HIMSS12 Interview: Maturing Cloud Services with Dr. Roger Eng

Dr. Roger Eng, Chairman of Radiology, Chinese Hospital, and President of Golden Gate Radiology Medical Group, stopped by our booth last week at HIMSS to talk about healthcare’s  growing interest in cloud services, his experience using CARESTREAM Vue Cloud Archive for disaster recovery to complement his RIS/PACS system and the progress vendors have made addressing security cloud security concerns.

Watch his video interview below to hear about how his department’s location in a major earthquake center drove the decision to store the entire  data portfolio — going back to 2006 (approximately 40,000 imaging procedures per year) — in the cloud as a storage back up.

Dr. Eng is a member of Carestream’s advisory board.


How do you see the healthcare cloud services industry developing and what are your facility’s plans? 

Medical Imaging Trends From HIMSS 2012

More than 30,000 healthcare IT professionals and vendors will exit HIMSS and Las Vegas today and spend the next few days, weeks and even months processing all they learned, saw and shared.  At the Carestream booth, many visitors were kind enough to take time on camera to talk about the hot topics that captured their attention at the conference.  Over the new few days we’ll bring their insight and opinion to you on Everything Rad.

First up: Brian Casey, editor-in-chief of AuntMinnie.com, discusses how medical imaging is being integrated into the larger healthcare IT discipline, cloud computing and radiology’s inclusion in stage 2 of meaningful use.

For a CIO perspective, Gregg Zolton, chief information officer at Crystal City Orthopedic Center in Ohio, talks about attending HIMSS is an important learning opportunity for his practice’s meaningful use attestation.

Jeff Fleming, vice president of healthcare information solutions, sales and service at Carestream, saw strong clinical interest in storing medical images in the cloud.


What health  IT innovations did you see at HIMSS that will have major implications on radiology?

HIMSS 12: Presenters Urge It’s Not About Technology, But Connecting People

Robert Salmon

Robert Salmon, Carestream Health

Intel’s executive breakfast session on the opening morning of HIMSS ’12—where 200 brave and surprisingly sober souls arrived for a refreshing 6:30 a.m. start—was a great use of time. This was a nice reward where time is more valuable than money (don’t tell the casinos that…) at this information-rich conference that just gets bigger and better each year (early estimates predict 35,000 are in attendance).

Jason Hwang, MD, co-founder and Executive Director of Healthcare at Innosight Institute, and Eric Dishman, Intel Fellow and Global Director of Health Innovation and Policy for Intel, discussed some hard realities:

  • Facilities will need 20 times the PC capability and 16 times the storage capacity by 2015—and those needs increase exponentially in years to follow.
  • How will we provide care for an aging global population that will double the number of people over 60 years of age by 2050?
  • There simply will not be enough healthcare professionals at any level to manage this.

Both presenters explained there is no big-win-solution that will make everything fall neatly into place and urged that healthcare needs to move beyond a central paradigm approach to more personalized, outpatient care with more patient involvement at every level to create a more coordinated and improved care model.

This model, where healthcare IT plays an even greater role, can lead to greater access to care. Decentralization through disruption will enable healthcare providers to do more on their own while creating opportunities for people to make empowered decisions involving their health.

Now, this does not portend the end of the hospital as we know it. If I am going to have heart surgery, I am still going to the best hospital I can find as that is exactly where this level of care needs to be provided. But there are many services provided at hospitals that can be delivered in a decentralized manner, and doing so can provides greater access for broader segments of the population. Mr. Dishman used the term “Brickless Clinic,” where primary care practices, the home and the community play a greater role, supported by a healthcare IT infrastructure that enables its success.

I found this executive breakfast to be a great lead into HIMSS’ opening keynote session (as told through tweets curated by Health IT News below) by Biz Stone, co-founder of Twitter, where a packed house heard the personal inside story of the creation of Twitter. But a statement from Biz early in his presentation rang true with this audience of health IT professionals:

 “Remember it’s not about the technology, it’s about bringing people together to do things for humanity.”

This echoed Intel’s session – technology alone does not lead to better patient care.  Health IT is the connection. It can bring physicians and patients together, connect specialists and speed information sharing between individuals for greater access, more collaboration and faster decision making.

At an IT show like HIMSS – it was great to start with a focus on humanity.

Did you attend either of these sessions? What’d you think? Stop by at booth #2614 to share your thoughts. 

[View the story “Twitter Recap: Biz Stone Keynote” on Storify]

HIMSS Cloud Report: What Are You Spending on Image Management?


In the past, PACS was primarily a radiology decision.

The advent of cloud-based services for PACS has moved this critical system onto the radar of healthcare IT decision makers and hospital executives—and into the center spotlight in the exhibit halls and technical sessions of this year’s HIMSS conference.

In Booth #2614, we’ll be diving deeper into the total cost of ownership of in-house archives from technology maintenance to hidden costs like data migration and IT staffing requirements.  Cloud services offer an attractive clinical delivery model for many healthcare facilities and can cut costs by up to 30 percent.

With the cloud no capital investment is required since the supplier owns all the data centers and equipment, and the service is paid for on a per-study cost. Software and hardware upgrades can be included in the contract. The cloud delivers instant scalability that easily accommodates increases, or decreases, in imaging volumes. Our cloud costs savings infographic offers a quick primer (click image to view full size).

At HIMSS 12, you’ll also be able to see the cool capabilities of CARESTREAM Vue for Cloud Services including:

  • Full PACS functionality as well as vendor-neutral archiving for DICOM and non-DICOM data
  • Support for data access from mobile devices using Carestream’s Vue Motion zero footprint viewer
  • Higher levels of encryption and security through use of the Intel® Xeon® processor E7 family
  • A works-in-progress cloud patient portal (not commercially available) that will allow patients to access, view and share their own medical imaging data with physicians, specialists and other healthcare facilities.

And we hope you can join us at complementary workshop with Intel on Tuesday, Feb. 21, from 2:00-3:00 p.m.

The session titled, “From Theory to Reality: Building a Secure Cloud Environment for Diagnostic Imaging,” will highlight industry proof points from several facilities who have successfully deployed diagnostic imaging to the cloud.

Please register in advance to join us.

If Vegas is too hot, you can find some relief in the cloud at HIMSS. Looking forward to the discussion!

Seven Ways to Use Social Media at ECR 2012

Editors Note: We collaborated with Andreasz Diesenreiter, part of ESR’s ECR2012 team, to put together  this guide of social networking tips for the upcoming congress.

ECR2012 is the perfect opportunity to not only connect with us at Carestream, but to also use of social media as a networking and information sharing tool.

  1. ‘Like’ us on Facebook – comment on what we’ve got planned for the show, what you’re hoping to see and find out more about, and let us know when you’re coming.  Once you’re there you can post your images of the show there, along with your thoughts on what you think of the show.
  2. Connect with MyESR on Facebook and keep up with all of their pre and at-show events.Carestream at ECR2012
  3. Let us know that you’re going to be there.  Follow and tweet us at @Carestream. If you’re not a regular twitter user then feel free to ask for advice – it’s a friendly community and an invaluable source of up-to-the-minute information.
  4. You can follow @myESR as well – as the conference organizers they’ll have the most up-to-date picture of what’s happening in the run up to the show (and during the show itself).
  5. Use Twitter hashtags – they’re like internal chatrooms and an excellent way of finding people talking on the same subject.  Here’s a few that we use regularly: #Cloud #HealthIT #Radiology #HIT #ECR2012.
  6. If you’re attending a particular session and want to tweet about it, add the room identifier to the #ECR2012 hashtag, eg #ECR2012A, #ECR2012B, #ECR201Studio – it’s a great way of letting people know what they’re missing out on and gives the show organizers some instant feedback.
  7. Check in to ECR2012 using Facebook places & Foursquare. Let us know that you’re there and we’ll look out for you!

And if you do all of this, you can check yourself out on the ECR Social Media Wall.  Visible throughout the congress venue the wall will collate all of the ECR2012 social media activity into one place. And even if you’re not at the venue, you can get online and view the wall, so there’s no excuse to miss out on a thing!

Come and see us in Booth #210.


Consumerized Healthcare: HIEs Will Only Succeed with Patient Access to Imaging Data

Patrick Koch

Patrick Koch, Worldwide Business Director, Vue Cloud Services, Carestream

As we prepare for HIMSS12, health information exchanges will be a hot topic at the event. And if February’s Health Imaging Magazine cover story, “Images in the HIE: Clearing the Hurdles,” is any indication, I anticipate lots of discussion on the technical and financial issues that are standing in the way of a direct connection between radiology and most HIEs. But I hope we also spend sometime talking about patient empowerment and the HIE at HIMSS.

How will our approach to HIEs need to change?

The HIE must have an interface that reflects the patient as part of the care cycle. The interface should be intuitive, require no training, no application to download, and imaging data should be embedded with the EHR for one-stop access.

You can read my full thoughts on the importance of addressing the push for “consumerized” healthcare by designing HIEs that go beyond the provider and give consumers the ability to manage the exchange over at Intel’s Healthcare IT Professionals blog.

Stop by booth #2614 at HIMSS and let me know what you think. Can HIEs succeed without patient access? 


Digital Radiology Comes of Age

Sean Reilly

Sean Reilly, publisher, Imaging Technology News

Editor’s note:  This post first appeared on ITNonline.com’s  publisher blog. Re-posted with author permission. 

Murphy’s Law… One day before this year’s Super Bowl, my ten-year-old TV gave up the ghost.  Forced to go emergency shopping, the adage, “They don’t build ’em like they used to” came to mind as I gazed upon a wall of bright, ultra-thin LCD displays at the electronics superstore.  Gone forever were the bulky analog TVs of old.  Technology and consumers had moved on.

The same was evident with X-ray technologies on display at RSNA 2011.  While “workflow” and “dose” were much-discussed, and PET/MR technology captured a share of the spotlight, most surprising to this publisher was the buzz surrounding digital detector and mobile DR technology.  Vendors – including those who provide heavy-iron technologies that typically attract the greatest attention – placed heavy emphasis on their new or emerging digital X-ray solutions.  This was something I haven’t seen in years.

DR technology, like flat panel televisions, is hardly new.  Both have existed for years.  The challenge both initially faced was that of cost.  A decade ago, I just couldn’t justify laying out heavy green to view content offered by networks or cable providers on a state-of-the art screen.  Healthcare providers faced a similar challenge with DR.  Ten years ago, despite the promised benefits of improved workflow and PACS integration, transitioning from film to digital technology was cost-prohibitive.  For the most part, DR remained in the background, taking a back seat to lower-cost solutions like computed radiography.

But at RSNA 2011, the paradigm changed.  New DR solutions took center stage.  A spotlight shined on digital detectors that can be retrofitted to work with, and shared between, conventional X-ray systems.  Wireless detectors generated iPhone-like excitement.  Mobile X-ray systems – “meat and potato” technology – climbed to the top of the menu with the “secret sauce” of digital detectors.

Why the sudden shift?  Perhaps one reason is that vendors had not only listened closely to the needs and challenges of healthcare providers, but responded with solutions enabling them to transition from film to digital in a logical, economically feasible way.  From my perspective, I find it extremely gratifying to see those looking for solutions, and those delivering them, in sync.  The end result is a positive one.

Watch for a comparison chart with detailed specifications for all the leading models of DR systems in the April issue of Imaging Technology News.   You can also find news about the latest advances in digital radiography in the DR Channel of ITNonline.com.

ECR 2012 Looms Large with Some Major Changes

Philip Ward

Philip Ward, editor-in-chief, AuntMinnieEurope.com

Editor’s note:  With ECR 2012 quickly approaching, Philip Ward, Editor-in-Chief, AuntMinnieEurope.com, highlights some changes to the congress agenda. 

Something I love about the European Congress of Radiology (ECR) is that it signals the start of spring. The worst of winter is over, and the best part of the year stretches out ahead. And then there’s the opportunity to visit Vienna, the permanent venue for ECR since 1991. With its stunning architecture, calming atmosphere and cultural and culinary pleasures, the city never fails to stimulate.

As the congress approaches, it’s important to realise there are some differences this year. The opening day (Thursday) is now virtually a full working day, and although the commercial exhibits don’t open until Friday, the scientific sessions begin at 10.30 am on 1 March. Also, to ensure good attendance levels on all five days, many of the best sessions have now been moved to Thursday and Monday. This means the program has a much more balanced look, but it also means that delegates need to arrive as early as possible.

It will be fascinating to see whether attendance falls slightly this year due to the current economic problems besetting most of Europe. Italy and Egypt are among the guest nations featured in the three ‘ESR meets’ plenary sessions – the other is Romania – and in view of the severe difficulties faced by many Italians and Egyptians, it is quite possible that the number of delegates from these two nations will be lower than expected.

To find out what else is new at ECR 2012, I interviewed congress president Prof. Lorenzo Bonomo from Rome. He’s led a personal campaign to increase collaboration between radiology and radiation oncology, and this will be a major theme during the congress. Chest radiology also features prominently. You can read my full interview with Prof. Bonomo  on AuntMinnieEurope.com. The site is free-of-charge, and it provides daily news and weekly case reports from across Europe.

We will be celebrating our first anniversary at ECR, and I look forward to seeing you there!

HIMSS12 Trends: Q&A with Intel’s Chief Architect of Healthcare

Kristina Kermanshahche

Kristina Kermanshahche, Chief Architect of Healthcare, Intel Corporation

Editor’s note:  With HIMSS12 quickly approaching, we sat down with Kristina Kermanshahche, Chief Architect of Healthcare, Intel Corporation, to get her thoughts on the hot topics she expects at this year’s show.

Q: With HIMSS12 just weeks away, what are the issues shaping the agenda of HIT executives at the show?

A: HIMSS 2012 is happening at a critical moment in health IT. Government mandates are transforming patient care and healthcare CxOs are tasked with aligning the right technology to speed this change. However, these priorities actively compete with major budget cuts and growing economic concerns.  Healthcare CxOs are placing more emphasis on operational excellence – certainly, how to do more with less – but also how to free up capital investments on the administrative and technical side, while reinvesting appropriately in clinicals.  How does one drive business innovation through smart operational design, building upon a foundation of improved access, resource utilization, automation, and economies of scale.

Q:  Let’s talk a little more about operational excellence. What advice do you have for CIOs and IT administrators to optimize their performance and get more value from their existing systems?

A: Let’s look at medical imaging as an example:  Radiology is still acclimating to the meaningful use regulations and navigating the proposed changes to reimbursement mechanisms.  At the same time, it’s experiencing the rise of “big data” in the wake of developments in CT, MR and digital radiography.  Advanced visualization, 3D reconstructions, and multi-modality data sets, result in significant storage and processing demands, along with innovations like breast tomosynthesis, with dozens of additional images per study.  Complicating matters is the demand for timely patient data, particularly across multiple sites in expanding provider networks. This has a cumulative effect of degrading the performance and functionality of existing information systems.

For diagnostic imaging, smart operational design equates to delivering scalable performance which enables you to freely add and remove data, users, sites, and tools as your workload dictates – without giving up functionality or responsiveness.  It means providing secure access to authorized individuals from remote locations using authenticated devices.  It means addressing scarcity with effective allocation of resources and expertise. And it means reducing upfront capital and unpredictable operational expenses like energy consumption and data center capacity issues.

Here’s a great example. We recently collaborated with Carestream Health to evaluate how Intel® Xeon® processor E7 family could help medical imaging providers get optimal performance from their SuperPACS platform and server investments. Compared with the prior generation, the E7 family resulted in a 28% performance improvement, resulting in the ability to support 20% more users on a given configuration.

Q:  Cloud computing and mobility will both be hot topics at this year’s show. What are some of the factors that should be assessed when evaluating cloud services and remote access to patient information?

A: Using the cloud generally requires working closely with a managed services provider to ensure end-to-end data security, data protection, and privacy safeguards, and that can be a concern for healthcare providers who are accustomed to traditional, perimeter-oriented, security techniques.

Well-designed cloud services protect the privacy and security of data through a combination of application, technical and administrative controls.  Security services must be designed from an end-to-end perspective, including data transparency, access control, audit and compliance tracking.  Hardware-assisted security can provide significant reduction in risk while enhancing performance and productivity.  Physical and administrative controls include a seasoned security team who regularly performs risk assessments, evaluates supporting mitigations, and conducts practice drills in disaster recovery and breach response.  Healthcare facilities should request and evaluate detailed documentation on security & DR practices from every managed services provider under consideration.

On Tuesday, February 21 from 2-3 pm, we’re hosting a complementary HIMSS workshop, “From Theory to Reality: Building a Secure Cloud Environment for Diagnostic Imaging,” exploring this topic in more detail. We will present industry proof points from several customers who have successfully deployed diagnostic imaging to the cloud.  Please register in advance to join us.

Q: What’s the top question you’d encourage HIT execs to ask vendors when evaluating solutions?

A: The one question I hope I’ll hear echoed in the Venetian, “How do I deliver more value from my network while leveraging the cloud for non-core competencies? “

PACS Progress in Paris – Streamlining Radiology Workflow

Dr. Daniel Reizine

Dr. Daniel Reizine, Lariboisière Hospital in Paris, PACS coordinator, AP-HP

Editor’s note: we asked Dr. Daniel Reizine, radiologist at Lariboisière Hospital and PACS coordinator for the AP-HP, to share updates about the Paris PACS project.

The APHP is the main group of hospitals in Paris. It has 22,000 beds, and performs 2 million  radiology exams per year on more than one hundred modalities. These modalities are connected to 37 RIS from 47 departments (31 radiology departments and 16 nuclear medicine departments).

We now have a centralized data center integrating the archives of 20 sites that were previously independent. Since 2005, the Carestream PACS at APHP has accumulated more than 8 million exams and 400TB of data.  150,000 new studies are added each month. This new registry has created a global worklist that can be used to view all patient exams that may have been taken at  several sites, while still allowing each site to work independently of the data center.

A few months ago, we installed a module called “reporting from PACS” which allows us to generate reports directly in the PACS using speech recognition and templates. This module improves radiologist workflow because it eliminates the need to use RIS for reading and reporting. We now use the PACS worklist, where prior reports are also viewed, and the final report is automatically sent to the RIS.

Our main priorities  for future development of the APHP PACS are: integrating 2 Agfa PACS installed in 2 APHP hospitals, into the Carestream system; updating local PACS and installing the Carestream full web image distribution across the APHP (and integrate it in the Orbis electronic patient record); exciting projects to come!

More on our PACS project can be found on AuntMinnieEurope.com.  A French version of this post can be found below.


Evolution du PACS de l’APHP – amélioration du workflow

Note de l’éditeur: Nous avons demandé à Daniel Reizine, radiologue à l’hôpital Lariboisière de nous écrire quelques mots sur l’actualité du projet PACS de l’APHP dont il est le coordinateur.

L’APHP est le principal groupe d’hôpitaux dePariset de la région parisienne. Il représente 22,000 lits, et on y réalise 2 millions d’examens de radiologie par an sur plus d’une centaine de modalités ; ces modalités sont elles-mêmes connectées aux 37 RIS de 47 services (31 services de radiologie et 16 services de médecines nucléaires).

Nous avons désormais un data center centralisé qui regroupe les archives des 20 sites auparavant indépendants. Depuis 2005, le PACS Carestream de l’APHP a accumulé plus de 8 millions d’examens correspondant à 400TB de données, et 150 000 nouveaux y sont ajoutés chaque mois. Cette nouvelle base de données centralisée a permis la création d’une liste de patient globale qui peut être utilisé pour visualiser l’ensemble des examens d’un patient qui ont pu être réalisés sur plusieurs sites. Néanmoins, chaque site peut travailler indépendamment du data center.

Il y a quelques mois, nous avons installé un module appelé « reporting from PACS » qui permet de générer des comptes-rendus directement dans le PACS en utilisant la reconnaissance vocale ainsi que des comptes-rendus types. Ce module améliore le workflow du radiologue car il permet d’éliminer la phase d’utilisation du RIS pour le diagnostic. En effet, on utilise la worklist du PACS, les comptes-rendus antérieurs sont aussi visualisés dans le PACS, et le rapport final est automatiquement envoyé dans le RIS.

Concernant les futurs développements du PACS à l’APHP, nos principales priorités sont : intégrer les 2 PACS Agfa installés dans 2 hôpitaux de l’APHP dans le système Carestream, mettre à jour les PACS locaux et installer le système Carestream de distribution web des images au sein de l’APHP (et l’intégrer au dossier patient Orbis) ; de beaux projets en perspective !

Vous pouvez aussi consulter l’article posté sur AuntMinnieEurope.