United in our desire to help, any small way we can


Jack Williams (center) and other volunteers helping patients with Carestream technology, outside the Port-au-Prince airport

Medical imaging trade articles like this one, from Imaging Technology News, and countless other stories like it, give us a small glimmer of hope for the situation in Haiti. While it’s difficult to find anything remotely positive about the devastation and loss of life, we are inspired by the way our industry, and those in the radiology profession, are reaching out and providing equipment and care for those in need.

Numerous medical imaging companies have donated equipment and/or cash to support the massive relief efforts. We were extremely fortunate to have had one of our service engineers, Jack Williams, volunteer to travel to Haiti with our mobile x-ray solution. On Friday of last week, Jack landed in Haiti with our Point-of-Care CR-ITX 560 System, which provides instant digital images for the local urgent care center. We had tremendous success using a similar piece of equipment after the tragic earthquake in Chengdu, China.

The system is up and running at a temporary hospital established under tents at the airport. We’re also sending medical x-ray film, chemistry and cassettes to a hospital in Port-au-Prince, Centre Hospitalier du Sacre-Coeur/CDTI, where they were almost out of film as of this past weekend. And we plan to send additional x-ray film to Justinian Hospital at Cap Haitien, in the north portion of the country, outside the earthquake zone, which has been overwhelmed with casualties.

Given the enormity of this disaster, our efforts are just one small component of a much-needed and comprehensive response that in the months ahead will extend beyond relief into rebuilding. While many of us feel helpless, we can take pride in how so many individuals and groups are responding with grace and compassion.

And, of course, we can all help by considering a donation to an organization like the American Red Cross

– Kelly McCormick-Sullivan, Human Resources, Carestream Health

Editor’s Note: AuntMinnie.com has also posted a very informative article about a University of Virginia radiologist who is currently in the field supporting the relief effort in Haiti.

Interoperability: Where to from Here?

Cracking the interoperability puzzle

Many of us remember the days when clinicians accessed RIS and PACS platforms from separate workstations. Today, however, most U.S. facilities have an integrated desktop and are pursuing integration of RIS/PACS with other clinical information systems as well as enterprise-wide systems such as EMR and, ideally, EHR.

There’s no question that interoperability is paramount for our customers. That’s why we as an industry need to do everything we can to deliver standards-based solutions—bringing more information into the diagnostic imaging process through use of HL7, DICOM, IHE profiles and XDS profile standards.

With the utilization of these standards, RIS/PACS and information management platforms provide radiologists with easy access to key information that can aide in more accurate and timely diagnosis. Radiologists can view the full patient record including video clips, laboratory results and biopsy results as they make a diagnosis—which can then, in turn, be shared with different departments and the treating physician.

Modern RIS/PACS platforms also offer Web 2.0 functionality, which supports web applications and delivers data sharing, real-time conferencing and enhanced interoperability between different products and systems. This infrastructure allows other information portals in the organization to easily access and utilize data for the entire patient record. 

As a radiologist, what patient information do you typically need to export to your referring physicians that they require when reading the report? Are they able to easily access this data? What key pieces of the puzzle are missing?

– Diana Nole, President, Digital Medical Solutions, Carestream Health

Customer spotlight: DR in the ER at Memorial Medical Center, Springfield, Illinois

DR technology is increasingly being implemented and optimized for the emergency/trauma hospital environment. Due to the myriad types of patient exams and positions that emergency/trauma centers deal with on a day-to-day basis, and the obvious urgency involved, flexibility and efficiency are paramount.

A great example of a Carestream customer effectively using DR in the ER is Memorial Medical Center, Springfield, Illinois. Here Marjorie Calvetti, Administrative Director, Radiology, discusses MMC’s use of the CARESTREAM DRX-1 and DRX-Evolution to maximize throughput in their ER X-ray rooms.


If  you have DR stories or experiences, we want to hear from you! Please share in the comments section.

A shift from ownership to usage in eHealth?

Patrick Koch, Carestream Health

Why do we have to own something to use it? In some areas, the question is not even asked. Take electricity, for example: it’s obvious that it does not make sense for everybody to own his or her own power plant. This same logic applies when discussing many other goods and services.

What is the key difference, and why is the answer more obvious in some cases than in others?

The level of competence and effort necessary to maintain usage of an asset may influence the decision about ownership (e.g., maintaining and repairing the car, maintaining the house or patching the software). Many people today are less willing to use resources to purchase and maintain “systems” — knowing that due to increased complexity of systems, the level of effort and energy is ever increasing. That may be why usage without ownership is increasing.

Examples of this shift abound in technology: the Internet, software provided as a service (SaaS), and so forth. But this is not the only situation. Take Michelin, the leading tire manufacturer. The company now offers tires as a service! It manages tires for big carriers, and charges for usage. As a result, Michelin can build tires that last longer without jeopardizing their revenue, and the carrier reduces or eliminates the need to manage supplies and inventory.

All of this is creating what is known as the “service economy”, or “functional service economy.”

Did you know… Carestream Health entered this “service economy” years ago and is already hosting 12 million medical imaging studies per year in its data centers? Customer benefits include long-term management, protection of study and image data, and more (check out our website for more eHealth Managed Services info).

And what about you? Are you ready to do whatever it takes to retain and protect your data during the coming decades?

– Patrick Koch, Worldwide Business Director, eHealth Managed Services

Will 2010 be the year of the EMR (finally)?

Will paper-based health records finally go the way of the dinosaur?

While many of us were enjoying the final days of 2009 with some much-needed time off with family and friends, The Centers for Medicare and Medicaid Services (CMS) was readying its much-anticipated proposed rules for the meaningful use of electronic health records. Once final, these rules will be used to determine Medicare and Medicaid incentive payments authorized under the American Recovery and Reinvestment Act.

While we sift through the 500+ page document, on file at the Office of the Federal Register, it’s refreshing to know that some leading-edge facilities are already well into their EMR implementations and are successfully linking their radiology and EMR systems.

One such Carestream Health customer is Crystal Run Healthcare, of Middletown, NY—a large medical practice that serves patients in the Mid-Hudson Valley and lower Catskill regions. With 180 physicians and almost a dozen facilities, Crystal Run has what many health networks only dream about: a modern RIS/PACS that efficiently shares information with its EMR.

After an imaging exam is conducted at one of Crystal Run’s sites, a radiologist reads the exam using its CARESTREAM RIS/PACS. The initial report is immediately transferred to the EMR where the radiologist approves it, and it immediately becomes viewable by the referring physician. The result is efficient reporting and fast, easy clinician access to critical information—improving both productivity and patient care.

In our news release today, Miguel Hernandez, Director of IT for Crystal Run, comments, “One of the key reasons we selected the newest generation RIS/PACS from Carestream Health was its modern architecture and its ability to interface with a variety of other systems, including enabling bidirectional information exchange with our EMR.”

Despite the significant hurdles that remain for widespread adoption, stories like Crystal Run’s—along with the U.S. government’s focus on fostering and encouraging use—make us think that maybe 2010 will be the year of the EMR. We’ll be doing everything we can to help our customers get the most out of their EMR systems and qualify for the CMS incentives.

What’s your take? Will this be the year real progress is made? Or will we having this same conversation 12 months from now?

–          Joe Maune, Carestream Health



Dr. David S. Channin

Guest-post from David S. Channin, M.D., CPHIMS, CRA, CIIP

So, another annual meeting of the Radiological Society of North America has come and gone. The ghosts of contracts past fade as we await the transmogrification of handshakes present into the ghosts of contract future. We sit back and decompress a bit, perhaps loosen the belt a notch, crack open a ‘vieux Armangnac’, gaze into the pensieve and begin to winnow the chaff that are customer dreams. It is an eternal conundrum that potential customers want what they know but know not what they need and existing customers have what they need but now know what they want. Yet, come Monday, January 4, father time will be burning engineering hours (at both ends?!) to do something! But, what?!

The key to the workstation must be radiologist productivity in a complex workflow aggravated by increasing procedure volume, increasing procedure set size, increasing regulation all the while amidst declining reimbursements. We need to examine each part of THE use case* (see below) to make sure that both the human and machine are each doing what they do best in absolutely the most efficient way possible; a truly cyborg relationship. It turns out that the computer’s and the human’s abilities are complimentary. The computer can be notoriously good at managing the process and the human, remembering things, searching, organizing, filtering, displaying and communicating. The human, as it turns out, is spectacularly bad at those tasks yet surprisingly good at some very hard tasks; image segmentation, content-based image memory retrieval and general and specific medical knowledge inferencing.

It would seem, therefore, relatively straightforward to provide the computer with all of the data and interfaces it needs to get its job done while providing the human with the minimum graphical user interface to get its job done as rapidly and as accurately as possible. Looking at the use case, it becomes apparent where the computer’s smarts can be applied: clever use of worklists to gather necessary data, sophisticated hanging protocols, fast, automated display, context sensitive, embedded lexicons and reference materials. For the human, the workstation can provide fast, standards based annotation and markup tools, and powerful embedded reporting in a variety of flavors.

The good news is that there are de facto, if not true standard ways to assimilate all of this functionality into the workstation. Remember, “We are the Borg. Lower your shields and surrender. We will add your biological and technological distinctiveness to our own. Your culture will adapt to service us.”

– David S. Channin, M.D., CPHIMS, CRA, CIIP

* The Radiology use case grammar (anything enclosed in [] is optional):

  [Resident Display [with historical(s)]] [Resident Annotation] [Resident Prelim Report] [Resident Critical Result Notification] Radiologist display [with historical(s)] [Radiologist Annotation] Radiologist Final Report [Resident Feedback] [Resident Discrepancy Notification] [Radiologist Critical Result Notification] [Technical QA] [ Professional QA] [Clinical Trial Specific Processing] [Clinical Trial Specific Annotation] [Clinical Trial Case Report Form Submission]  [TF Creation]

Editor’s Note: Dr. Channin is a paid guest-speaker for Carestream Health.