How to Add Intelligence to the Healthcare System

Jerry Zeidenberg Publisher & Editor Canadian Healthcare Technology & Technology for Doctors Online

Jerry Zeidenberg
Publisher & Editor
Canadian Healthcare Technology &
Technology for Doctors Online

Radiologists are, without a doubt, some of the smartest people we’ll ever meet. But they’re not infallible, and IT systems are now being implemented to add further intelligence to the medical system. A case in point:

In September, Torontonians were shocked when a large community hospital announced that one of its radiologists made interpretive errors – missing stomach cancer in a patient who died eight months later – and that he might have made other mistakes.

Since the announcement, other patients have come forward saying they received clean bills of health after radiological exams at the hospital, only to discover later that they had tumours. Overall, 3,500 of the radiologist’s exams are now being re-assessed by an outside team.

Over the last couple of years, mistakes made by radiologists at other hospitals across Canada have been spotted. As a result, quality has emerged as a pressing issue, and projects are now being launched to double-check the work of diagnostic imaging departments.

In Hamilton, Ont., for example, a test system is being trialled that sends DI reports to a second radiologist for review. Neither physician knows the identity of the other, so professional embarrassment is avoided.

If a problem is noted, it is corrected before the results are sent to the referring physician. Similar tests are being run in British Columbia and Alberta.

The basic problem is that radiologists are only human and make errors. So the idea is to inject more checks and balances into the system and to catch mistakes early.

Another way of catching errors is to make greater use of computer-aided detection (CAD) systems. Some radiologists have pooh-poohed the technology as being inaccurate and only available for a few specialties, such as lung, breast and colon cancer.

However, these types of tumours are the top killers when it comes to cancer – any assistance in identifying them, as early as possible, would be a boon to patients.

What’s more, new CAD systems have steadily emerged, and there are new methods of dealing with the false-positives that tend to proliferate with CAD. Rather than writing-off CAD software holus-bolus, radiologists could be trained to better recognize the types of lesions that are identified by the automated systems. In this way, they can learn how to separate false-positives from actual tumours. A study by Nishikawa et al., reported in the March 2012 edition of the American Journal of Roentgenology, found the use of CAD in breast cancer screening increased the identification of tumours by 10 per cent. The authors concluded that additional benefits would accrue if radiologists learned how to better respond to the alerts given out by CAD systems.

On another front, medical attention can sometimes kill the patient with kindness – for example, too many X-rays, or doses that are too high, can result in radiation poisoning and illness.

That’s why both the Canadian Association of Radiologists (CAR) and the Canadian Association of Medical Radiation Technologists (CAMRT) have been advocates of the ‘image wisely, image gently’ movement.

Vendors have been responding with systems that can measure the X-ray doses received by patients from any number of machines. It’s a great way to identify patients who are getting too much ionizing radiation.

Moreover, the systems use analytics to determine when radiologists and technologists are using protocols that deliver too much radiation – managers can then provide feedback and constructive criticism to improve the way exams are delivered.

Analytics, of course, can also identify logjams and bottlenecks in patient flow – giving managers the opportunity to troubleshoot and improve workflow. The result? Better economics for DI departments and clinics. It also provides greater ‘customer satisfaction’ when the patient no longer waits as long for tests.

No one likes making mistakes, and if a computerized solution can reduce the number of medical errors that are made, reduce X-ray doses, and speed up the flow of patients, who can argue?

In the end, the public benefits, and the healthcare system achieves its goals of helping more patients and achieving higher quality ratings. It’s a win-win for patient and provider.

Jerry Zeidenberg is Publisher and Editor of Canadian Healthcare Technology, based in Toronto.

RSNA 2013: The ACR Teleradiology White Paper and What it Means for the Industry

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

The American College of Radiology (ACR) released a white paper back in May titled, “ACR White Paper on Teleradiology Practice: A Report From the Task Force on Teleradiology Practice.” The purpose behind this in-depth document is to provide best-practice guidelines for the practice of teleradiology, along with providing recommendations regarding future practices due in part to the large volume of changes that have been occurring throughout the healthcare sector the past few years, as well as the many future changes that we are sure to see.

The ACR opens the whitepaper by stating that the teleradiology market penetration peaked in 2010 at 50%. Because of this, many of the teleradiology companies have sought to expand and grow through acquiring existing hospital radiology contracts. These actions have prompted the ACR to declare that, “Uncertain market forces have compelled other teleradiology companies to rebrand or retrench.” From this and current trends, the ACR has made their recommendations based on the following principles:

  1. Patients are the primary focus
  2. On-site coverage is preferred
  3. There should be a single high professional standard of quality for both teleradiology providers and on-site radiologists
  4. Teleradiology service should be incorporated into the local operations related to safety and quality within the radiology practice, hospital, imaging center, and be assimilated into the usual medical staff credentialing and privileging process

What follows these principles is a list of recommendations regarding key aspects of the teleradiology business. Focusing on the teleradiologist, the teleradiologist’s work environment, interpretive services, payment and regulatory considerations and technology-specific considerations, the ACR has pinpointed the major areas that must be addressed if teleradiology is to remain a vibrant component of the medical imaging industry.

From its analysis of these areas, the ACR assigned 13 practical considerations for radiology practices in regards to teleradiology. The organization notes before listing these recommendations that they are not meant to be legal advice, and it is not an all-inclusive list of the issues that should be considered:

  1. There should be a clear statement on what constitutes a study or examination
  2. Hours of coverage
  3. Minimum and maximum volumes of examinations
  4. Response time – there should be a defined time for most reports to be available
  5. Modalities covered – specific modalities to be covered should be specified
  6. Subspecialty interpretations – clear definitions of what constitutes a subspecialist
  7. Credentialing – figuring out how many teleradiologists will be granted privileges and who is responsible for any associated fees
  8. Quality assurance – an established quality assurance program should be established that has undergone a formal peer review
  9. Malpractice coverage – all local requirements should be met
  10. Accreditation – the teleradiology provider should meet all requirements for the facility’s accreditation processes
  11. Record – contract should define who owns records and is responsible for sotrage and HIPAA compliance
  12. IT requirements – responsibility for network connections, reporting and resolving issues and tech support hours should be defined
  13. Standard contractual issues – delineation of typical requirements for contracts

At Carestream, we have multiple answers to these teleradiology best practices. The first and foremost focus is on quality of the reading and result distribution process, whether the teleradiologist onsite or remote, without disrupting the local clinical acquisition and PACS solution. For example, with the new Vue PACS Reporting tool that enables automatic insertion of measurements, key images and quantitative comparisons such as vessel analysis and measurements from modalities to reduce error and improve productivity of the radiologist. Such multi-media report along with the planned ability to include bookmark navigation to key anatomical markers can add significant clinical value to aid clinicians in treatment planning. With the planned Web-based teleradiology module being shown as a work-in-progress at RSNA 2013, we will also be able to demonstrate the flexibility to expand professional reporting services without requiring significant IT investment without replacing any existing referral site workflow.

The teleradiology white paper released by the ACR is sure to be a hot topic at RSNA 2013. Its best practices are sure have a strong influence on how both teleradiology offices function, as well as how these organizations and radiology departments collaborate on handling exams and business as a whole.

You can click the following link to access and download the white paper in its entirety.

RSNA 2013: Understanding the Importance of Dose Evaluation and Reporting

Sam Richard, PhD, Senior Research Scientist, Carestream

Sam Richard, PhD, Senior Research Scientist, Carestream

Radiologists wish to keep the amount of radiation during a medical imaging exam “As Low As Reasonably Achievable” – known as the ALARA principle – but just how much radiation are we receiving? First we need to be able to quantify it. Radiation dose is measured in units of Gray (Gy) which is proportional to the amount of absorbed energy per unit mass. In turn, the absorbed energy is proportional to the physical damage on the cell’s chemical bonds- such as DNA double strand breaks. Radiologists determine how changes in techniques impact radiation dose and image quality, which helps your physician determine whether the benefits from the diagnostic information outweigh the exposure risks of the exam. It should be noted that in most exams the benefits far outweigh any measurable risks. Reporting and monitoring of dose also enables hospitals to track dose and ensure that patients are receiving acceptable levels of radiation based on established guidelines.

Effective dose is an another measure of dose which quantifies the risk associated with an exposure and is reported in Sieverts (Sv). The Sievert allows comparison of the risk estimates associated with partial or whole-body radiation exposures. This quantity first requires the measurement of organ dose (in Grays) and incorporates the different radiation sensitivities of the various organs in the body. This evaluation tool is useful for comparing exposure levels across different x-ray imaging system and from different sources – man made or natural. The chart below compares imaging procedures with natural background radiation, that is, how long it would take to receive the same amount of radiation (effective dose) from the natural background in a normal environment.

CSH_Comparison_Chart

Source: www.radiologyinfo.org

For further information on Dose Evaluation and Reporting, please refer to the presentation below:

Patients Going Mobile: The Consumerization of Radiology

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

This post originally appeared on Intel Healthcare’s website as a post in support of the Intel Health & Life Sciences Innovation Summit webcast series.

A patient using a mobile device for healthcare-related purposes is no longer a surprise. There is a plethora of applications available for people to track health trends, set reminders to take medications, and provide tips related to exercise and diet. One area of medicine that is absent from the mobile patient revolution is radiology/medical imaging, but we at Carestream see that this is going to change soon.

We commissioned a study by IDR Medical earlier in 2013 that looked into whether patients would be interested in gaining access to their medical images. The results overwhelmingly showed that patients do want access to these images, and not only do they want access, but they want the ability to share these images too—be it with family members or with other physicians. Out of 1,000 survey participants, only 83% said they would be interested in using a patient portal for their medical images. Additionally, parents indicated that a patient portal would be helpful in storing, sharing and accessing their children’s images. Eighty percent of respondents said that they would use an imaging portal in such a way.  As an added bonus among our findings, patient portals were found to be desirable among all age groups, from the 18-24 year olds, all the way up to those 71 and older. In fact, 59% of those 71 and older considered themselves “very likely” to use a patient portal if provided the opportunity. From these findings, we have found that not only are patient portals important to providing patients with valuable health information, but that medical imaging is a component that should be a part of these technologies.

Our solution to including radiology in the patient engagement trend is the patient portal, MyVue, which allows patients to access and share their medical images. Among trials conducted, we’ve seen positive results from patients—both on how much they enjoy the technology, but also about how easy it is to navigate the portal. When working with Houston Medical Imaging, less than 2% of users needed to make support calls regarding the technology, and most of the calls made were to reset passwords.image_myvue_laptop_3

Another trial we conducted with Ferrara Hospital in Italy saw that 98% of patients were satisfied with the ability to view their diagnostic images through the web on a personal computer or iPad. The key point being that, like with Houston Medical Imaging, the patients found the technology to be intuitive. With a platform that is easy to learn and use, we predict that future users will have a similar easy experience when first accessing MyVue. If the technology were difficult to understand or took a great deal of training, then we would not be seeing the successful adoption rates that we have been seeing so far.

As expected, the rise mobile in healthcare applications has resulted in increased involvement from the FDA. Current FDA guidelines state that “if a mobile app is intended for use in performing a medical device function (i.e. for diagnosis of disease or other condition, or the cure, mitigation, treatment, or prevention of disease), it is a medical device.” Because of this rule, Carestream is predicting that all image viewers being developed and going to market—whether they are meant for patients, physicians, or clinicians—will need to have FDA clearance for diagnostic use as a medical device.

It is clear that we have entered an age where patients want to be more involved in their healthcare–be in in tracking information, using that information to make healthy choices, or being able to share the information with different healthcare providers. As vendors, it is our responsibility to build and provide the technologies that address these needs. If we fail to accomplish this then we are hurting ourselves, healthcare providers and the patients, and we do not want a lose-lose-lose situation.

RSNA 2013: Working to Improve Medical Imaging through the Power of Partnerships

Carestream CMO

Norman Yung, Chief Marketing Officer, Carestream

We’re about six short weeks away from the world’s biggest event in medical imaging. RSNA 2013 promises to be another year full of impressive displays and demonstrations of innovations and trends taking place within the industry. Plus, with the theme of this year’s event being “The Power of Partnerships,” the speakers, attendees and vendors are sure to enlighten us all on about changes taking place and technologies being develop that enhance this theme throughout medical imaging.

As a dedicated member of the RSNA community, we are thrilled to be a part of 2013’s event. At the show, we will be demoing our medical imaging and healthcare information technology systems. Our goal will be to show visitors how they can remain at the forefront of radiology – achieving higher productivity, fostering collaboration and enabling outstanding patient care. Below is a select example of some of the products and services that will be featured at RSNA 2013:

DR/CR Systems

    1. Bone Suppression software(work in progress) is being designed to create a companion image to suppress the appearance of posterior ribs and clavicles and enhance the visualization of soft tissue in the chest.
    2. IHE Dose Reporting that is intended to collect and distribute comprehensive dose information from all Carestream DR and CR systems to a healthcare provider’s PACS.

Printing Systems

  • DRYVIEW 5950 Laser Imager: This printing technology offers integration of high diagnostic image performance. The applications for this technology includes CR, DR, MRI, CT, ultrasound, and digital mammography.

Health IT Systems:

  • In addition to Carestream’s Vue Cloud PACS and Vue Cloud Archive, the company now offers its Vue Motion physician portal and Vue BeyondMyVue Patient Portal as cloud services. Carestream’s physician portal cloud service helps equip healthcare providers with a convenient way to deliver remote viewing on workstations, laptops and mobile devices such an iPad. Its patient portal service equips patients with electronic access to their radiology reports and imaging exams.
  • A new image exchange capability (currently a work in progress) is designed to help expedite reading by remote radiologists without requiring significant investment by either the radiology group or the healthcare facility will also become part of the Vue Cloud Services family.
  • Carestream’s Vue RIS Stage 2 capabilities (shown as works in progress) are intended to include: family health history, health information portability and sharing, online patient access to information and communication as well as changes to comply with the way information is tracked so it can be more effectively shared to improve overall patient outcomes.

Mammography

  • Carestream will showcase (as works in progress) enhancements to its digital breast tomosynthesis (DBT) module that are intended to include the display of DICOM-compliant 2D synthetic views, which are calculated from the 3D dataset. The use of synthetic views is being considered as an alternate approach to reducing dosage while allowing full advantage of the benefits of digital breast tomosynthesis.

Pediatrics

  • Small format DRX 2530C Detector: This is the newest addition to the DRX family of digital detectors. The 25×30 size allows the detector to fit right in the Bucky tray in a bassinet, and the cesium iodide design makes it dose sensitive, a feature that of the most importance for smaller, developing patients.

Oncology

  • Lesion Management PACS clinical tool: Thetool enhances assessment of oncology patients with quantitative measurements, bookmarking and comparisons overtime to aid oncologists’ diagnosis and treatment. With these capabilities, clinicians can appreciate the ability to have the comprehensive oncology imaging reports in accordance to industry standards such as Response Evaluation Criteria in Solid Tumors (RECIST).

RSNA 2013 is sure to be an exciting event this year. We have always done our best to create the technologies that allow our customers to do their jobs effectively and efficiently, and believe that we have been living up to the theme of “Power of Partnerships.” You can click on this link for more information about the products and services we will be demoing at RSNA 2013.

New Technology for Treating Traumatic Brain Injuries

Diana Nole, Carestream Health

Diana L. Nole, President, Digital Medical Solutions

Medical professionals around the world have escalated efforts to develop better treatment of traumatic brain injury (TBI) as concern grows over the serious consequences of head trauma and the increased damage that can result from repeated injuries.

TBI is caused by a blow or jolt to the head, or a penetrating head injury that disrupts the normal function of the brain. In the United States traumatic brain injuries contribute to deaths and cases of permanent disability. Every year, a significant number of TBIs occur either as an isolated injury or along with other injuries. Repeated traumatic brain injuries have a cumulative impact on brain pathology and neuropsychiatric health.

Recently, Carestream announced an agreement with the NFL Buffalo Bills football team to collaborate in gathering information for use in the development of new technology to diagnose and treat head injuries, including:

  • Early diagnosis and accurate assessment of injured areas;
  • Development of medical standards that indicate if an athlete can return to play; and
  • Research that can assist in early diagnosis of long-term degenerative medical conditions in the head and brain.

Carestream’s work with the Bills will help ensure that the unique requirements for diagnosing and managing athletic injuries are included in our product design considerations. In addition, our collaboration with biomedical researchers from the world-renowned Johns Hopkins University can accelerate development efforts to deliver the best product for this critical area of medicine.

“Carestream and Johns Hopkins University are collaborating on the development of new 3D imaging systems, including a cone beam CT (CBCT) system that could provide unprecedented levels of image quality suitable to imaging of TBI. The collaboration involves the scanner design, development of imaging techniques and algorithms optimized for TBI imaging, and early clinical evaluation. Areas of application range from the hospital ICU to trauma, sports and the military theater,” said Jeffrey H. Siewerdsen, PhD, FAAPM, Professor, Department of Biomedical Engineering, Johns Hopkins University. “Recognizing the major health burden associated with TBI – much of which has only recently come to light – our hope is to develop a dedicated system for high-quality imaging of head trauma and brain injury in a form that is well suited to the point of care.”

Our goal is to expand the existing knowledge of traumatic brain injuries. The work ahead of us is challenging, but our R&D staff has the expertise to work with other research experts to develop new medical imaging systems that can help physicians diagnose and treat these debilitating injuries at the earliest stages.

Have physicians at your hospital changed the way traumatic head injuries are diagnosed or treated?

What can you share about TBI diagnosis and treatment to add to this ongoing discussion?

A Systematic Approach to Pediatric Low Dose

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

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

For years radiology has worked on this problem—how to minimize X-Ray dose for children, who are vulnerable not only because of their sensitivity but because of the cumulative effect of radiation that stays with the patients their entire lives.

Carestream supports the “Image Gently” campaign of the Alliance for Radiation Safety in Pediatric Imaging at www.pedrad.org. The remainder of the post outlines guidelines that we and the alliance believe are important.

One size does not fit all…image gently

There’s no question:  X-rays are important tools in pediatric care.  But when we image, radiation matters.  Children are more sensitive to radiation.  What we do now lasts their lifetimes.  So, when we image, let’s image gently.

More is often not better–when X-ray is the right thing to do:

  • Measure patient thickness for “child-size” technique
  • Avoid using grids for body parts less than 10–12 cm thick
  • X-ray only the indicated area with proper collimation and shielding
  • Check exposure indicators and image quality

We have developed a Carestream white paper “Maximizing Dose Efficiency for Pediatric Patient Imaging,” available at http://bit.ly/15yCe0k. In this paper we discuss dose reduction in image acquisition as well as efficiencies in image processing, image display, and in quality control. Our DRX-Revolution Mobile X-ray System is now doing rounds in many children’s wards and hospitals, with the result that we hear repeated often:2530C DRX_small

“We started noticing that we could drop our doses down, so we went down a little more. We found that with our DRX portable, we were cutting our dose in half,” said Casey Dye, Diagnostic Coordinator, Intermountain Primary Children’s Hospital

New low-dose, small-format DR detector.

In addition, with the introduction of our new small-format DRX 2530C wireless DR detector, we can provide clinicians yet another opportunity to reduce dose: our smaller detector is designed to fit into pediatric incubator trays and offer higher DQE (detective quantum efficiency) with its Cesium scintillator, which can lead to lower dose requirements than CR cassettes or gadolinium scintillator detectors. The DRX 2530C is compatible with both our DRX Revolution Mobile X-ray System as well as with other portables upgraded with our DRX-Mobile Retrofit Kit.

Technique based on the patient’s size and age, new DRX portables, and our new Cesium detector (the DRX 2530C) help to keep dose to a minimum. In addition, image processing optimized for the size and age of the patient can also be employed to emphasize appropriate details in the image after acquisition, sometimes providing an acceptable image in a situation that might otherwise require a repeat. Finally, new analytic reporting software allows the clinician to evaluate performance over time and to identify areas for possible improvement.

To make the imaging experience more comfortable for our young patients, Carestream has developed a coloring book for children about X-rays, titled “I can see your bones,” available by visiting this link.

Combating the Challenges of Portable Imaging

Rafael Fernandez, DMS Product Specialist, Spain, Carestream

Rafael Fernandez, DMS Product Specialist, Spain, Carestream

The Spanish translation of this post can be found after the English version.

For a period of time, portable imaging had been mostly forgotten, the least evolved of medical imaging trends. A few years ago, it was common seeing radiographers pushing a contraption that looked like a wheelchair through the corridors completely loaded while another technician would push a piece of analog equipment that tended to be at least 10-years-old. Interestingly, these devices were used with the most critical patients (ICU, Pediatrics), who needed a better diagnostic quality due to injury or critical life situations

Portable imaging continues to face three key challenges: mobility, image quality and productivity. To address these challenges, Carestream designed the DRX-Revolution System:

  1. Mobility: ICUs are filled with appliances, tubes, cables, etc. that leave little space available in the room that tripping over any cables can disconnect some vital equipment. For this, the DRX-Revolution system has the first column and retractable (up to 135 cm), allowing technicians to see any obstacle in front of them and can capture a quality image with limited patient mobilization. This along with a volume of only 0.89 m3, this makes the DRX-Revolution an ideal team member for their work in the ICU
  2. Image quality: the great power of the generator (32 kW), the use of wireless sensor DRX-1/DRX-1 C/DRX 25x30C with cesium iodide scintillator result in improved image quality and in reduced dose. In addition to being wireless, we can use sterile bags in clean environment without causing contamination. The ability to retrieve patients’ previous images was done via the hospital’s PACS and copy radiographic technique with which it became the latest study. The images are made with quality unknown to date and under the same boundary conditions, which makes tracking the evolution of a disease such as pneumothorax easily.
  3. Productivity: instead of bringing the patient to the X-ray, the X-ray room can now be taken to the patient. The DRX-Revolution design gives the ability to maximize a radiology department’s investment, as it is the first mobile X-ray system with two screens (19 “screen and a secondary 8” tube). User identification via QR code cards have been designed by and for diagnostic imaging technicians. In the end, this serves as an ideal system in the portable imaging revolution.

I enjoyed giving a speech on October 4, 2013, at the Congress of the Association of South Radiologists in Cadiz, sharing and explaining scientific advances in the field. This is a time when Carestream is embracing the opportunity to lead through the challenges and changes in the portable radiology sector.

SPANISH TRANSLATION

Los Retos de la Imagen Portátil

Históricamente, la imagen portátil ha sido la gran olvidada, la que menos ha evolucionado en el tiempo. Hace unos años, era muy común ver por los pasillos a técnicos de radiodiagnóstico empujando una silla de ruedas (o algún artilugio similar) cargado  de chasis junto con otro técnico que empujada un equipo analógico con una edad media de más de 10 años. Curiosamente, los pacientes en los que se usaban estos equipos eran los enfermos más críticos (UCI, Pediatría) y los que necesitaría una mejor calidad diagnóstica debido a lesiones o situaciones vitales críticas.

La imagen portátil se sigue enfrentando a tres retos fundamentales: movilidad, calidad de imagen y productividad. Para  hacer frente a estos retos Carestream Health ha diseñado el sistema DRX-Revolution que cambia radicalmente la imagen portátil y soluciona totalmente dichos retos.

  1. Movilidad, las unidades de cuidados intensivos (UCI) se encuentran llenas de aparatos, tubos, cables, etc. que hacen que se disponga de muy poco espacio útil y que cualquier tropiezo con un cable pueda desconectar algún aparato vital (respiradores, etc.…), para ello, el sistema DRX- Revolution tiene la primera columna retráctil del mercado y la que mayor alcance tiene (hasta 135 cm), lo que hace que el técnico pueda ver siempre el obstáculo que tiene delante y puede alcanzar mejor al paciente sin necesidad de su movilización. Esto junto con un volumen de sólo 0,89 m3 hace del DRX-Revolution un equipo ideal para su trabajo en UCI, incubadoras, etc.…
  2. Calidad de imagen, la gran potencia del generador (32 Kw), el uso del detector wireless DRX-1/DRX-1 C/DRX 25x30C con centelleador y yoduro de cesio, hace que la calidad de imagen y la reducción de dosis deje de ser una quimera. Además al ser wireless, podemos usar bolsas estériles sin dejar cables no esterilizados en entornos limpios y sin que se produzcan enganchones. La posibilidad de recuperar las imágenes previas que el paciente tenía en el PACS del hospital y copiar la técnica radiográfica con la que se hizo el último estudio, hace que las imágenes se realicen con un calidad desconocida hasta la fecha y en las mismas condiciones de contorno, lo que hace que ver la evolución de una patología como el Neumotórax, sea muy fácil.
  3. Productividad, en vez de llevar el paciente a la sala de R-X, llevamos la sala de R-X al paciente. El diseño del DRX-Revolution hace que maximicemos nuestra inversión, ya que es el primer equipo con dos pantallas (19” de pantalla principal y una secundaria de 8” en el tubo), identificación del usuario mediante tarjetas con códigos BIDI y diseñado por y para técnicos en diagnóstico por imagen, hace que sea el sistema idóneo y revolucionario para la imagen portátil.

Me encantó dar el discurso el pasado 4 de octubre de 2013, en el congreso de la Asociación de Radiólogos del Sur en Cádiz, para compartir los avances científicos en esta reunión  España y poder explicar como Carestream quiere liderar el los retos en la radiología portátil.

The Latest in Medical Imaging and Health IT to be Shown at JFR 2013

Patrick Koch, Carestream Cluster Manager for France , Belgium and Luxembourg.

Patrick Koch, Carestream Cluster Manager for France , Belgium and Luxembourg.

The French translation of this post can be found after the Engish version. / La traduction française de cet article peut être trouvée après la version en anglais.

A few days before the opening of the Congress of Journées Françaises de Radiologie (JFR) we would like to take a few moments to focus on the specifics of the French market for medical imaging, as well as some of the solutions that we will be showing in our Carestream booth.

The French market–a market influenced by a strong political will
As many know, France is a country of great medical tradition that has a health care system which is often presented as one of the most advanced in the world .

Although more than 65% of medical imaging examinations are performed in the private sector by over 2,000 specialized imaging sites that offer local access for patients, the French market for medical imaging is strongly influenced by the policies of successive governments.

As an example of this, telemedicine projects and “regional PACS” that bloom throughout France are the result of a strong desire to create platforms for the exchange and sharing of medical information between all stakeholders in a territory, both public and private . The aim is both to pool investments to reduce the cost and to improve patient care.
These projects also aim to catch up in the adoption of PACS and will put France at the forefront of medical informatics through the early adoption of “cloud” technologies that are particularly suited to these big multi-site projects.

In France, as in other European countries, the economic situation remains difficult and carries a great load of pressure on the budgets of public hospitals. Again there is a political will to centralize purchasing to get better prices, which explains the growing influence of public and private purchasing groups.

On the other hand, demographic changes and the quality requirements continue to drive demand for imaging examinations. Therefore, we can see prioritization given to projects that improve productivity while reducing the initial investment. It is in this direction that the Carestream solutions are developed.

The DRX- Evolution digital X-ray rooms are able to replace several existing systems, and the Vue Cloud platform allows the sharing of archive infrastructure for archiving and exchange between several sites, using pay per exam. The success of major infrastructure projects such as the private cloud of AP-HP (main public group of hospitals in Paris), the success of our multi-tenant hosting platform in France combined with the deployment of the territorial PACS of the Loire department allowed us to take a decisive step in technical and organizational management for this type of project.

In a few days will be the Congress of Journées Françaises de Radiologie

The JFR congress is one of the essential medical imaging events in Europe, Africa and Middle East. With an attendance of over 18,000 people, JFR gather each year healthcare professionals, participating in numerous scientific conferences as well as the impressive technical exhibition .

In the field of e-Health, in addition to our recognized Vue Cloud Services’ solutions, we present MyVue application which gives patients the opportunity to consult exams reports and images on their smartphones and tablets within a secure access portal. Regarding digital radiology, you will see almost all of our solutions, including the mobile radiology DRX- Revolution and its new pediatric applications. The  DRX- Revolution works with the DRX- 1 mobile digital detector , which is the heart of all the X -Factor range.

Other applications will also be presented such as new applications for 3D dental radiology (CB CS9300) and film and paper medical printing solutions  :  Carestream DRYVIEW imagers and CHROMA printers.
We will be delighted to welcome you to JFR and present the latest in medical technology. It will also be a special time of sharing about your current and future projects .

You can click the link for more information about JFR 2013.

JFR2013 3D picture

A rendering of the Carestream booth at JFR 2013

FRENCH TRANSLATION

Patrick Koch, Carestream Cluster Manager pour la France, la Belgique et le Luxembourg.

Patrick Koch, Carestream Cluster Manager pour la France, la Belgique et le Luxembourg.

Les dernières nouveautés du secteur de l’imagerie et  de l’informatique médicale seront présentées aux JFR 2013

A quelques jours de l’ouverture du congrès des Journées Françaises de Radiologie, prenons quelques instants pour nous intéresser aux spécificités du marché français de l’imagerie médicale, ainsi qu’à quelques unes des solutions que nous exposerons sur notre stand Carestream.

Le marché français, un marché influencé par une volonté politique forte

Comme chacun sait, la France est un pays de grande tradition médicale qui possède un système de santé souvent présenté comme l’un des plus avancé au monde.

Bien que plus de 65% des examens d’imagerie médicale soient réalisés dans le secteur privé par plus de 2000 sites d’imagerie spécialisés qui offrent un accès de proximité aux patients, le marché français de l’imagerie médicale est fortement influencé par la volonté politique des gouvernements successifs.

Ainsi, les projets de télémédecine et de « PACS régionaux » qui fleurissent à  travers la France sont le résultat d’une volonté forte de créer des plateformes d’échanges et de partage des informations médicales entre tous les acteurs d’un territoire, tant public que privé. L’objectif est autant de mutualiser les investissements pour en diminuer le coût que de permettre une amélioration des soins délivrés aux patients.

Ces projets visent également à rattraper le retard pris dans l’adoption des systèmes PACS et vont remettre la France à la pointe de l’informatique médicale grâce à une adoption précoce des technologies liées au « cloud » qui sont particulièrement adaptées à la dimension multi-site de ces projets.

En France, comme dans d’autres pays Européens, la situation économique reste délicate et impose une pression forte sur les budgets des hôpitaux publics.  Là encore existe une volonté politique de centraliser les achats pour obtenir de meilleurs prix, ce qui explique l’influence grandissante des groupements d’achats publics et privés.

D’un autre côté, les changements démographiques et les exigences de qualité continuent d’alimenter une demande d’examens d’imagerie importante. De ce fait, on observe une priorisation de projets visant à améliorer la productivité tout en limitant l’investissement initial. C’est dans cette direction que sont développées les solutions Carestream ; nos salles de radiologie numériques complètes DRX-Evolution sont capables de remplacer plusieurs installations existantes, et notre plateforme Vue Cloud permet la mutualisation de l’infrastructure d’archivage et d’échange entre plusieurs sites, avec un financement à l’examen. La réussite  de projets majeurs d’infrastructures Cloud privées comme les hôpitaux de l’APHP, le succès de notre plateforme publique d’hébergement en France conjuguée au déploiement du PACS territorial du département de la Loire, nous ont permis de franchir une étape décisive dans la maîtrise technique et organisationnelle de ce type de projet.

Dans quelques jours aura lieu le congrès des Journées Françaises de Radiologie

Les Journées Françaises de Radiologie (JFR) se positionnent comme le lieu de rencontres incontournable de l’imagerie médicale en Europe,  Afrique et Moyen Orient. Avec une fréquentation de plus de 18 000 personnes, les JFR rassemblent, chaque année, l’ensemble des acteurs de la santé, qui  participent aux nombreuses conférences scientifiques ainsi qu’à l’impressionnante exposition technique.

Dans le domaine de la « e-Santé », en plus de nos solutions reconnues « Vue Cloud Services », nous présenterons l’application « MyVue » qui donne aux patients la possibilité de consulter sur leurs smartphones et tablettes leurs résultats d’examens grâce à un portail d’accès sécurisé.

En ce qui concerne la radiologie numérique, vous pourrez voir pratiquement l’ensemble de nos solutions, et essayer le mobile de radiologie DRX-Revolution et ses nouvelles applications pédiatriques. Le DRX-Revolution utilise le détecteur numérique mobile DRX-1, également présent sur les autres solutions de la gamme X-Factor.

D’autres applications seront également présentes sur notre stand comme les nouvelles applications de radiologie dentaire en 3D (Cone Beam CS9300) ainsi que nos solutions d’impression médicales sur film et  papier (N&B et couleur) : reprographes CARESTREAM DRYVIEW et imprimante CHROMA.

Nous serons très heureux de vous accueillir aux Journées Françaises de Radiologie et de vous présenter les dernières nouveautés de la technologie médicale. Ce sera également un moment privilégié d’échange au sujet de vos projets actuels et futurs.

Pour plus d’informations sur les JFR 2013 : http://www.carestream.fr/jfr-2013.html

Providing Pediatric Patients with a Safe X-ray Experience

Helen Titus

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

The delicate state of a patient in a hospital is never taken lightly by medical imaging professionals. These patients are in situations where they are at their most vulnerable and it is up to the physicians to provide a sense of comfort while patients are in their care. This is exacerbated with pediatric patients because of the fragility of their developing bodies.

There are numerous technologies that have been or are being developed that address these younger, smaller patients. At Carestream, we’ve brought flexibility and mobility to the X-ray room with the DRX-Revolution, but versatility is not the only issue that should be addressed. Younger, developing bodies are more susceptible to radiation dose, so it is up to us to ensure that we are accomplishing two main objectives when capturing an image:

1)      Capturing the highest quality image so that physicians can make an accurate diagnosis quickly

2)      Accomplish #1 while simultaneously delivering the lowest radiation dose possible to the patient

The Image Gently initiative created by the Society for Pediatric Radiology has long been driving home the importance of dose reduction and efficiency within pediatric imaging. The impressive library of resources and research the organization possesses has done a great deal of good for the cause, especially in raising awareness about the problem and getting radiologists to act.

On our part as a vendor, it is our responsibility to provide the technologies that allow radiologists to accomplish dose reduction and safe imaging. Our most recent offering is the DRX-2530C digital detector. The small size fits right in the Bucky tray in a bassinet, and the Cesium iodide (Csl) design is ideal for dose-sensitive pediatric applications. These are the types of technologies that live up to the mission put forth through the Image Gently initiative.

We have recently seen success from the 2530C in action. According to a recent story, Melbourne’s Monash Children’s Hospital was the first in the world to receive the DRX-2530C detector, which was built specifically for pediatric imaging. The physicians and radiologists were able to see benefits from the detector and how it is an important integration within the digital radiography (DR) process:

Monash Health chief radiographer Mark Burgess said X-raying babies in the hospital’s neonatal intensive care unit had previously been time-consuming, involving the use of a more cumbersome X-ray plate.

”We had to take the plate out, walk back to the X-ray department, process the image there and then send it back up to the unit. Now that all happens wirelessly, straight away,” he said.

Monash neonatal physician Arvind Sehgal said receiving images instantly was particularly useful when doctors needed to make minute adjustments to devices and tubes linked to vital organs.

When capturing images from pediatric patients, physicians must ensure that the patient is safe throughout the entire process. Timeliness is important throughout the process, another testament as to the benefits of DR In the end, it is the patient who remains the center of attention. All of our efforts must be put geared towards making sure that radiologists can capture the best image while also keeping the patient comfortable and safe. This will always be especially true for children.