Live from HIMSS 2011: Innovation will move healthcare IT to the intelligent age

Robert Salmon, Carestream Health

One of the co-presenters of an educational session on “Creating and Sustaining Innovation in Healthcare” I attended at today’s kick off of the HIMSS 2011 conference opened with the following statement:  “We are each born to be creative and innovative, and it begins when we are very young.” 

The seeds of creativity sprout early to nurture the imaginative and fantasy-filled days of childhood, then soon reveal more creative expression brought on by exposure to education, music, literature, the arts and much more. As we mature, our creative energies blossom further as opportunities to pursue higher forms of education lead us into careers, passions and life commitments that take us down new roads in this unique journey of life. 

The speakers went on to pose the question: “Why then—with such vast power available to us—does healthcare innovation lag as compared to so many other areas of society?” If a definition of innovation includes a change of method or technology fueled by a positive, useful departure from a previous way of doing things—then what is needed to unleash more of the power of innovation upon our healthcare system? 

Innovation involves people beyond the IT, R&D and product development teams. The creative circle of innovation must include customers, patients, vendors and suppliers in shaping new concepts—and the epicenter of IT innovation needs to be at the community hospital and the community physician practice where the vast majority of healthcare is delivered. We must be careful of being too “vendor focused” as real innovation is a group activity. Critically important is spending time with patients as it provides tremendous knowledge and insight—and it changes you. 

To move healthcare IT from transactional to transformative, organizations must actively encourage innovation at every level and make it not optional. Developing cross- generational teams, busting routines and breaking down silos—coupled with the funding, staffing, management support and development resources to be successful—can lead to innovations in healthcare to get things where patients and customers want them to be.

Creating a culture of collaboration can move healthcare IT from the information age to the intelligent age. Innovation is a culture, not a project. Innovation is about ideas, process, culture and execution. Groups of people given the right tools in a dynamic, diverse and stimulating environment supported by a culture that generously rewards continuous innovation can do amazing things.

The future is now and as one noted author suggested—it arrived yesterday. The pace of finding creative, innovative solutions to the many challenges facing healthcare can increase exponentially if we unleash the power of innovation to run, grow, and successfully transform the business of delivering healthcare.

What did you think of this summary?  How does your facility encourage innovation?

The new frontier of Mobile Radiology

One of the most exciting trends in healthcare is the use of mobile devices for clinical applications. The total market for medical applications on mobile devices is expected to total $80 million in 2010, with exponential growth anticipated in the next several years.[1]

The FDA approved the first diagnostic radiology application in February and research teams at major hospitals worldwide are already testing iPhones and iPads for preliminary diagnosis of selected studies. Hospitals are also starting to use mobile devices to provide patient images and information to referring physicians. As hospitals tested the use of mobile devices for imaging applications, the major problem reported was not image quality or security concerns—it was extremely slow download speeds.  

This challenge can be solved with an imaging viewer that has zero download footprint capabilities—now offered with a new generation of PACS. A zero footprint viewer enables physicians to review patient images and reports from a mobile device while moving within a hospital or their practice.

We’ll be demonstrating our new enterprise distribution viewer at HIMSS 2011 and the European Congress of Radiologyit’s not only zero footprint but can also be embedded into an EMR. Embedding the viewer equips physicians to access imaging studies and radiology reports directly from existing clinical applications they are familiar with. This avoids the added step of launching another application or viewer.

Whether physicians primarily work at a practice or a hospital, they are constantly moving. So it makes sense that technology needs to deliver access to patient data and images to mobile devices. Embedding zero footprint imaging capabilities to the EMR further enhances that convenience—seamlessly connecting imaging to the enterprise.

Is your hospital currently sending patient data/images to clinicians’ mobile devices? Are physicians embracing this delivery method? 

– Neville Skudowitz, Product Line Manager, Carestream Health

[1] Kalorama 2010

Is imaging’s procedure volume glass half empty or half full?

The author, Brian Casey,

Guest Post: Brian Casey, Editor in Chief,

A new report was published this week that probably isn’t a big surprise to anyone: The volume of medical imaging services paid for within the Medicare system dropped in 2009, the first such drop in 11 years.

The report, sponsored by the Access to Medical Imaging Coalition (AMIC), found that the volume of advanced imaging services billed within the Medicare system decreased by 0.1% in 2009 compared with 2008, while overall imaging services declined by 7.1% for the same year-to-year comparison. You can read the full story on by clicking here.

I say the report is no surprise because several other recent studies have documented similar drops in imaging volume in the U.S., in particular a study presented at the 2010 RSNA meeting by Dr. David Levin and colleagues from Thomas Jefferson University. The declines have been across the board, both with respect to advanced imaging services like CT, MRI, and PET, but also more basic procedures like radiography and screening mammography.

It’s also no secret what’s causing the declines — big cuts in Medicare reimbursement for imaging procedures, such as those implemented in the Deficit Reduction Act of 2005 (DRA), coupled with increased scrutiny of imaging on the part of third-party payors, who are using radiology benefits management firms and other tools to cut back on what they see is inappropriate utilization.

AMIC portrayed this week’s report as an example of how Medicare beneficiaries are being denied access to lifesaving imaging technology. And if that’s really happening, it’s unfortunate — all of us in radiology are witnesses on a daily basis to the incredible power of imaging — to find hidden disease, change patient management, or treat a patient less invasively and with faster recovery than ever before

But if you step back and look at the report from another perspective, you’ll see that the procedure volume glass may actually be half full rather than half empty. Rightly or wrongly, medical imaging has taken a public relations beating in recent years as one of the drivers behind runaway healthcare costs in the U.S.

With imaging procedure volume slowing, maybe policymakers and administrators can at last step back and look at ways to manage imaging utilization wisely rather than through brute-force instruments like the DRA. Other positive moves in this direction include the announcement — also this month — that the Center for Medicare and Medicaid Services (CMS) is moving ahead on a pilot project to examine the role of clinical decision support software in directing appropriate imaging utilization.

So, I’m choosing to look at this week’s report with a positive spin, as a sign that radiology is getting its house in order and that perhaps inappropriate imaging utilization by other medical specialties is on the wane.

What’s your take? Is the glass half empty or half full?

– Brian Casey, Editor in Chief,

Editor’s Note: The views expressed by guest bloggers are soley those of the author, and do not necessarily reflect those of Carestream Health, Inc.

And for our next act? The evolution of digital radiography

Digital radiography has come a long way in a relatively short time.  What a simple statement, but a big change in the way that we perform general radiographic imaging! 

Not so long ago, if you wanted to use a DR detector in a general radiographic setting, your only choice was to purchase a whole room full of new imaging equipment.  The advent of cassette-size wireless DR detectors opened the door for upgrading your existing rooms to utilize the productivity of DR, in a cost effective manner.

Next came the ability to upgrade your existing portable imaging equipment to take advantage of these new DR detectors.  Now, even new DR rooms, with automated and integrated equipment use these wireless, cassette-size detectors. The best part is that the same detector can be shared between all three: upgraded rooms, upgraded portables and new rooms!

So what’s next for general radiography? Where do we go from here?

Well, one area where precious little improvement has occurred over the past 30 years is portable imaging. Just adding a DR detector to the same old square box and the same old workflow is a lot like having ice cream with no cone to hold it in.

Typically, the sickest patients in our hospitals get the worst images and even those images are difficult to obtain. The time has come to take portable imaging quality and ease of use, up to the same level as the integrated DR rooms in your department.  Having a cart that has a place for all of your tools, along with the horsepower and technology to create “room quality” images is the next frontier. 

Who knows, the future may be closer than you think… where is your facility taking DR?

 – Jimmy Ogle | Worldwide Product Line Manager – Digital Radiography

 Editor’s Note: Hear more from Jimmy on how wireless detectors are changing how facilities view x-ray imaging in our Wireless DR eBook.

Health IT Visionaries: Q&A with Diana Nole

Diana Nole, President, Digital Medical Solutions

In an ever-changing healthcare environment, it’s important that health IT evolves to meet the needs of providers.  Diana Nole, President of Carestream’s Digital Medical Solutions business, shared her thoughts with Health Data Management about Carestream’s perspective on key industry trends.

Q:  In five years, what will organizations be able to achieve—in terms of clinical and financial excellence—that they are unable to do today? How will your technology help make that happen?

A:  Organizations should have a more complete patient record that clinicians can access to help deliver a higher standard of clinical care. Our PACS systems and cloud-based eHealth services help enhance the patient record by supporting communication of patient data and imaging exams to other information systems, including EHRs. We also help reduce expenses: our cloud-based eHealth services deliver fully featured capabilities at a very affordable cost-per-use basis and our SuperPACS Architecture enables facilities to share information among disparate PACS systems to preserve their existing investments. Advanced functionality built into our PACS platform delivers a more productive, cost-effective workflow and our RIS offers business intelligence tools to enable managers to improve equipment utilization and profitability.

Q:  Do you envision a time when the U.S. healthcare industry will achieve true interoperability?  What needs to happen today to make that possible tomorrow?

A:  Healthcare providers are beginning to participate in health information exchanges, which will play a vital role in interoperability, as will vendor-neutral repositories. Carestream Health’s Clinical Data Archive not only image enables an EMR, it also collects and consolidates data from multiple sites into a single patient portfolio. The archive manages imaging exams, lab and pathology reports, video files, JPEG images and other data types. Communication with other systems is enabled through support for DICOM, HL7 and XDS, as well as IT standards such as CIFS and FTP.

Q:  How do you foresee the health IT landscape changing over the next decade? How will you ensure your company is a market leader in that new environment?

A:  We see two major trends: a movement to thin-client/zero-client information management solutions and greater use of cloud-based services. Thin-client solutions enable IT managers to manage the burgeoning growth of healthcare data by reducing time-consuming software downloads and other manual tasks. IT managers may also elect to use cloud-based services to serve the IT needs of radiology and other departments. This will allow staffs to devote limited funds and personnel to the support of EHR and other hospital-wide solutions. As an established market leader in radiology healthcare solutions, we already have both products and services that address these trends.

Q:  What do you see as looming threats to the security and privacy of patient health information?  How, as an industry, do we need to mitigate and/or eliminate those threats?

A:  Many independent organizations are working with healthcare technology suppliers to help providers ensure the privacy and security of patient information. Medical device manufacturers have implemented a variety of data security standards in recent years. HIPAA requirements are well established, and new standards address the need for greater security across healthcare organizations’ rapidly expanding networks. The Health Information Trust Alliance (HITRUST) is leading development of a common information security framework that can help enable secure sharing and management of patient data.