or three click normalî templates. BRIT highlighted its Discordance Tool, which facilitates the communication of findings between ER doctors and radiologists. BRIT's pay-per-study CARE (Complete Archive & Read Ensemble) Program is tailored to meet the specific needs of Critical Access Hospitals; it provides a bundled PACS and RIS solution and optionally, diagnostic reading services.
Cedara Software, a Merge Healthcare company, showcased its C4 (Cedara Clinical Control Center) development platform. C4 allows clinical applications and plug-ins to be tightly integrated into a single workstation, sharing system resources and facilitating integration of clinical applications into any information system.
Cerner Corp. demonstrated enhancements to its unified RIS/PACS solution that include a critical results documentation and notification solution that helps support JCAHO's National Patient Safety Goal, as well as order review and approval tools that help optimize this traditionally paper-based process.
CoActiv Medical Business Solutions introduced a multi-modality cardiovascular module to its EXAM-PACS web-based enterprise PACS.
Commissure launched RadWhere Workflow Orchestrator and RadCube Suite. The new component to RadWhere Suite enables radiology departments to connect together multiple PACS, RIS, 3D, advanced visualization and teleradiology information into a central worklist. RadCube Suite provides multidimensional data mining tools to reveal trends and tendencies within radiology departments.
Digital AMS demonstrated PACS-in-a-BOX solutions including Catella RIS and Catella PACS.
DR Systems exhibited its new Unity RIS/PACS platform. Unity covers the entire medical imaging exam workflow process. It has been designed to provide an advanced medical imaging and information management system infrastructure for regional health information organizations (RHIOs). The company also discussed the role of its 64-bit operating system and Intel processors in managing massive datasets.
Dynamic Imaging featured its latest IntegradWeb PACS integrationsódigital mammography and Barco Voxar 3D VesselMetrix. The company also demonstrated PET/CT functionality, IntegradWeb Ortho and IntegradWeb RIS/PACS.
Eastman Kodak Company showed the current version of CARESTREAM PACS and RIS and shared future enhancements to its CARESTREAM Radiology Solutions platform. The current version of CARESTREAM PACS software offers a virtual desktop environment that allows any application, including 3D processing, to be delivered to any desktop inside or outside the organization. Kodak's newest CARESTREAM RIS platform includes a complete outpatient practice management system. It will support workflow grid computing, which facilitates storage and retrieval of information throughout an enterprise with a shared infrastructure that can serve multiple sites. The company also debuted RIS Mammography Technology as a work in progress.
Emageon Inc. demonstrated new features on its Enterprise Visual Medical System (EVMS) including Technologist QC and Personal Content Management (PCM). Technologist QC is a native quality control tool that runs in the EVMS Advanced Visualization environment, providing a streamlined process and enabling users to correct errors before interpretation occurs. PCM distributes the entire user environment rather than just the images in the teleradiology environment.
Empiric Systems announced a partnership with FUJIFILM Medical Systems that leverages the Windows-based and web-based architecture of Fuji's Synapse PACS and Empiric's Encompass. NET RIS and the expertise of each company to deliver a streamlined, full-featured PACS/RIS designed for smaller departments and imaging centers.
eRAD unveiled its web-based RIS. An OEM agreement with RIS Concepts provides eRAD with a branded RIS that has been integrated into a RIS/PACS solution.
Evolved Digital showcased Radweb RIS and View2 PACS. Radweb manages image and data flow across patient registration, order entry, image viewing, dictation, transcription and reporting. Evolved's View2 PACS stores radiology and cardiology images on a centralized web-based platform.
FUJIFILM Medical Systems USA announced plans to deliver a comprehensive and fully scaleable PACS/RIS solution for outpatient imaging facilities via an agreement with Empiric. A co-marketing agreement with ProSolv centers on an integrated distribution and reporting software solution with ProSolv cardiology PACS and Fuji's radiology PACS technology to provide increased continuity of care during the diagnostic process. Fuji also launched Synapse version 3.2 with additional digital mammography image management capabilities.
GE Healthcare featured Centricity PACS, Centricity RIS and Centricity CVIS. GE also highlighted Centricity RIS-IC and its combined Centricity Imaging-PACS 3.0 and advanced visualization solution. The solutions work in tandem to provide workflow and image management solutions that can be shared across multiple procedural areas while maximizing data capture from medical devices and automating workflow. GE's Centricity PACS combined with Centricity AW Suite 2.0 gives clinicians tools for sifting through data-intensive procedures without needing to move to a separate workstation.
GE also announced that it has expanded its alliance with Intermountain Healthcare to include the development of standardized terminology, clinical knowledge management technology and clinical process content as part of their multi-year project for the development of an ëenterprise clinical information system' built on GE's Centricity Enterprise Solution.
Guardian Healthcare Systems released FlowPoint 6.2. The integrated, web-based RIS and PACS enables healthcare enterprises to combine patient medical data and radiology images into one digital record to facilitate enhanced patient care, reductions in potential medical errors and lower administrative costs. Enhancement to FlowPoint RIS include integrated document scanning technology, support for cash payments and patient invoicing, single user-logon in Microsoft Windows environments, system integrations with industry billing
companies and enhanced charge capture support for HCPCS codes and improved label printing flexibility with Zebra printers.
INFINITT of North America announced the commercial release of INFINITT Radiology Suites which is a fully web-based RIS/PACS with advanced 3D capabilities operating on a single platform. This solution fuses RIS, PACS and 3D and enables remote access. The company also highlighted INFINITT Cardiac PACS that features image management tools, including image acquisition, storage, display and web distribution devices for the cardiology enterprise.
Intelerad Medical Systems shared its Reporting and Transcription and Teaching File modules, a Referring Physician's Portal and InteleViewer Workstation.
Intuitive Imaging Informatics (I3) announced PET Fusion functionality for its Rational Imaging PACS, new Rational Imaging features and ImageQube enhancements. New PACS developments include MIP Imaging. ImageQube web-based PACS enhancements include the ability to support paperless workflow, teleradiography scheduling, Instant Messaging, integrated 3D and teaching files.
McKesson Corp. announced a distribution agreement with Toshiba America Medical Systems that allows Toshiba to offer McKesson's Horizon Medical Imaging PACS solution with Toshiba's diagnostic imaging devices, including the Aquilion line of CT scanners. The company also showcased Horizon Medical Imaging ER Discrepancy Tracking, Horizon Radiology RIS/PACS solution, Horizon Radiology Manager, Horizon Medical Imaging PACS and Horizon Cardiology CVIS.
Medweb demonstrated its range of PACS and teleradiology solutions including fully hosted RIS/PACS/PM with DICOM Workflow Grid; completely 3D, web-based PACS; disk publisher with a touchscreen interface and enterprise-wide monitoring, service gateway and statistics program for managing clinical workflow across multiple PACS/RIS/HIS systems.
Merge eMed unveiled Fusion RIS/PACS MX, Fusion PACS MX, Fusion RIS MX and clinical applications. Fusion RIS/PACS MX delivers a single system with access to all patient-related information and images. Fusion PACS MX provides 64-bit capabilities for fast simultaneous loading of thousands of images. Fusion RIS provides a workflow solution that accelerates productivity from scheduling through billing; enhancements include a Call Center Scheduler Module and capabilities for real-time dashboard analytics. Clinical applications included MergeMammo, MergePET/CT and Merge Ortho.
Meta Fusion introduced Meta Fusion Helium RIS/PACS. Helium is designed for imaging centers and small hospitals.
Misys Healthcare displayed its RIS, Misys practice management system and its enterprise system with fully integrated CPOE. Misys Radiology 5.0 RIS manages information and images in a single source. Current enhancements to Misys Radiology 5.0 include scheduling, patient tracking and procedure history module improvements. Misys Radiology integrates with all PACS systems. Misys Vision is a complete practice management solution that can improve productivity, enhance revenue and increase operational efficiencies. The combination of Misys Vision and Misys Radiology enables users to track patients' radiology data with administrative information to improve scheduling, registry and billing. Misys CPR 5.0 is an enterprise clinical information management system and CPOE solution. It features a Web-based platform that gives physicians the ability to access patient data without delay, 24/7, from any web browser.
Neurostar Solutions introduced online services that expand the Virtual Radiology Network (VRN) clinical image workflow platform from an expert opinion consulting service to a portal enabling online sign up and configuration of a customized VRN solution. The company also showed its expanded Virtual Radiology Community Website (VRC) and VRN eStore.
NovaRad Corp. released NovaPACS 6.5 with enhanced administration console tools to enable better sorting, reporting and information gathering and viewing. The new release also provides increased tool availability on the referring physician viewer.
Numa showed NumaStore and NumaRead. NumaStore provides a robust, reliable and user-friendly image management system designed for nuclear medicine and PET/CT. NumaRead streamlines transfer of archived data maintained on media such as CD, MOD and DAT tape to more sophisticated storage including NumaStore online RAID, DVD and other long-term archives including PACS.
Philips Medical Systems showcased iSite solutions, ViewForum workstation and EasyAccess PACS. iSite image and information management system delivers on-demand diagnostic-quality images over existing hospital networks, with advanced radiology reading stations and ìalways onlineî long-term storage. iSite PACS comprises iSite Enterprise, iSite Radiology and iVault. iSite Enterprise is based on iSyntax technology, which provides physicians with access to just-in-time diagnostic-quality images anytime, any place throughout the healthcare environment. ViewForum multi-modality workstation is centered on the patient. It provides users with instant access to all of the patient's studies for review and a wide range of clinical applications on a single workspot. Philips EasyAccess Radiology PACS, which is a built-in partnership with Sectra, consists of image and workflow management systems and viewing packages; its architecture can be scaled to fit the clinical needs of any radiology department.
RADinfo SYSTEMS launched Micro PowerPACS Mammography that allows a facility to efficiently view, manage, distribute and store digital mammography images from CR, full-field digital mammography and other modalities offered by a broad range of manufacturers.
Ramsoft debuted RamSoft One, a fully integrated practice and image management solution, and showed PowerServer PACS 4.2. RamSoft One's integrated RIS and PACS reduces paper, film and labor and makes patient records accessible to the staff from anywhere. Its Referring Physician portal allows referring physician offices to place electronic requisition orders, view and print reports and view images.
Sage Software, formerly Emdeon Practice Services, showcased the expanded functionality of Intergy RIS 3.5 by Sage and Intergy PACS by Sage. Intergy RIS 3.5 includes new referring provider marketing fields and diagnosis validation. It offers new alert functions, such as insurance plan alert; referring provider alert and document delivery system status alert; additional productivity reports; appointment limits feature, report approval enhancements; a supervising provider function and more. The RIS incorporates features and dynamic management tools to help users analyze and assess the state of the business. Intergy PACS offers improved workflow-based productivity combined with flexible access and an intuitive, advanced web-based architecture. The PACS harnesses the web to deliver access to images, reports and patient information from any location at any time, from any web-accessible PC.
ScImage introduced Version 3.0 of PicomEnterprise. The new version transitions from enterprise PACS to a complete multi-department workflow system. The unified solution enables exams from multiple departments to be scheduled, tracked, reported, archived and distributed via a single web-based logon by employing a single database to organize data from each department. ScImage also highlighted an agreement for the distribution of Orthocrat's TraumaCad digital orthopedic surgical planning and templating solution.
Sectra highlighted Sectra Control Tower and Breast Imaging PACS. The company also demonstrated Sectra PACS and Sectra Orthopedic Package. The Sectra Control Tower provides department managers full control and overview of current production statistics as well as historical data used for trend analysis. New features include live reports to reveal and analyze bottlenecks in real time. The latest improvements to Sectra Breast Imaging PACS facilitate smooth and accurate workflow at breast imaging centers. The company showed workflow optimization, with blind-double reading, CAD capabilities and tight integration with information systems. Sectra PACS is optimized for handling extremely large datasets and provides speed for the user in displaying and managing large stacks. Finally, the latest version of the Sectra Orthopedic Package adds automatic calibration and new improved semi-automatic hip planning tools.
Siemens Medical Solutions emphasized workflow optimization within the imaging department, the healthcare facility and across the healthcare continuum. The company unveiled the most current release of its works in progress RIS software, syngo Workflow Version 28.0 SLR. syngo Workflow Version 28.0 SLR was designed as an easy-to-learn system that focuses on helping customers optimize and streamline their resource and patient care workflows, while assisting them in controlling costs and meeting business objectives. The new version features syngo Portal Radiologist, a web-based solution that serves as an information and planning center where radiologists are presented with a user interface configured to their role. A radiologist has easy access to patient-relevant information, such as previous reports, lab values and allergies, as well as scanned documents, in one application window. syngo Workflow Version 28.0 SLR supports both UNIX and LINUX operating systems; Microsoft Windows-based PCs as workstations; and enhanced Graphical User Interface (GUI) functionality. Through the use of its extensive communication features, document scanning, sophisticated clinical alerts, embedded voice recognition and advanced workflow management, it can help maximize radiological department productivity and resource efficiency.
SourceMedical launched an enhanced version of SourceRad, an integrated application service provider (ASP)-delivered RIS/PACS/Billing system. SourceRad has been upgraded to a Microsoft.NET smart client, creating application functionality for the user such as drag and drop scheduling and multiple tabs running simultaneous workflows. The improvements enable auto-updating and require minimal network bandwidth. Application functionality enhancements to the product include billing workflow optimization, document scanning capabilities and integrated PACS.
Thinking Systems Corp. announced the company's release of its new plug-in for Philips/Stentor's iSite PACS. The iSite plug-in provides comprehensive third-party PACS solutions to iSite users for all modalities, including PET/SPECT-CT fusion, nuclear cardiology processing, 3D/MPR, calcium scoring, cardiac CTA and orthopedic templating. The integrated platform enables enterprise-wide access to these modalities. The company also highlighted the new version of ThinkingPACS with supports for the new DICOM 3.0 2006 hanging protocol standard and enhanced support for PET-CT fusion.
Toshiba America Medical Systems and McKesson Corporation introduced the Horizon Medical ImagingStore 100. The new mini-PACS is exclusively available for Toshiba products and will enable smaller hospitals and imaging centers to store data in a manageable and cost-effective way. Horizon Medical Imaging Store 100 offers the ability to store cases online safely and efficiently, without requiring an enterprise PACS.
Viztek launched Opal-Rad. The web-based, thin-client PACS incorporates advanced image streaming that delivers studies in real time utilizing any available bandwidth internet connection. The system offers image viewing, management and communications features.
Going with the flow
The latest vendor offerings promise improved workflow and deeper integrations. Many new systems incorporate the next level of advanced visualization tools, enabling radiologists to employ 3D and remain at a PACS workstation, which represents a workflow plus. Embedded advanced visualization tools overcome the limits of dedicated 3D workstations and distributes advanced visualization to all workspots throughout the enterprise.
Advanced visualization applications weren't the only new offerings. DMIST results are out, and the first CR mammo system is on the market. Digital mammo has turned the corner, and sales are skyrocketing.
Both advanced visualization and digital mammography bring similar challenges. That is, radiologists need a cohesive work environment — not separate workstations, says Brad Levin, vice president of marketing for Dynamic Imaging. Several vendors aim to simplify the intricate challenges of storing and recalling digital mammography images with new PACS workstations approved for interpretation of current and prior studies and incorporate embedded CAD and multi-modality imaging viewing.
Enterprise top of mind
Another buzzword heard loud and clear around McCormick Place was enterprise imaging. Sites are looking for a single solution for cardiology and radiology archiving and distribution, says Ed Heere, president of CoActiv Medical Business Solutions "The lines between imaging departments — radiology and cardiology — are blurring," concurs ScImage National Sales Director Richard Taylor. For example, both cardiologists and radiologists need to view static and dynamic images, a trend that will strengthen as cardiac CT and MR grow.
Other vendors, including McKesson and PACSGear, pointed to the bigger picture — image-enabled care — and the need to integrate all types of images including non-DICOM ENT, bronchoscopy and pathology images. An enterprise solution that wraps in DICOM and non-DICOM images could be ideally positioned to meet the storage, IT and financial needs of the enterprise.
While vendors touted the 'enterprise,' they also honed in on the little guy. PACS has penetrated the majority of large and mid-sized hospitals, but many smaller sites, imaging centers and specialty practices are eyeing digital image management solutions. "PACS/RIS is migrating to the masses — imaging centers and community hospitals," notes Tim Law, president of NovaRad. These sites do have unique needs, which may include older, non-DICOM modalities, a barebones or non-existent IT staff and an ultra-tight budget.
Scaling systems for smaller practices
SourceMed and Dynamic Imaging point to the validity of web-based solutions that can grow with the smaller site as its clinical and technical needs evolve. "A web-based solution can scale from one to two to multiple distributed facilities," Dynamic Imaging's Levin points out.
The Deficit Reduction Act and declining reimbursement could be a positive for some PACS vendors, says Tim Kulbago, chief strategy officer, for Merge Healthcare. That's because hospitals and imaging centers will increase their reliance on technology to counteract dropping reimbursement. Imaging centers may grow their business by investing in new tools designed to improve relationships with referring physicians, predicts Aine Cryts, AMICAS marketing communications manager.
The show floor was peppered with new advanced workflow solutions, designed to minimize disruptions to radiologists, streamline communication and mine data to facilitate optimization of staff and modality resources. The other half of this trend is consulting services. According to Kulbago, more sites are requesting practice analysis services to help grow their businesses.
Cost sensitivity
Another effect of the belt-tightening? Some sites are evaluating less expensive PACS. Sites in the replacement market should analyze their service contract to make sure it remains viable and determine if the installed PACS meets current and anticipated future needs such as digital mammography, says Vijay Ramanathan, president and CEO of RamSoft, Inc.
It was possible to get beyond the here and now at RSNA '06. Visitors to GE Healthcare's Science and Technology Pavilion were propelled into the future. GE shared a prototype Graffiti PACS that can bypass the mouse and allow users to scribble commands. Other works-in-progress incorporated touchscreen technology enabling multiple users to interact with the entire patient record including images and patient data like cholesterol levels.
The show floor also featured a host of related solutions, ranging from new RIS solutions to next-generation speech recognition offerings, furniture and peripherals such as digitizers and CD burners.
Agfa HealthCare launched functional extensions for digital mammography reading and reporting applications for IMPAX PACS and its business consulting group and shared IMPAX Data Center. The company also demonstrated IMPAX Clinical Applications. Finally, Agfa shared information about a potential wireless integration of IMPAX with Ascom and discussed a new alliance with Vocada, Inc. centered on improved distribution of clinical results.
AMICAS debuted RadStream, announced Vision Reach and launched Vision Series PACS Version 5.0. RadStream is designed to integrate disparate RIS and PACS environments, boost soft-copy reading and automate communication and documentation of positive results. Vision Reach facilitates end-to-end radiology practice in a filmless and paperless radiology operation and integrates the radiology report with key images to create a single ìmulti-mediaî report for referring physicians.
BRIT Systems announced the release of 3D imaging tools native to the company's Roentgen Files PACS and available on any BRIT Vision workstation. Improved MPRs, MIPs, volume rendering and basic 3D imaging tools, along with more efficient viewing tools, are now native applications on properly configured BRIT Vision workstations. The company also showed new administrative and reporting tools, such as ìtwo or three click normalî templates. BRIT highlighted its Discordance Tool, which facilitates the communication of findings between ER doctors and radiologists. BRIT's pay-per-study CARE (Complete Archive & Read Ensemble) Program is tailored to meet the specific needs of Critical Access Hospitals; it provides a bundled PACS and RIS solution and optionally, diagnostic reading services.
Cedara Software, a Merge Healthcare company, showcased its C4 (Cedara Clinical Control Center) development platform. C4 allows clinical applications and plug-ins to be tightly integrated into a single workstation, sharing system resources and facilitating integration of clinical applications into any information system.
Cerner Corp. demonstrated enhancements to its unified RIS/PACS solution that include a critical results documentation and notification solution that helps support JCAHO's National Patient Safety Goal, as well as order review and approval tools that help optimize this traditionally paper-based process.
CoActiv Medical Business Solutions introduced a multi-modality cardiovascular module to its EXAM-PACS web-based enterprise PACS.
Commissure launched RadWhere Workflow Orchestrator and RadCube Suite. The new component to RadWhere Suite enables radiology departments to connect together multiple PACS, RIS, 3D, advanced visualization and teleradiology information into a central worklist. RadCube Suite provides multidimensional data mining tools to reveal trends and tendencies within radiology departments.
Digital AMS demonstrated PACS-in-a-BOX solutions including Catella RIS and Catella PACS.
DR Systems exhibited its new Unity RIS/PACS platform. Unity covers the entire medical imaging exam workflow process. It has been designed to provide an advanced medical imaging and information management system infrastructure for regional health information organizations (RHIOs). The company also discussed the role of its 64-bit operating system and Intel processors in managing massive datasets.
Dynamic Imaging featured its latest IntegradWeb PACS integrationsódigital mammography and Barco Voxar 3D VesselMetrix. The company also demonstrated PET/CT functionality, IntegradWeb Ortho and IntegradWeb RIS/PACS.
Eastman Kodak Company showed the current version of CARESTREAM PACS and RIS and shared future enhancements to its CARESTREAM Radiology Solutions platform. The current version of CARESTREAM PACS software offers a virtual desktop environment that allows any application, including 3D processing, to be delivered to any desktop inside or outside the organization. Kodak's newest CARESTREAM RIS platform includes a complete outpatient practice management system. It will support workflow grid computing, which facilitates storage and retrieval of information throughout an enterprise with a shared infrastructure that can serve multiple sites. The company also debuted RIS Mammography Technology as a work in progress. Emageon Inc. demonstrated new features on its Enterprise Visual Medical System (EVMS) including Technologist QC and Personal Content Management (PCM). Technologist QC is a native quality control tool that runs in the EVMS Advanced Visualization environment, providing a streamlined process and enabling users to correct errors before interpretation occurs. PCM distributes the entire user environment rather than just the images in the teleradiology environment.
Empiric Systems announced a partnership with FUJIFILM Medical Systems that leverages the Windows-based and web-based architecture of Fuji's Synapse PACS and Empiric's Encompass. NET RIS and the expertise of each company to deliver a streamlined, full-featured PACS/RIS designed for smaller departments and imaging centers.
eRAD unveiled its web-based RIS. An OEM agreement with RIS Concepts provides eRAD with a branded RIS that has been integrated into a RIS/PACS solution.
Evolved Digital showcased Radweb RIS and View2 PACS. Radweb manages image and data flow across patient registration, order entry, image viewing, dictation, transcription and reporting. Evolved's View2 PACS stores radiology and cardiology images on a centralized web-based platform.
FUJIFILM Medical Systems USA announced plans to deliver a comprehensive and fully scaleable PACS/RIS solution for outpatient imaging facilities via an agreement with Empiric. A co-marketing agreement with ProSolv centers on an integrated distribution and reporting software solution with ProSolv cardiology PACS and Fuji's radiology PACS technology to provide increased continuity of care during the diagnostic process. Fuji also launched Synapse version 3.2 with additional digital mammography image management capabilities.
GE Healthcare featured Centricity PACS, Centricity RIS and Centricity CVIS. GE also highlighted Centricity RIS-IC and its combined Centricity Imaging-PACS 3.0 and advanced visualization solution. The solutions work in tandem to provide workflow and image management solutions that can be shared across multiple procedural areas while maximizing data capture from medical devices and automating workflow. GE's Centricity PACS combined with Centricity AW Suite 2.0 gives clinicians tools for sifting through data-intensive procedures without needing to move to a separate workstation. GE also announced that it has expanded its alliance with Intermountain Healthcare to include the development of standardized terminology, clinical knowledge management technology and clinical process content as part of their multi-year project for the development of an ëenterprise clinical information system' built on GE's Centricity Enterprise Solution.
Guardian Healthcare Systems released FlowPoint 6.2. The integrated, web-based RIS and PACS enables healthcare enterprises to combine patient medical data and radiology images into one digital record to facilitate enhanced patient care, reductions in potential medical errors and lower administrative costs. Enhancement to FlowPoint RIS include integrated document scanning technology, support for cash payments and patient invoicing, single user-logon in Microsoft Windows environments, system integrations with industry billing
companies and enhanced charge capture support for HCPCS codes and improved label printing flexibility with Zebra printers.
INFINITT of North America announced the commercial release of INFINITT Radiology Suites which is a fully web-based RIS/PACS with advanced 3D capabilities operating on a single platform. This solution fuses RIS, PACS and 3D and enables remote access. The company also highlighted INFINITT Cardiac PACS that features image management tools, including image acquisition, storage, display and web distribution devices for the cardiology enterprise.
Intelerad Medical Systems shared its Reporting and Transcription and Teaching File modules, a Referring Physician's Portal and InteleViewer Workstation.
Intuitive Imaging Informatics (I3) announced PET Fusion functionality for its Rational Imaging PACS, new Rational Imaging features and ImageQube enhancements. New PACS developments include MIP Imaging. ImageQube web-based PACS enhancements include the ability to support paperless workflow, teleradiography scheduling, Instant Messaging, integrated 3D and teaching files.
McKesson Corp. announced a distribution agreement with Toshiba America Medical Systems that allows Toshiba to offer McKesson's Horizon Medical Imaging PACS solution with Toshiba's diagnostic imaging devices, including the Aquilion line of CT scanners. The company also showcased Horizon Medical Imaging ER Discrepancy Tracking, Horizon Radiology RIS/PACS solution, Horizon Radiology Manager, Horizon Medical Imaging PACS and Horizon Cardiology CVIS.
Medweb demonstrated its range of PACS and teleradiology solutions including fully hosted RIS/PACS/PM with DICOM Workflow Grid; completely 3D, web-based PACS; disk publisher with a touchscreen interface and enterprise-wide monitoring, service gateway and statistics program for managing clinical workflow across multiple PACS/RIS/HIS systems.
Merge eMed unveiled Fusion RIS/PACS MX, Fusion PACS MX, Fusion RIS MX and clinical applications. Fusion RIS/PACS MX delivers a single system with access to all patient-related information and images. Fusion PACS MX provides 64-bit capabilities for fast simultaneous loading of thousands of images. Fusion RIS provides a workflow solution that accelerates productivity from scheduling through billing; enhancements include a Call Center Scheduler Module and capabilities for real-time dashboard analytics. Clinical applications included MergeMammo, MergePET/CT and Merge Ortho.Meta Fusion introduced Meta Fusion Helium RIS/PACS. Helium is designed for imaging centers and small hospitals.
Misys Healthcare displayed its RIS, Misys practice management system and its enterprise system with fully integrated CPOE. Misys Radiology 5.0 RIS manages information and images in a single source. Current enhancements to Misys Radiology 5.0 include scheduling, patient tracking and procedure history module improvements. Misys Radiology integrates with all PACS systems. Misys Vision is a complete practice management solution that can improve productivity, enhance revenue and increase operational efficiencies. The combination of Misys Vision and Misys Radiology enables users to track patients' radiology data with administrative information to improve scheduling, registry and billing. Misys CPR 5.0 is an enterprise clinical information management system and CPOE solution. It features a Web-based platform that gives physicians the ability to access patient data without delay, 24/7, from any web browser.
Neurostar Solutions introduced online services that expand the Virtual Radiology Network (VRN) clinical image workflow platform from an expert opinion consulting service to a portal enabling online sign up and configuration of a customized VRN solution. The company also showed its expanded Virtual Radiology Community Website (VRC) and VRN eStore.
NovaRad Corp. released NovaPACS 6.5 with enhanced administration console tools to enable better sorting, reporting and information gathering and viewing. The new release also provides increased tool availability on the referring physician viewer.
Numa showed NumaStore and NumaRead. NumaStore provides a robust, reliable and user-friendly image management system designed for nuclear medicine and PET/CT. NumaRead streamlines transfer of archived data maintained on media such as CD, MOD and DAT tape to more sophisticated storage including NumaStore online RAID, DVD and other long-term archives including PACS.
Philips Medical Systems showcased iSite solutions, ViewForum workstation and EasyAccess PACS. iSite image and information management system delivers on-demand diagnostic-quality images over existing hospital networks, with advanced radiology reading stations and ìalways onlineî long-term storage. iSite PACS comprises iSite Enterprise, iSite Radiology and iVault. iSite Enterprise is based on iSyntax technology, which provides physicians with access to just-in-time diagnostic-quality images anytime, any place throughout the healthcare environment. ViewForum multi-modality workstation is centered on the patient. It provides users with instant access to all of the patient's studies for review and a wide range of clinical applications on a single workspot. Philips EasyAccess Radiology PACS, which is a built-in partnership with Sectra, consists of image and workflow management systems and viewing packages; its architecture can be scaled to fit the clinical needs of any radiology department.RADinfo SYSTEMS launched Micro PowerPACS Mammography that allows a facility to efficiently view, manage, distribute and store digital mammography images from CR, full-field digital mammography and other modalities offered by a broad range of manufacturers.
Ramsoft debuted RamSoft One, a fully integrated practice and image management solution, and showed PowerServer PACS 4.2. RamSoft One's integrated RIS and PACS reduces paper, film and labor and makes patient records accessible to the staff from anywhere. Its Referring Physician portal allows referring physician offices to place electronic requisition orders, view and print reports and view images.
Sage Software, formerly Emdeon Practice Services, showcased the expanded functionality of Intergy RIS 3.5 by Sage and Intergy PACS by Sage. Intergy RIS 3.5 includes new referring provider marketing fields and diagnosis validation. It offers new alert functions, such as insurance plan alert; referring provider alert and document delivery system status alert; additional productivity reports; appointment limits feature, report approval enhancements; a supervising provider function and more. The RIS incorporates features and dynamic management tools to help users analyze and assess the state of the business. Intergy PACS offers improved workflow-based productivity combined with flexible access and an intuitive, advanced web-based architecture. The PACS harnesses the web to deliver access to images, reports and patient information from any location at any time, from any web-accessible PC.
ScImage introduced Version 3.0 of PicomEnterprise. The new version transitions from enterprise PACS to a complete multi-department workflow system. The unified solution enables exams from multiple departments to be scheduled, tracked, reported, archived and distributed via a single web-based logon by employing a single database to organize data from each department. ScImage also highlighted an agreement for the distribution of Orthocrat's TraumaCad digital orthopedic surgical planning and templating solution.
Sectra highlighted Sectra Control Tower and Breast Imaging PACS. The company also demonstrated Sectra PACS and Sectra Orthopedic Package. The Sectra Control Tower provides department managers full control and overview of current production statistics as well as historical data used for trend analysis. New features include live reports to reveal and analyze bottlenecks in real time. The latest improvements to Sectra Breast Imaging PACS facilitate smooth and accurate workflow at breast imaging centers. The company showed workflow optimization, with blind-double reading, CAD capabilities and tight integration with information systems. Sectra PACS is optimized for handling extremely large datasets and provides speed for the user in displaying and managing large stacks. Finally, the latest version of the Sectra Orthopedic Package adds automatic calibration and new improved semi-automatic hip planning tools.Siemens Medical Solutions emphasized workflow optimization within the imaging department, the healthcare facility and across the healthcare continuum. The company unveiled the most current release of its works in progress RIS software, syngo Workflow Version 28.0 SLR. syngo Workflow Version 28.0 SLR was designed as an easy-to-learn system that focuses on helping customers optimize and streamline their resource and patient care workflows, while assisting them in controlling costs and meeting business objectives. The new version features syngo Portal Radiologist, a web-based solution that serves as an information and planning center where radiologists are presented with a user interface configured to their role. A radiologist has easy access to patient-relevant information, such as previous reports, lab values and allergies, as well as scanned documents, in one application window. syngo Workflow Version 28.0 SLR supports both UNIX and LINUX operating systems; Microsoft Windows-based PCs as workstations; and enhanced Graphical User Interface (GUI) functionality. Through the use of its extensive communication features, document scanning, sophisticated clinical alerts, embedded voice recognition and advanced workflow management, it can help maximize radiological department productivity and resource efficiency. SourceMedical launched an enhanced version of SourceRad, an integrated application service provider (ASP)-delivered RIS/PACS/Billing system. SourceRad has been upgraded to a Microsoft.NET smart client, creating application functionality for the user such as drag and drop scheduling and multiple tabs running simultaneous workflows. The improvements enable auto-updating and require minimal network bandwidth. Application functionality enhancements to the product include billing workflow optimization, document scanning capabilities and integrated PACS.
Thinking Systems Corp. announced the company's release of its new plug-in for Philips/Stentor's iSite PACS. The iSite plug-in provides comprehensive third-party PACS solutions to iSite users for all modalities, including PET/SPECT-CT fusion, nuclear cardiology processing, 3D/MPR, calcium scoring, cardiac CTA and orthopedic templating. The integrated platform enables enterprise-wide access to these modalities. The company also highlighted the new version of ThinkingPACS with supports for the new DICOM 3.0 2006 hanging protocol standard and enhanced support for PET-CT fusion.
Toshiba America Medical Systems and McKesson Corporation introduced the Horizon Medical ImagingStore 100. The new mini-PACS is exclusively available for Toshiba products and will enable smaller hospitals and imaging centers to store data in a manageable and cost-effective way. Horizon Medical Imaging Store 100 offers the ability to store cases online safely and efficiently, without requiring an enterprise PACS.
Viztek launched Opal-Rad. The web-based, thin-client PACS incorporates advanced image streaming that delivers studies in real time utilizing any available bandwidth internet connection. The system offers image viewing, management and communications features.
| RIS Ramps Up with New Features |
| Radiology information systems remain relevant to radiology. RSNA'06 brought several new and improved solutions that further streamline and offer features like improved and enterprise scheduling and automated billing. Other solutions are geared to specialty markets such as teleradiology and imaging centers. Absolute Medical Software Systems, Inc. introduced a comprehensive RIS solution with enhanced practice management functionality. The multi-site, fully web-based RIS provides comprehensive electronic management of a facility's radiology workflow and includes real-time and batch patient insurance eligibility verification, an enhanced claims editor/clearinghouse solution and automated self-pay collection processes to enable precise management of the revenue cycle. InStar Systems International, Inc. exhibited its RIS that features enterprise wide scheduling capabilities; web portal with scheduling and viewing of patient reports; appointment cancellation tracking and simple rescheduling of exams; real-time patient status tracking; workflow management across the enterprise and embedded dictation/voice recognition. RIS Concepts, Inc. demonstrated RAD-RIS. The web-based radiology workflow application is fine-tuned for radiology groups reading studies for multiple client facilities. It creates an integrated worklist combining studies across multiple enterprises and locations, while simultaneously interfacing PACS solutions in use at different hospital and clinics. Swearingen Software, Inc. launched RISynergy that combines RMS RIS with new features including a fully integrated Billing component, streamlined connectivity features, a DICOM Worklist Manager, daily worklist screens, and ongoing Customer Service. The company also highlighted Web Schedule Requestor, which allows patients and/or referring physicians to request an appointment online at their convenience. Finally, a partnership with JulySoft incorporates the ReminderPro Patient Messaging System into Swearingen's newly released RISeptionist module. RISeptionist handles functions including routine patient communications. |
| Speech Talks |
| Speech recognition has made the leap from early adopters and pioneers into the mainstream. "Speech has come of age," sums Linda Reino, chief operating officer of Medquist. The current generation of solutions delivers, says Nick van Terheyden, MD, director of business development for Philips Speech Recognition Systems, with back-end systems bringing as much as a 30 to 40 percent increase in productivity. Turnaround times drop as much as 90 percent with speech, says Nuance Communications Senior Vice President Peter Durlach. On the front end that completely bypass transcription and rely on the physician to edit reports. What's more, the systems pay. According to MedQuist, some customers have realized ROI in as little as three to 12 months. The newest solutions offer a high level of flexibility, enabling users to flip between front- and back-end recognition. Most systems don't force physicians to self-edit, but many (even the skeptical) adopt self-editing when they realize its simplicity and efficiency. According to Nuance, up to 80 to 85 percent of PowerScribe users self-edit. What's more, simple one-click and voice commands boost productivity and simplify the speech process. Crescendo announced a new front-end speech recognition module for its MD Center-XL dictation, speech recognition and electronic signature application. MD Center-XL now automatically produces text from dictations right on screen. With the front-end module, physicians can oversee the entire documentation workflow, from dictation and correction to sign-off and final report distribution, using one interface. Grundig Business Systems showcased DictaCordEx wireless dictation microphone. The DictaCordEx connects with the PC through a USB port. MedQuist, Inc. demonstrated enhancements to its next release of SpeechQ including: improved speed, improved scalability, tighter desktop integration with PACS and templating. Nuance Communications, Inc. highlighted its Dictaphone PowerScribe system and its PACS/RIS Extension Partner (PREP) program. PowerScribe combines speech recognition software and physician self-editing tools to reduce report turnaround time. The PREP program integrates Dictaphone PowerScribe Workstation with a wide range of RIS and PACS, including Cerner, FUJIFILM, GE, McKesson and Siemens. The company also announced an integration agreement with Vocada that creates a simplified user interface for radiologists and pathologists to quickly and accurately communicate critical patient findings and report test results. Philips Speech Recognition Systems showcased SpeechMagic as a thin-client solution within Citrix environments and ProScribe, a mobile display based on thin-client technology. An enhancement to SpeechMagic enables adequate speech recognition in Citrix environments. The SpeechMagic Citrix Extension enables the centralization of IT administration for easy installation and maintenance. |
| Digitizers & PACS Peripherals |
| PACS did not completely steal the show. As digital image management penetrates the market, users require auxiliary systems to optimize PACS. These include digitizers, CD burners and printers. Other goodies facilitate non-DICOM image management, migration and PACS adoption in the tough to serve areas like the OR. Agfa HealthCare announced its new CR 30-X tabletop computed radiography compact digitizer designed to offer customers the same efficiency and high image quality available from full floor-size models. It integrates to local PACS networks to maximize the value of existing or future PACS. aycan Medical Systems displayed x-ray print, a DICOM paper print system that allows inexpensive communication with referring physicians and patients. BRIT Systems showcased Roentgen Router, a DICOM routing module that can be used with any vendor's DICOM-compliant PACS or teleradiology system for auto-routing and prefetching of DICOM studies triggered by information in the exam order and/or study. Codonics showcased its new Virtua Medical Disc Publisher, a network-based CD/DVD publisher that automatically records and labels patient studies. Virtua's dual-drive functionality allows large studies such as multidetector CTs to record onto several discs without operator intervention. The company also highlighted its Codonics Horizon XL Multi-media Imager, a dry imager that supports 36-inch and 51-inch film output for digital applications. DeJarnette Research Systems announced a new version of its PACSware Migration Toolkit, which supports Canon PACS migrations and includes new features such as a separate GUI for scheduling, separate pre-fetch and background migration schedules and wider support for DICOM objects. The company also unveiled xDL Cross-Enterprise Document Librarian. xDL addresses the growing demand for inexpensive, robust and reliable off-site storage of PACS data. xDL is a software layer that can be placed on top of any off-site storage vendor's service offering to uncouples the medical imaging domain specific knowledge from the off-site storage vendor's service offering. Digital AMS showed Catella CD Burners and Labelers. The systems duplicate studies to provide images to referring physicians, patients and for special back-up needs. ETIAM debuted showcase CD-In that automatically integrates radiology exam images recorded on DICOM CDs and DVDs into a PACS. Foresight Imaging released a software-only version of its TIMS DICOM Gateway software and highlighted TIMS' improved workflow and functionality.†The software-only version of the TIMS DICOM Gateway converts JPG, BMP, and AVI files generated by several hospital departments including dermatology, pathology, and ophthalmology to DICOM. Konica Minolta Medical Imaging USA released DryPro 832, a small-scale dry-film laser imager that can be located nearly anywhere within a facility, at a remote clinic or used for mobile imaging services. Mitsubishi Digital Electronics America introduced the CP-30DW digital color printer. The dye sublimation printer is a fast medical digital printer that features 423-dpi head resolution. North American Imaging highlighted its PACS Print Server software for management of hard-copy preferences using existing DICOM printers and laser cameras. The software acts as a transparent manager, directing hard-copy requests to the appropriate output device. ODS Medical announced V2.6 Feature/Function software release for PACS≠comm. The new release enhances DICOM import to include the ability to auto-reconcile patient and study information by using a worklist server. An external query selector enhances flexibility in study search capabilities by allowing the user to specify single or multi-archive searches. PACSGear introduced MediaSuite and new PacsSCAN features. MediaSuite features the import of external DICOM CDs. The connectivity solution for documents, film and multimedia images enables hospital file rooms and imaging centers to use one application to access all functionality for a consistent user experience; digitize plain film; import external DICOM CDs; scan paper and include electronic forms and send multimedia images from files, digital cameras, USB memory sticks and flash memory for access to clinical images. SENCOR demonstrated ORstation, a DICOM workstation integrated with a large touch screen and computer. ORstation, which does not use a keyboard or mouse, has been developed for operating room use. The workstation allows surgeons to view and manipulate images all in a single, easily cleaned, self-contained unit. Sony Electronics showed its FilmStation dry-film imager, which delivers high resolution in 4,096 shades of gray through a new thermal print head and blue thermal film specifically engineered for the system. The resulting diagnostic-quality images facilitate interpretation of studies in a full range of modalities frequently used by orthopedists, including DR, CR, CT, MRI, and others. TeraMedica launched Evercore — VisLite Information Manager. Vislite integrates and manages all (VL) Visible Light modalities including endoscopy, path≠ology and surgery, into a single cohe≠sive infrastructure. The information manager then serves this vital visible light dataset to the EMR or EHR. |