The Stage 2 Opportunity for Zero-footprint Universal Image Viewers

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

As the radiology community makes sense of the final stage 2 meaningful use rules many provider CIOs, CMIO and radiology department heads are looking closer at their CEHRT image access strategy.

In the final rule, CMS set a threshold of 10 percent or more of imaging results accessible through certified EHR technology, with exclusions for providers who order less than 100 scans in an EHR reporting period, and for providers who do not have access to electronic images.

CMS also clarified that images do not have to be stored in the EHR, but there must be a link to where the image and information can be accessed.  This important measure provides easy access to patient images to reduce the ordering of duplicate, unnecessary exams, minimize exposure to radiation and help contain healthcare costs.

To prepare for compliance with stage 2, providers will now need to identify how they will merge EMR systems with RIS and PACS to enable image sharing and collaboration for improved care coordination.

One avenue to satisfy meaningful use criterion is a zero-footprint viewer than can serve as an intermediary between the RIS/PACS and EMR. To fulfill this potential, the viewer must be available remotely to enhance physician access to all PACS images. It must allow embedding in an EMR system to provide access to reports and images alongside the patient’s other medical information. Moreover, the viewer must provide access to DICOM, as well as non-DICOM image related data, such as JPEG images and PDF documents. The viewer’s use must not be restricted to a single IT-system or facility, but offer extensive compatibility to provide secure access to images across and beyond the enterprise—for physicians and patients alike.

Carestream’s Vue Motion vendor-neutral imaging viewer can be embedded in EMR and HIS portals to access images contained in the PACS, thereby image-enabling the enterprise. The viewer can be launched without calling up a separate application or logging into another system. Alternatively, it can be launched in a separate window without requiring a separate log-in, using a URL from within the system.  It leverages the PACS server to do the vast majority of the rendering, thereby significantly reducing the volume of data to be transmitted. And, because rendering is done on the server side, there are no data storage requirements on the zero-footprint side.  Features like the display of current and prior images side-by-side and the ability for clinicians to input order notes to the exam can facilitate better collaboration between referring physicians, specialists and other clinicians. Here’s a quick demo of how our Vue Motion works:

Are you evaluating zero-footprint image viewers as a piece of your strategy for stage 2? 

DRYVIEW Chroma Imager Trade Trial at Italian Hospital: Satisfied Physicians, More Referrals

Editor’s Note: Casa di Cura Sileno e Anna Rizzola hospital in San Donà di Piave, Italy, recently participated in a trade trial for Carestream’s DRYVIEW Chroma Imager. We asked Dr. Riccardo Dus, M.D., Director of Diagnostic Imaging Services, to discuss the hospital’s experience with the product.

Through a trade trial with Carestream’s DRYVIEW Chroma Imager, we found that high-quality paper output of medical images from this device enhanced satisfaction among our referring physicians – to the extent that referrals have increased.

Let me provide some context: Our diagnostic imaging team performs 50,000 imaging exams annually on the CR, DR, MR, CT and ultrasound imaging systems at our 100-bed Casa di Cura Sileno e Anna Rizzola hospital. Previously, we furnished referring physicians CDs containing patient images from these exams. As part of the trade trial, we began supplying hardcopies of selected images, along with a full compilation of images on CD. The hardcopies constituted images printed on Chroma glossy medical paper in A3 (420 x 297 mm) and A4 (210 x 297 mm) sizes.

DRYVIEW ChromaOur referring physicians responded enthusiastically. We learned that they greatly appreciate the convenience of viewing images on paper at their desk or in an exam room with a patient. Consequently, as mentioned above, these physicians have begun referring more patients to our hospital.

We now print approximately 600-800 medical images per month with the DRYVIEW Chroma Imager. Handling the volume has not been a challenge: The printer has a roll paper feeder that automatically cuts the paper to either A3 or A4 size, thus improving the productivity of our department. We simply select the paper size and the printer handles the output. This is a tremendous advantage: Our technicians do not need to constantly check and replenish the printer’s paper supply throughout the day, nor do we need to stock two different paper sizes.

The printer also was easy to set up and has proved extremely reliable. Plus its initial price and ongoing operating costs make it very cost effective. But we did not install the DRYVIEW Chroma Imager for these reasons. Our primary motivation was to find a printer that could deliver high-quality paper output to better meet the needs of our referring physicians. We accomplished that thanks to the DRYVIEW Chroma Imager.

The Culture of Technological Evaluation: Tackling Spain’s Healthcare Challenges

David Magboulé

David Magboulé, Marketing Manager, Carestream Health Spain and Portugal

Despite the current economic problems affecting the healthcare market in Spain, everyone involved in the decision making process agrees on the need to invest in innovation to take us in the right direction. In this particular case, new technologies will play a crucial role in speeding up and improving the work of medical teams. In turn this will have a direct impact on improving diagnostics and will help lead to a better quality of life for patients and better patient care.

To tackle these challenges, a new concept has recently been introduced at national level. Derived from the application of the use of new technologies in the health system,  La Evaluación En Red (Network Evaluation) is an agency network set up to evaluate healthcare technologies and disseminate information to simplify the decision making process in the Spanish National Health System .

In Spain, the average life of diagnostic equipment in hospitals, such as CT scans or MRIs, is approximately 10 years.  For radiology rooms it is 8 or 9 years. Often medical equipment continues to be used past this timeframe as many hospitals do not have the financial resources to buy new equipment. For that reason it is a priority to get the message across that the implementation of new technology is a mid-long term investment and not a cost, and one that will have a direct impact on the improvement of the service, diagnostics and the quality of patient care. In that sense, our country is an international leader in the implementation of information technology in the healthcare sector, ahead of countries like Australia, Canada, the United Kingdom, France, Germany, Singapore or the United States. Our country is focused on how to make it easier to share patient information between organizations, which will then have a positive impact in preventing medical errors, reducing healthcare costs and reducing paperwork.

Of course there is a long way to go when it comes to the use and application of new technologies in the healthcare sector. One example that we can take as a reference point in Spain is the Agency for the Evaluation of Healthcare Technology in Andalucía, whose principal task is to provide quality information to help citizens to get involved in the decision making processes and promote an evaluative culture among healthcare professionals. At a European level there is also a global evaluation network run under the auspices of the Health Technology Assessment International association (HTAI), which over the last few years has become a benchmarking tool for healthcare managers and helps in the prioritization of healthcare resources and the adoption of new technologies.

It is truly necessary to create a culture of evaluation throughout Spain, using comparative models to raise awareness and to enable an appropriate response to global needs without losing the local perspective. This balance is essential, especially when it comes to evaluating technologies. The creation of a national agency will help with the decision to renew technology in hospitals and drive technology standards in all healthcare centres at a national level. The Evaluation Agency will also allow healthcare providers to make decisions on matters of healthcare technology that will help to optimize resources and improve the quality of patient care.

This long term investment in innovation should be the strategic vision of a healthcare model that goes beyond companies and public bodies to position the country as a reference at an international level.

A Spanish version of this post is available.  Continue reading

Video: AHRA Attendees Finally Get Their Hands on the DRX-Revolution

Don Thompson, Digital Capture Solutions, Marketing Manager, Carestream U.S. & Canada

Don Thompson, Digital Capture Solutions, Marketing Manager, Carestream U.S. & Canada

At last year’s annual meeting of the Association for Medical Imaging Management, radiology administrators had an opportunity to view a quick presentation and provide feedback on Carestream’s prototype DRX-Revolution Mobile X-ray System, which was not yet commercially available. A lot has changed in a year. The DRX-Revolution is now commercially available, and attendees at last week’s AHRA 2012 meeting finally got to see the product firsthand to see if our design addressed the needs users voiced:

Mobility – “There is a common fear of running into someone or something with a portable x-ray machine. The big column in the middle of the unit obstructs an operator’s view.”

  • So easy to maneuver, you can make a 360-degree turn while steering it with just one hand.
  • An automatic collapsible column shrinks the system to just over four feet tall, giving you complete visibility when moving the system to any location.
  • A long tubehead reach gives you easy access to the patient in crowded rooms.

Image Quality – “We discovered technologists didn’t use the grid for mobile imaging because of the challenging workflow parameters.”

  • Unique Tube & Grid Alignment System optimizes image quality and encourages grid use.
  • DRX-Revolution offers prior image review including techniques and exposure history by using query/retrieve from PACS.
  • Optional tube and line visualization software instantly verifies placement of tubes and peripherally inserted central catheter lines in seriously ill or injured patients.

Workflow: “Radiologic technologists wear gloves. They bag detectors when going to patient beds to avoid the transfer of disease. They clean their equipment with sanitizing wipes. But the mobile x-ray imaging unit they drive does not carry any of these tools.”

  • Touch screen monitors at both the tube head and main display provide two work zones just like a stationary DR room.
  • Position quickly with the lightweight, wireless DRX detector that eliminates trip hazards and reduces the spread of infection.
  • On-board bins keep gloves, sanitizer, paperwork, markers and lockable detector storage at your fingertips.

The imaging managers from Health First in Florida and Seton Highland Lakes Hospital in Texas both took test drives of the DRX-Revolution at the show and were kind enough to offer insight into portable imaging at their facilities, as well as their impression of the DRX-Revolution:

Did you take the DRX-Revolution for a test drive at AHRA? What did you think? 

New Real-Time Data Mining Tools Can Transform Radiology Administration

Robert Mack

Bob Mack, U.S. Manager of Vue Cloud Services, Carestream

With pressure for improved service quality and productivity, today’s radiology administrators need insight into the business side of imaging for critical decision support. At AHRA 2012 this week, much focus was placed on how to become a more decision-centric department and harness data in real-time.

We spent time with administrators at the show letting them get hands on with our new Vue Beyond software that delivers analytics and data mining to your desktop. Our business intelligence and reporting dashboard accesses PACS data to provide a real-time understanding of department workflow. You can easily view and drill down into accurate, quality performance metrics like study volume, modality mix, patient type, report turnaround and critical results notification to shorten patient wait times and enhance profitability. Access to real-time data can equip administrators to optimize personnel and equipment utilization, improve report turnaround times, and drive patient satisfaction.

This focus on the business of imaging is a shift from previous AHRA events. At the show, I spoke with Marianne Matthews, editor of Imaging Economics, about how vendors are stepping up to meet administrator business intelligence and data-mining needs:


Do you use data mining tools or have automated processes to assist with management of radiology processes? Does your current solution offer real-time data?

Live from AHRA 2012: A Peek at Dekalb Medical Center’s Digital Radiography Conversion

Erica Carnevale

Erica Carnevale, Digital Media Manager, Carestream

One of the best things about AHRA is the opportunity to hear directly from radiology managers about their successes and challenges. Malissa Smith, Radiology Manager at Dekalb Medical Center in Georgia swung by the Carestream booth at AHRA 2012 to discuss her experience converting from computed radiography to digital x-ray. The medical center recently converted their portable unit to digital radiography with Carestream’s DRX Mobile Retrofit Kit, having a big impact in the operating room and with surgeon satisfaction.

Malissa also provides feedback on the DRX-Revolution Mobile X-Ray System and how she anticipates it will benefit technologists.

How has converting to DR improved your rad department?

AHRA Opening Keynote: Success Through Partnership

Robert Salmon

Robert Salmon, Director, Corporate Communications, Carestream

Yesterday’s opening session at AHRA 2012 was equal parts enjoyment and enlightenment as Dr. John Paling—an Emmy-awarded, National Geographic wildlife photographer with an energizing gift for discussing how to deal with change and achieve incredible results in a world of uncertainty—offered insights on how to gain valuable perspective by looking at the natural world.

Many of us think of dealing with change as a relatively modern phenomenon, whereas Dr. Paling included segments from his stunning wildlife films as memorable metaphors for his key messages, as he provided breathtaking examples of how the animals and organisms that we have around us today are the winners of centuries of relentless change.

In listening to his presentation in which he portrayed the ways in which doctors and patients view risks differently and how they communicate, I began to think about how healthcare providers and technology vendors communicate and approach partnership, and how best to succeed.

Dr. Paling shared some fantastic imagery of a rainforest treetop orchid that successfully pollinates through a natural partnership with a green male beetle. The beetle in turn benefits from the pollen it carries from one orchid to another as it is bathed and perfumed by the orchid’s nectar in the process, which makes it more appealing to its female counterpart. It is a synergistic relationship that is mesmerizing in its beauty, and both organisms achieve life-giving results that play a key role in the survival and propagation of both species.

As I looked back at the many business relationships I have been privileged to form over the years, those relationships that have indeed become successful partnerships come the closest to the “Beetle and Orchid Ballet.” Where there is a trusted exchange of resources, information and support that satisfies the express needs of each party, and results in the success and healthy growth of those involved—those relationships are the ones where all involved have thrived. As often seen in nature, those relationship built on trust, respect and genuine collaboration where all participants understand and respond to each others needs are the ones that share the greatest success.

My passion for the wonders of nature could easily lead me to look at many more vivid examples of remarkable partnerships and life giving exchanges. But to bring it around back to the business and practice of healthcare: “How do you approach partnership? What was your greatest success and what insights have you discovered?”

Business Intelligence & Mobile Imaging To Take Center Stage At AHRA

Doug Spotts

Doug Spotts, General Manager, United States and Canada Medical Sales, Carestream

When the exhibit floor at AHRA opens tomorrow radiology administrators will be looking for innovative new technologies.  I’ll be in Carestream’s booth (#609) as we unveil capabilities that can impact radiology administrators, technologists, radiologists and ultimately patients:

  • A real-time view of departmental workflow that can help administrators improve staff productivity and profitability
  • New mobile imaging tools that display current and prior images side-by-side on an iPad; and
  • Features for the DRX-Evolution that can help limit patient exposure and optimize chest and pediatric imaging.

Our new Vue Beyond for Radiology can produce shorter patient wait times and enhanced profitability by providing a single real-time view into metrics like study volumes and turnaround times, modality usage, patient type and critical results notification to help administrators detect and understand any bottlenecks that exist in the departmental workflow.

Radiology administrators can take the DRX-Revolution for a test drive and see a demo of the Vue Motion imaging viewer that delivers two important features: side-by-side display of current and prior images on an iPad—a much-requested feature—and the ability for clinicians to input order notes to an exam.

With dose reduction sure to be on the mind of every professional at the meeting, our staff will describe a host of new capabilities for the DRX-Evolution including: image processing techniques optimized for pediatric views; linear tomography (not commercially available in the U.S.) that aids in viewing anatomy obscured by overlying organs and tissues; asymmetric collimation to help limit patient exposure during an exam, and Pneumothorax Visualization Software that creates a companion image (from the original exposure) to accentuate the appearance of free air in the chest cavity and aid in visualization of a collapsed lung.

This meeting offers the perfect blend of knowledge sharing and hands on access to new products that will redefine image capture and management. Hope to see you there.

What new technologies are you most interested in seeing at AHRA? 

AHRA 2012 Symposium: Will Cloud Services Impact Radiology Operations?

Robert Mack

Bob Mack, U.S. Manager of Vue Cloud Services, Carestream

Cloud Services Savings InfographicIs cloud computing on your agenda at AHRA? You’re not alone.

The adoption of free and simple cloud computing tools such as Google Apps, Skype, Flickr and iTunes for personal affairs, has lead CIOs and other technology executives to begin using those cloud-based software tools at work. At the same time, enterprise-focused cloud services such as Amazon Web Services are making it possible for startups and other companies to run their businesses at much lower costs. These two forces of cloud computing, adoption and economics, are driving down the cost structure of business at an accelerating rate. Cloud-based computing is fast approaching a tipping point that will make it the standard for IT.

For healthcare, the old days of IT systems and architecture built and managed entirely in-house, or partly outsourced to a few mammoth vendors, may soon be gone. In its place a hybrid model rises — one that maintains elements of the traditional IT foundation, but also takes advantage of new technology and platforms as they emerge.

Transitioning to the cloud enables healthcare organizations to take advantage of savings and improved functionality without complicating existing workflows. It can also position them to use the cloud to provide new services to patients and enter new markets, driving revenue and growth. Healthcare currently treats these two paths separately. However, at some point they will need to converge. When they do, Radiology Administrators will need to understand what it takes to effectively manage an integrated cloud model.

As you build your schedule for AHRA, I hope you join me Monday, August 13 at 7:45 AM in the exhibitor symposium, where we’ll talk about:

  • The impact of cloud computing on radiology operations
  • The developing role of patient portals
  • The changing relationships between radiology archives, clinical applications and patient data management
  • Effective roles that Radiology Administrators can carve out as their departments move to the cloud

Please stop by booth 609 to share your experience and opinion on cloud service adoption in radiology. Let’s dig into market transitions, delivery models, TCO and changes to vendor, provider and patient relationships. Hope to see you there.

AHRA 2012 Preview – The Countdown is On

Luann Culbreth

Luann Culbreth, M Ed, MBA, RT(R)(MR)(QM), CRA, FSMRT, FAHRA

Editor’s Note:  The Association for Medical Imaging Management opens it’s annual meeting on Sunday in Orlando, FL.  You can find Carestream in booth 609. Luann Culbreth, M Ed, MBA, RT(R)(MR)(QM), CRA, FSMRT, FAHRA, president of the 2011-2012 AHRA Board of Directors, offers a preview of the meeting in the guest blog below. Luann is also executive director of cardiology, medical imaging, radiation oncology at Saint Thomas Health in Nashville, TN. Luann can be reached at

This year’s AHRA Annual Meeting will, of course, be an intensely educational one for the radiology administrators who attend as our roles shift in light of healthcare reform and economic conditions. We’re required to get creative and back to basics by doing more with less. Yet, we’re still heavily focused on the patient and providing the best care possible.

AHRA 2012Our biggest opportunity as administrators is to be leaders of this transformation. We need to use our gifts of creativity and innovation to develop new healthcare delivery models. We need to be a part of the solution, utilizing cutting edge technology while realizing healthcare will not only be delivered in our hospitals but in our communities. With 32 million people having access to healthcare coverage, we need to model and encourage all healthcare professionals to practice at the top of their licenses and provide care that truly leaves no one behind. We need to understand how to meet the needs of the community at large, with focus on population health and population health management as our future.

In light of this, trends that are driving the meeting curriculum are healthcare reform and regulatory issues. The biggest thing addressed in the breakout sessions will be pay for performance – identifying and addressing radiology management concerns that affect quality, measurable outcomes, and reporting structure. Several of our breakout sessions are specific to charge capture, accurate coding and billing, and identifying opportunities to better position departments to avoid triggering audits.

AHRA DatalynxWe will also be educating attendees on AHRA’s new benchmarking tool, AHRAdatalynx. It is populated with data from a set of comprehensive surveys filled out by AHRA members. The ultimate goal is to have detailed operational metrics that will ultimately help drive better imaging operations. There will be an on site demo station for meeting attendees to see the tool in action, as well as an educational session on Monday August 13 at 4:00 PM.

And, of course, attendees always love the Wednesday night theme party (this year: Havana Nights!) and keynote speakers. There’s also going to be a special guest appearance by the young star of Broadway’s Billy Elliott (who just so happens to be an AHRA past president’s son!).

Attending an AHRA conference is like looking in the mirror… you see yourself everywhere. Look around and you find yourself surrounded by those who have the same professional experiences and needs you do. We all have the same requisite for education on the latest accreditation and government requirements, HR matters, safety issues, customer service ideas, etc. AHRA members are my content experts, they are who I turn to for ideas, know hows, and best practices.