Why Multiple Modalities are Key for RIS/PACS

The ability to look at multiple modalities on one display is an important feature for PACS/RIS and one that technologists routinely rely on for studying medical images.

In the video below, Neil Halin, Chief of Cardiovascular and Interventional Radiology at Tufts Medical Center, demos the Carestream Cardiology PACS. Dr. Munn explains how the products of PACS/RIS vendors that can handle larger systems have a big advantage. This is because if those vendors can handle larger systems well, then the accumulation of quality data for submission in terms of ACO status will become important and helpful.

For more information, you can read about Carestream Vue PACS and its various features.


Why the Cloud is Leading the Way in Medical Imaging Storage

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

The findings released in a recent Wall Street Journal article about the storage of medical images were not the least bit surprising. According to Frost & Sullivan, the amount of storage volume needed to house medical images has more than tripled since 2005, and is projected to double in the next five years. To address these alarming numbers, healthcare facilities are more often looking to the cloud, and for good reason.

The hospital in the article, Henry Ford Health System, needed to invest $200,000 in hardware and software upgrades to its image archiving system, it opted for cloud services. The biggest financial advantage of this was the removal of the large capital investment and the installation of a more affordable service that housed the images offsite at a reasonable upfront cost and monthly usage fees.

A story like this is becoming all too familiar in today’s healthcare industry. The Wall Street Journal article stated that 15% of healthcare systems in the U.S. are using cloud storage services and that number is only going to increase as image volume does. In addition to the financial advantages that cloud services provide over time, the human capital space needed to invest in managing in-house storage facilities are also alleviated. The days of internal data centers are dissipating, along with the numerous hours invested in maintaining the hardware and software. With cloud services, those responsibilities fall on the service provider.

VNA accessThe article was smart to point out one of the key concerns when it comes to cloud services: security. This concern has easily been the strongest roadblock to adoption, but it can be combated with trust between the healthcare organization and the service provider. While human capital is moved away from the hardware and software upkeep, it is now focused on partnering with the provider to understand where the data is stored, how data are stored, the security measures that the vendor has in place, and a checklist to ensure that all compliance measures are in place.

In all of this talk of cloud services and medical image storage, the key question to keep in mind is, “What allows the healthcare organization to provide the best care possible for its patients?”

Cloud adoption is not universal yet. Not by a long shot. But it’s gaining ground, and this is because health facilities who implement it are finding that they are able to provide healthcare that is more affordable, of a higher quality, and is more efficient. The switch to the cloud won’t happen overnight, but with more stories like the Wall Street Journal article showing up, that switch is destined to happen at a more rapid pace.

You can click on the following links for more details about Carestream’s cloud and archiving capabilities.

What is a Vendor-Neutral Archive and How Can it Benefit Healthcare Facilities?

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

Workflow is everything in a hospital. Not only do doctors need to perfect surgical processes, but informational processes must be perfected too, or else care might not be delivered to a patient in a timely manner. There is a breadth of technologies available today for facilities that work to improve the quality and efficiency of delivered care. The vendor-neutral archive (VNA) is one of the more popular technologies and for good reason.

The definition of a VNA often refers to an enterprise storage and workflow solution that uses neutrality to resolve a range of workflow challenges within the organization. To work properly, a VNA system must work seamlessly with other installed systems. Integrating with storage systems and adhering to numerous open standards allow the capabilities of the VNA to manage large volumes of information sharing.

The concept of neutrality is literally central to a VNA. Data must be stored in non-proprietary, interchange formats. This is what differentiates a VNA from a traditional departmental archive running a proprietary or DICOM (digital imaging and communications in medicine) only format. The sharing of DICOM and non-DICOM data, text-based information, PDF documents, and images requires large volumes of storage and sharing, so even if a facility’s initial plans call for DICOM-only storage, neutral systems must be present to support other systems.

The importance of neutrality continues in the ongoing process of the consolidation and migration of clinical information. The strategic plan for an imaging system should acknowledge the data migrations across heterogeneous vendor systems, which leads to establishing a balance of clinical workflows and data consolidation. This approach provides the benefit of allowing a facility to maintain a legacy archive to manage historical information until a new storage system can be purchased.

The consolidation of data requires mechanism to ensure its integrity and synchronization—both vital in supporting worklists across various facilities around the world. Physicians require a unified view of a patient’s available information. To achieve this, the synchronization of incoming DICOM and non-DICOM images, reports, lab results, notes, etc., is a necessity. This capability also enables a multi-VNA installation to provide geographic disaster recovery and business continuity. That way if one system fails, the information remains accessible and transmittable in times of need.

In the end, the consolidation of existing clinical storage systems through virtualization and the elimination of multiple online/offline tiers can be made possible by the use of a VNA. Doing so creates opportunities to move infrastructure to the cloud, as many VNA providers offer managed services that maintain all aspects of the system-related expense. The result is significant cost savings and management benefits since fewer personnel are needed for system upkeep. To improve enterprise imaging workflow, the zero-footprint universal viewer serves as an important link. In all, the VNA can alleviate the daunting IT demands that go into supporting hardware and software for larger clinical bases.

For more information about VNAs, as well as real-world examples of healthcare facilities implementing VNAs to improve workflow, check out the white paper below, “Vendor-Neutral Archives: A Real-World Solution for Patient-Centric Workflow.”

A Perfect Fit: Uniting Medical Imaging & Patient Engagement

Instead of seeing health reform as a challenge, our own Cristine Kao, global market director for HCIS at Carestream, believes it is an opportunity to improve what we are doing in healthcare on a day-to-day basis. That opportunity for improved care is being led by the patients, who are becoming increasingly involved in the monitoring and management of their own care.

In the video below produced by Intel Healthcare, Kao explains why patients are becoming more involved in their care, how medical imaging fits into the mix, and what Carestream’s MyVue patient portal offers to complement this trend.

The portal empowers patients to access, share and help manage their own images and exam data using a range of user-friendly browser-enabled devices. It allows real-time collaboration between patients and healthcare providers – helping to eliminate the need for duplicate exams and the production of CDs, DVDs or films.

[youtube http://www.youtube.com/watch?v=nRqdD41XRVI?rel=0&w=560&h=315]

Doing MORE with Health IT Through Applications

Saskia Groeneveld, Wordwide Marketing Manager, HCIS, Carestream

Saskia Groeneveld, Wordwide Marketing Manager, HCIS, Carestream

Picture archiving communication systems (PACS) are a norm when it comes to uniting the needs of medical imaging and healthcare IT.

An important idea to keep in mind is that the complete capabilities of a PACS do not stop upon installation. To effectively provide the best service and functionality, healthcare facilities with a system must be up-to-date with upgrades and applications offered.

Carestream is currently offering our customers MORE when it comes to using our Vue platform of PACS applications. The upgrades and applications being offered include:

The latest version of Vue PACS: Provides new tools to help radiologists speed through 3-D volumetric studies, CT, PET, ultrasound and more. This upgrade can also allow access to new embedded clinical applications, reporting tools, Vue Motion, MyVue, Vue Beyond and archive expansion.

Powerful processing tools: All-in-one clinical workstation housing a suite of powerful processing tools lead by the PowerViewer. These applications reduce the reporting cycle without compromising the quality of the diagnosis.

Diagnostic confidence: New, embedded clinical applications like Lesion Management are diagnostic tools designed to improve productivity and diagnostic confidence. Precise lesion measurement is critical for reliable evaluation of metastatic disease and faster assessment of the patient response to cancer treatment. This upgrade introduces the capability as a native PACS application, helping to eliminate the cost and delays of a dedicated workstation, and enhancing assessment of oncology patients.IB_X_medium_RGB

Digital Breast Tomosynthesis (DBT): Allows the ability to read traditional Mammograms, Breast Ultrasound, Breast MRI, General Radiology or Digital Breast Tomosynthesis (DBT) exams from a single desktop. We can also securely archive DBT exams to allow access from any Vue PACS Mammo Workstation.

Reporting – Vue Reporting: This tool delivers native digital dictation or voice recognition, enabling much faster dictation. Radiologists no longer have to handle multiple log-ons or erratic integration, or lose time inputting clinical context such as measurements or DICOM metadata.

Patient empowerment – MyVue: This application allows patients to access, share and manage their own images and exam data. A secure portal, MyVue allows real-time sharing and collaboration between patients and healthcare providers, helping to eliminate the need for duplicate exams and the production of CDs, DVDs or films. This means potentially significant savings in both time and money.

Accurate, timely delivery of information – Vue Beyond: This tool for PACS and Archive is a web-based dashboard that provides real-time access to the departmental performance indicators.

Consolidation: Clinicians need access to the entire patient portfolio to make sound critical decisions. Vue Archive offers a multi-tier repository for data stored using XDS, XDS-i, DICOM, and HL-7 standards as well as other non-DICOM objects. Paired with the Vue Motion universal viewer (which can access and display many types of clinical data) it provides a vendor-neutral repository that is safe, manageable, and flexible. Moreover, it protects users from technology obsolescence, and enables continuous adaptations for evolving IT needs.

While this post provides an overview for many of the Carestream applications that allow you to do more with Vue PACS, it does not cover everything. Click on the link to learn more about the applications and add-ons you can use to create a PACS setup that offers the most to your facility and to your patients.

Moving Forward in Carestream PACS Upgrades

We have an eXceed corporate commitment to our customers at Carestream that promises them that “our focus is your success.” One of the four components in this commitment is outstanding. This refers to delivering to outstanding performance to our customers–both through our service and through our products.

Innovation is vital to providing this outstanding performance. We must be sure that out products are addressing our customers’ need and allowing them to provide the best care possible to patients.

With our PACS, the next phase of our upgrade will include 64-bit computing. Over the last couple of years, some impressive improvements have been made to scanners that have created large volumes of images that need to be processed online. To address this, Carestream has made the decision to migrate our workstation platform and the server platform into full 64-bit support, allowing our customers to handle those larger data sets seamlessly.

Our director of R&D for PACS, Seffi Markov, explains more in the video below.

[youtube http://www.youtube.com/watch?v=6kTvIhawmUw]

What Features Should You Analyze When Shopping for a Mobile X-ray System?

Helen Titus

Helen Titus, Marketing Director, X-ray Solutions, Carestream

The benefits of using a mobile X-ray system are numerous. Because of this, it becomes the responsibility of the radiology team to truly narrow down the specifics of what they are looking for in this technology. What follows is an outline of key features that radiology departments should be looking into when analyzing mobile X-ray systems. By finding the best system possible, radiologists are assured that their processes will be efficient and effective in delivering high quality images, leading to improved healthcare.

Visibility and ease of transportation: With the need to move from room to room, mobile X-ray systems must not block the radiologist’s view when maneuvering the technology. A collapsible column is the perfect feature to provide the technologist with a clear view when steering the system around a facility. Additionally, it should be nearly effortless to transport a mobile X-ray system. Health facilities can be tight quarters, particularly ICU rooms, so the smoother an X-ray system moves, the less strain on the technologist.

Image processing speed and preview: Speed is of the essence in a state of emergency. The mobility of these units provides versatility for the system, and a speedy image processing time can allow technologists and attending physicians to preview and analyze images in a matter of seconds and send them immediately to the radiologist via PACs. This is imperative when working in areas such as the OR, ER, or ICU when time is of the utmost importance.

Reliability and flawless implementation process: A mobile X-ray system needs to be usable and effective at all times. Downtime is unacceptable, but if the unfortunate were to happen, administrators  must be confident in their service providers that the problem can be identified and fixed in a short amount of time. Likewise, the installation and implementation process must be quick. An intuitive mobile X-ray system that allows easy user functionality lets the staff learn about the technology in a short amount time, which means that they are in the ICU, OR, or ER using the system sooner rather than later.

Recently, as a testament to our dedication to creating and providing the best technologies to our customers, the Carestream DRX-Revolution Mobile X-ray System earned the top rating in MD Buyline’s First Quarter 2013 User Satisfaction Report for portable radiographic systems. The report includes user ratings in the following categories: system performance, system reliability, installation/implementation, applications training, service response time and service repair quality.

You can read more details about this announcement via this DRX-Revolution link.

DRX Revolution

Partnering Up with Intel to Test Next Generation of Efficient Image Storage and Management

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

Storage is an important component of our healthcare information solutions (HCIS) solution offering. Archiving images and allowing efficient and effective access to those images is a major offering in our PACS and VNA solutions, that to not provide our customers with the best services would serve as a disservice to both them and us. To consistently ensure quality storage, archiving, and access capabilities, we must work with the best business partners to stay ahead of the technology curve.

When it comes to allowing access to data, our cloud data center architecture must be engineered in a way that allows for optimal upload and transportation of images across their networks. With plans to expand our cloud services in the UK, a new data center is planned with optimal network and storage architecture. With Intel as a long time partner to Carestream, we decided to test a converged network adaptor that is designed to support heavy server traffic and image data volume on the storage area network. The early Proof of Concept along with the existing data center designs shows promising results of lower total cost while maintaining performance.

What Carestream gains in business values from an optimized cloud data center design, our customers will benefit as well. A partnership with companies like Intel allows Carestream to continuously evaluate the best technology solutions available, ensuring our customers has access to consistent high-quality service. Additionally, Carestream will be capable of upgrading to more flexible and manageable infrastructure, meaning that the company can adjust accordingly to meet the needs of our customers’ usage and technology requirements.

Existing in an ever-changing healthcare environment, versatility and agility are important to both us and our customers. This partnership with Intel ensures that we’re able to stay at the top of our game and provide the best products and services possible to our customers.

If you’d like more details about this partnership and the Intel converged network adaptor that we’re using, you can read the company’s case study about converging server and storage network traffic.

Solutions to Making Digital Breast Tomosynthesis Widely Accepted in Mammography Imaging

Ron Muscosky, Worldwide Product Line Manager, HCIS, Carestream

Ron Muscosky, Worldwide Product Line Manager, HCIS, Carestream

The challenges with digital breast tomosynthesis are well explained in this article on AuntMinnie, and very real. At Carestream, we have been working with digital breast tomosynthesis data from various vendors to provide solutions for these very same issues.  Although there are many different aspects to consider when adding digital breast tomosynthesis, I’ll explain some of the solutions we’ve found and hope others find them to be useful.

Since digital breast tomosynthesis is relatively new, we are finding that the level of support each vendor provides varies significantly.  We decided to embrace digital breast tomosynthesis from the start since we believe it will have a place among the various different technologies used to detect breast cancer.  Other technologies will continue to evolve to the point where each will have a place as well.  The clinical benefits of digital breast tomosynthesis are still being debated by some, but it has rapidly gained supporters in the Radiologist community.

While support continues to grow,  two main barriers that exist include reimbursement and dosage.  Reimbursement will definitely help encourage widespread acceptance from a business perspective. And, with the various acquisition device vendors working on synthetic 2D images, it appears the dosage barrier can be overcome as well.  This may open the door for digitial breast tomosynthesis to be used on a regular basis in the screening environment.

Regarding the storage of the digital breast tomosynthesis data objects, we have found that in addition to the use of lossless compression, adequate network bandwidth and intelligent routing/pre-fetching of data are vital to efficiently move such a large amount of data transparently to the user.  This is especially true when reading such procedures across multiple facilities and/or remotely. We are recommending that internal networks support 1 Gigabit, as some of the acquisition device vendors have done..

As mentioned in the AuntMinnie article, earlier digital breast tomosynthesis data may have been stored using a proprietary format. Our current understanding is that the conversion process being provided can be scheduled during the evening or weekend, so there is little or no impact during normal business hours. Although this conversion process can appear to be a daunting task at first, it is important for a site to maintain data that follows the DICOM standard moving forward for interoperability.  Otherwise, the task becomes much larger at a later time.  The same will be true for synthetic 2D images in the near future.

Another challenge outlined in the article is the additional time needed to read digital breast tomosynthesis images.  Similar to when digital mammography was first introduced, users experienced a learning curve not only with reading the images, but also with using the workstations and the tools that they provided.  We believe the same is true with digital breast tomosynthesis, where the reading time will decrease as both of these improve.  Focusing on the tools provided by workstation vendors, we have found that a key aspect to optimize the reading time is not only through basic tools that automatically scale and position both 2D and 3D images, but also advanced tools that can help localize pathology and allow the user to quickly navigate current and priors studies.  It is not enough to just stack a series of tomosynthesis slices and allow the user to scroll through them at will.  With traditional 2D mammography, digital breast tomosynthesis, synthetic 2D mammography, and other mammography procedures (e.g. breast US, breast MRI, etc.) being generated, workstations with hanging protocols that can support and display all of these in an efficient manner become extremely important.

As the IHE Mammography Image integration profile is expanded to include digital breast tomosynthesis, our expectation is that the interoperability issues experienced early on will at some point be resolved by most vendors.

The video below shares more information about digital breast tomosynthesis and Carestream’s capabilities in that area.

[youtube http://www.youtube.com/watch?v=31DX2Y_UOh0?rel=0&w=560&h=315]

Guess the X-Ray – April’s Image Challenge

A big congratulations to the person who correctly identified March’s Image Challenge, which was a mango. Many people identified that it was a melon, but it was definitely difficult to tell what type.

We’re chugging along in 2013, and we’re already onto the image for April! We’re ditching the fruit this month and heading back into the direction of devices. Please leave your answer in either the comment section below or on our Facebook page. The challenge will run until April 30 or until the first person correctly names the item in the image. Good luck!

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