HIT Paris 2012: Loire Region Cloud Project Draws Attention

Hugues Trousseau, Marketing Manager, France & Belgium, Carestream

“Cloud” was the buzz of last week’s HIT Paris 2012. And show-goers found particular interest in Carestream’s Vue Cloud services.

We demonstrated seamless access to patient data and integrated workflow across the continuum of care via our Vue Cloud Archive, Vue Cloud PACS and Vue Cloud Community.  We also highlighted the low initial costs and predictable total operating cost associated with our cloud services. Customers and prospects showed tremendous interest not only in these services, but also in how some of them are applied in France’s Loire Region.

The Loire Region recently began operating one of the country’s first hosted data and software applications networks using our Vue Cloud PACS and Vue Cloud Archive. When the project is fully implemented over the next several months, a minimum of nine private and public healthcare facilities will use our cloud services.

Loire As part of the project, data is hosted at the Roanne NumeriParc secure data centre (ISO27001 certified) and built around the Axione high-speed telecommunications network (optical fiber).

Saint Etienne University Hospital and Mutualité Française de la Loire led the group coordinating this ambitious project, which involved all major economic, political, technical and health players of the Loire. The group aims to share the purchase of services and equipment enabling medical image archiving, communication and diagnostic services to meet the needs of group members and aid cooperation between institutions and their partners. The group chose cloud-based services for the project instead of capital investment as these services enhance productivity and patient care, and the fee-per-study structure provides a predictable total cost of ownership (TCO).

A French version of this post can be found below.

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Le “Cloud” a fait le buzz sur le congrès HIT de Paris ! et les nombreux participants ont trouvé un réel intérêt pour les services « Vue Cloud » de Carestream.

Nous avons présenté nos solutions Vue Cloud Archive, Vue Cloud PACS et Vue Cloud Community qui permettent un accès transparent aux données du patient ainsi qu’un workflow intégré tout au long du parcours de soins. Nous avons également mis en évidence le très faible coût de l’investissement initial de nos services de cloud computing ainsi que le caractère complètement prévisible des coûts d’exploitation. Les différents visiteurs ont montré un grand intérêt, non seulement dans ces services, mais surtout dans la façon dont certains sont mis en application, notamment dans le département de la Loire.

Le département de la Loire a récemment mis en route la première plateforme mutualisée d’échange de dossiers d’imagerie médicale à l’échelle d’un territoire de santé, en utilisant nos applications Vue Cloud PACS et Vue Cloud Archive. Lorsque le projet sera complètement opérationnel, ce sera un minimum de neuf établissements de santé privés et publics qui utiliseront nos services de cloud computing.

Projet eSante de la LoireDans le cadre de ce projet, les données sont hébergées au NumeriParc de Roanne, centre de données sécurisé certifié ISO27001, construit autour du réseau de télécommunications très haut débit de la société Axione (fibre optique).

Le CHU de Saint-Etienne et la Mutualité Française de la Loire conduisent le groupe de coordination de ce projet ambitieux, qui a impliqué tous les grands acteurs économiques, politiques, et médicaux de la Loire. Ce projet a pour but de mutualiser l’utilisation d’infrastructures et de services d’archivage d’images médicales, de communication et de diagnostic, et de permettre la collaboration entre les différents établissements et leurs partenaires. Le groupement a choisi, pour ce projet, une solution en mode service de type cloud computing plutôt qu’une solution en mode investissement  notamment parce qu’elle permet à chaque établissement de souscrire le niveau de services correspondant à ses besoins et à ses contraintes à travers le « paiement à l’examen » qui offre, de plus, une visibilité complète sur le cout total de possession (TCO).

SIIM Panel Preview: Medical Imaging? There’s an App for That!

Diana Nole, Carestream Health

Diana L. Nole, President, Digital Medical Solutions, Carestream

Our mobile devices are communications command centers – both for business and for personal use. So it’s no surprise that mobile applications are entering the healthcare space.

A discussion that explores new mobile apps for medical imaging is the topic for a presentation entitled “Medical Imaging? There’s an App for That!” at the 2012 Society for Imaging Informatics in Medicine (SIIM) conference and exhibit. The session will be held Thursday, June 7, from 2:45–3:45 pm at the Exhibit Hall Innovation Theater at the Orlando World Center Marriott, Orlando, Fla. The moderator is nationally recognized researcher and speaker David S. Hirschorn, MD, Director of Radiology Informatics at Staten Island University Hospital.

This discussion is likely to touch on several key topics including:

  • Vue MotionHow zero footprint imaging viewers and other applications can streamline access while preventing the need for physicians to download—and log into— multiple applications.
  • Security measures that will be required for a mobile environment; and
  • Plans for patient access to medical images and data in the future and how/if mobile devices will be supported.

What is your facility’s biggest challenge to providing mobile access to imaging data?

If you already deliver mobile access to images/reports, has this improved physician satisfaction?  

Visit Carestream at SIIM 2012 in Booth #505.

Using Design for Lean Six Sigma in Healthcare Product Development

Helen Titus

Helen Titus, Marketing Director, Digital Capture Solutions, Carestream

Back in 2009, USA Today reported that “Each of the nation’s 5,700 hospitals must cut $2.6 million a year on average in costs in the next 10 years to meet the demands of President Obama’s proposed health care reform, a daunting task when half of those hospitals lose money.”

While healthcare reform continues to evolve, the recognition that eliminating efficiencies allows us to work smarter, not harder—and provide more cost-efficient higher quality care—is fueling lean six sigma process improvements throughout the hospital ecosystem.

But hospital providers aren’t the only ones turning to lean principles. Lean Six Sigma is driving innovation in our product development to ensure what hits hospital hallways has been designed through disciplined problem solving that helps overcome your challenges. Challenges like:

How do we bring the very best image quality to the sickest patients in the hospital (those in the ICU) in a way that is the most efficient and easiest for the technologist?

You can learn about the role LSS played in the design of our mobile x-ray system — the CARESTREAM DRX-Revolution — over on Blogging Radiography.

Researchers Favor Annual Mammograms With No Family History

Stamatia Destounis, MD, FACR

Stamatia Destounis, MD, FACR, Elizabeth Wende Breast Care

Editor’s note:  Doctors at the Elizabeth Wende Breast Care in Rochester NY recently presented a study in Vancouver on breast cancer risk factors in women under 40.  Stamatia Destounis, MD, FACR, the study presenter at the ARRS annual meeting in Vancouver, answers three quick questions about the study’s reception and the continuing breast screening controversy.

Q:  At the American Roentgen Ray Society Annual Meeting you presented your finding on the ideal age for women to begin screening mammograms and the appropriate intervals between screenings. How were your findings received at the conference?

A: There was interest and enthusiasm at our results which revealed that women in their 40’s with no family history of breast cancer benefit from having a yearly screening mammogram, as a considerable number of the cancers diagnosed in this age group were through screening mammography, and 64% of these women had invasive breast cancers with 26% of these having metastatic lymph nodes. These are cancers that need to be found and can’t wait for women to be fifty before starting to have a screening program.  Controversial recommendations from some Organizations have recently argued that women in their 40’s don’t need screening mammography until they are 50 and our data do not agree with them at all.
Q: The screening debate seems to have new twists and turns often. For physicians speaking with confused patients, how would you recommend guiding the discussion?

A: Most women don’t have a family history of beast cancer when they are diagnosed with breast cancer. We believe that a screening mammogram yearly starting at age 40 saves lives as many well organized and regulated trials have revealed in the last 20-30 years. We recommend a yearly mammogram for women in their 40’s and our own review just presented in Vancouver revealed that a considerable number of women in their 40’s with no family history of breast cancer were diagnosed with a screening mammogram, revealing approximately two thirds of these patients having invasive breast cancer and a third with metastatic breast cancer.

CARESTREAM Vue Mammo Workstation

Q: Do you feel the screening debate is harmful to women’s health? Has the media attention impacted screening rates?

A: I think women and their health care professionals are getting confused by the controversy surrounding screening mammography and the constant media frenzy with controversial and conflicting analyses, data collections and personal opinions. There are many opinions, and emotion regarding breast cancer and this adds to the continued controversy.

Push to measure, control pediatric dose gains steam

Helen Titus

Helen Titus, Marketing Director, Digital Capture Solutions, Carestream

Creating exposure ranges for pediatric patients is an important goal—with action taking place on several fronts. Researchers from six children’s hospitals in the U.S.are collaborating to build the first pediatric CT dose index registry. The QuIRCC project is designed to help healthcare providers “child-size” their scanning protocols by giving them a better metric to measure radiation exposure. This project establishes typical dose settings through surveys and then adjusts them, based on patient size, to levels that are significantly reduced while remaining diagnostic.

At the same time, a new FDA program focuses on scanner instrumentation as a means to reduce dose. New FDA guidelines, open for public comment, propose that new medical imaging devices would come with dose settings and instructions for children of different ages and sizes — or be labeled “not for pediatric use.”

Carestream’s latest software for our CR and DR imaging systems provides seven levels of dose control—which exceeds the four levels requested by the FDA. This software offers exposure techniques for seven different ages and/or sizes of pediatric patients. It equips technologists to quickly and easily set a different technique for a neonatal infant as opposed to a toddler.DRX-Revolution

Optional software also offers quality testing (using a phantom) to assure that the CR cassette and DR detector are meeting performance parameters. And analysis and reporting software monitors exposure indices for all exams conducted on Carestream’s CR/DR platforms. Existing customers can upgrade to the new software to take advantage of these dose optimization improvements.

Is your institution monitoring dose for pediatric patients? Have you set guidelines and how do you monitor pediatric exams?

Inside IT Strategies – Moving Radiology Workflows to the Cloud

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

Last May I was interviewed by Imaging Economics for a story about healthcare trends driving “The Cloud’s Clout” and its application in diagnostic imaging. A year later and many of the issues challenging providers remain the same – an explosion of big data, system consolidation and performance degradation, and scarce IT resources.  Add in healthcare reform, the emphasis on accountable care and value-based purchasing, and cloud is becoming even more prevalent in CIO conversations.

So it’s no surprise that cloud computing continues to dominate the discussion at health IT conferences like World of Health IT in Copenhagen or the upcoming SIIM event in Orlando. And in social media the cloud conversation is at a fever pitch with more than 125 tweets per hour sent with the #cloud hashtag.

But I am seeing a shift in the discussion. When I talk to healthcare CIOs we are no longer focused on cloud computing as a service that provides cost effective image archiving for diagnostic imaging. The conversation has shifted to virtualization of the complete radiology workflow. Can this infrastructure drive scalable performance? Distribute images to remote radiologists?  Provide access to advanced reading tools? Deliver reports to referring physicians? Act as redundant data storage? All while unlocking better resource utilization and lower operating costs?

These CIOs also want to understand how cloud-service providers are collaborating with the IT vendor ecosystem to protect them from technology obsolescence and ensure new levels of data performance, reliability and security. And they demand proof that the cloud’s early adopters have seen the promise of ehealth become a reality.

Our recent collaboration with Intel speaks to the growth and maturation of the cloud in diagnostic imaging. With 10 data centers worldwide and our study count rising to 80 Million, we regularly need to increase our processing power to account for ever-more-detailed images and the larger file sizes they bring. With the Intel® Xeon® processor E5 family, we can significantly boost the processing output that can be achieved with each server. Compared to the previous generation of Intel Xeon processors, the latest models can process images up to 28 percent faster and can handle 24 percent more users.

Watch the video below to see how three diagnostic image providers across the globe are reaping the benefits of cloud in their IT strategy and the impact the Carestream and Intel partnership has on their performance.

Enhanced security and disaster recovery drove Orleans Regional Hospital to be the first hospital in France to have chosen an off-site data center for medical image archiving and retrieval.

Cloud-based PACS system improves data availability for Klinik Dr. Hancken in Germany.

Renaissance Imaging Medical Associates in the U.S. coordinates the work of many radiologists in multiple locations through a private cloud solution.

How do you think the cloud buzz has evolved? What IT strategies for moving medical images to the cloud have caught your attention?

Explosion of Data, Need for Consolidated Archiving Prompts CIOs/CTOs to Consider Cloud

Bruce Leidal

Bruce Leidal, Chief Information Officer (CIO), Carestream

The largest integrated healthcare system in Illinois is investing $40 million in technology to consolidate its data centers into a private cloud. The system’s CTO discussed the project at the Interop 2012 conference inLas Vegas last week.

The staggering sum of $40 million (which represented only a portion of the total equipment investment) highlights the escalating costs created by the explosion of data in healthcare. Imaging modalities—particularly 3D scans such as MR, CT, cardiology, and fluoroscopy exams—are voracious consumers of storage resources. In addition to expanding storage resources, CIOs also need to consolidate legacy departmental systems into a vendor-neutral architecture that achieves efficient information exchange required by meaningful use regulations.

When faced with investing millions of dollars in a new storage platform, many CIO/CTOs may decide to evaluate cloud-based service providers that offer a full spectrum of capabilities and configurations.

Fully featured cloud based services include:

  • A pay-per-use basis; costs are predictable based on imaging/data volumes and does not require an upfront capital investment
  • A delivery of service model that is always available and keep up to date
  • Protection of infrastructure obsolesce over time
  • High service levels versus having to attract and retain top skilled IT infrastructure talent
  • Vendor-neutral infrastructure ensures patient information and images can be easily shared with all authorized users (collaboration with on-site and off-site doctors) or brand of solution regardless of location, as well as integrated into an EMR/EHR.
  • Provide your business users with zero-footprint viewers to expedite access to clinical results via mobile devices (including Apple iPads) as well as PCs or workstations,
  • Maintains ongoing compliance with ever changing regulatory requirements.
  • Ensures business continuity and disaster recovery

CIO’s need to carefully assess their capabilities of providing necessary services and support to ensure the highest level of service with the lowest operational expense. In addition, they must become comfortable with key data being stored outside of the four walls of the business.

Carestream Cloud Illustration

Have you evaluated cloud infrastructure services for your facility? What do you see as the benefits and drawbacks to cloud storage?

The future of breast imaging is in the making.

Anne Richards, Carestream

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream

Q: Are you seeing more young radiologists going into mammography services? 

A: At mammography conferences and continuing education courses around the world, I’ve been seeing younger participants than in the past. In fact, I’d say that more than half of the radiologists attending a recent seminar in Brazil were under the age of 40.

This is a great trend for the future of our field!

Historically, breast imaging in general—and mammography in particular—has been viewed as a difficult and unglamorous vocation.

It involved the monotonous task of looking at primarily normal images. It has been characterized by a high rate of recalls and retakes, as well as low reimbursement and higher risk of litigation. Compared to interventional radiology and other specialties, it just didn’t have the “wow” drawing power.

So what is attracting today’s up-and-coming radiologists to this area of specialty?

The multi-modality nature of breast imaging may be part of the answer, with mammography, ultrasound, MRI, and molecular imaging being used in tandem for screening and diagnosis. In addition, advances in digital technology are making this a cutting-edge discipline with appeal for younger medical school graduates.

Beyond just the technology, though, there is the point on which we all can agree: screening mammography saves lives. And saving lives is a strong motivator for anyone in the field of medicine.

If you have an open fellowship in breast imaging, let me know. Together, let’s do all that we can to encourage these future luminaries in the making.

What motivated you to go into the field of breast imaging? Who supported you in your efforts?

Place Your Guess in the May X-Ray Image Challenge

Congrats to Jeremy Enfinger, who was this month’s “Guess The X-Ray” challenge winner! Jeremy correctly identified the image as an ipod.

Place your guess in May’s image challenge in the comments.

may x-ray challenge

This month’s “Guess the X-ray” challenge runs until June 4.  The first person to correctly identify the subject of the x-ray will be the winner.

Happy guessing!

Sorry… Carestream employees and their agencies are prohibited from entering. 

Dream Job: Lead Radiology Technologist for the Dallas Cowboys

Norm Burgess is entering his 28th season of imaging professional football players. Today he’s Lead Radiology Technologist for the Dallas Cowboy’s home games–a dream opportunity for many rad tech sport fans. Burgess gives us a quick look into game time imaging of professional football players.

 Q: You’ve been a Radiographer for the Dallas Cowboys for some time- what is the best part about this job? 

Norm Burgess

Norm Burgess, lead technologist, on field with the Dallas Cowboys, 2011

A: I’ve been a radiographer for the Dallas Cowboys since 1984, working on game days. I’ve seen so many different coaching styles and team personalities.  I’ve been with them through 8 coaches, starting with Tom Landry.  Each coach brings different approaches and it is so much fun to be right up with all the action!  I’m located on the 30 yard line, Cowboys sideline,  in neutral NFL clothing, waiting for a page. Each game is fabulous, but participating in the 2010 Super Bowl game with the Green Bay Packers and Pittsburgh Steelers was awesome.  We see a lot of celebrities on the sideline from game to game, and they usually hang out standing by me on the 30 yard line.

Q: Tell us about imaging professional football players and the imaging facilities

A: One of the immediate obvious differences is the size of the patient.  Our table is a heavy-duty table designed to hold 1,000 pounds.  We have to adjust our techniques for the body mass of patients that are much larger and have much more muscle than the average person.

All our patients are STAT.  Myself and another technologist work as a team.  One of us with set up the image parameters, and the other will position the patient.  We have a third person that enters demographic data. The images are used immediately by the team physicians to determine if the player can return to the game and if the player needs additional medical attention.

Q: Working with professional football players has to be interesting, during game days, what is most imaged at the stadium? 

A: We are mainly asked to image extremities, ribs, shoulders, knees, elbows and sometimes cervical spines.  The clinicians are looking for fractures. During some games I’ll be on the sidelines for a full quarter then off to start imaging players, sometime until the entire game is completed.  We usually image 8+ players for each team during a game.  The stadium’s digital x-ray room the same size as an x-ray room in any medical center.  Only this one is only used during games.  The stadium is used for some college games, including the Cotton Bowl, so I’ll participate in those events too.  During the football season we’ll be at all the home Dallas Cowboy games and 4 or so college games.

Q: How imaging changed in the past 27 years? 

A: I became a Registered Technologist with the ARRT in 1967 through a hospital based program in Austin Texas.  When I started with the Cowboys, our imaging was film based.  Now we are all digital.  We image for both teams.  At the end of each game we download images to CD/DVD’s of the visiting team to take back with them. During the game we can transmit the images via our PACS to the visitor locker room for them to review on their workstation.  In my wide variety of radiographer roles throughout my career, the commonality is STAT.  The quicker the image is available, the sooner the player can diagnosed.

What is your dream radiology job?