Diagnostic Reading #13: Five Must Read Articles from the Past Week

Carestream logoHere are five readings that you may have missed this week. Relationships between physicians and radiologists was a theme this week. The readings include, an examination of the costly problem of unnecessary care, using social media to drive patient engagement, two studies from the Journal of the American College of Radiology, and an article that tells the story of a new style of healthcare provision.

1) Medical Necessity and Unnecessary Care – the Full Story

This article addresses the costly problem of unnecessary care. According to the author, procedures that are not evidence based account for about 30% of total healthcare costs.

2) Using Social Media for Community Engagement: A Success Story

Social media is growing in just about every industry, healthcare is no different. Read about the benefits that social media use can offer healthcare providers and customers, and how its effective use can be the next step on the journey to encourage patient engagement.

3) Primary Care Doctors Say Imaging Improves Patient Care

An email survey conducted by the Journal of the American College of Radiology found that physicians depend on imaging to find results that are not otherwise available. An impressive percentage of physicians find imaging valuable to their job and that it helps them make better decisions.

4)  Interactive Radiology Reports Preferred by Referring Physicians

Another study by the Journal of the American College of Radiology revealed that physicians see benefits in using interactive radiology reports. The study found interactive reports improved understanding of radiology findings by correlating images to text reports and provided easier access to images while monitoring progression of a disease or condition.

5) ‘Direct Primary Care’ Shown to Please Patients and Reduce Costs, Including for Imaging

Insurance that covers unlimited visits to a primary-care for a monthly fee has proven to pay off in more than one way. While the system has satisfied patients across the board, it also cuts down on imaging and healthcare costs.


The Top Medical Imaging Trends of 2015

VNA storing and sharing information

Technologies such as a VNA can provide telemedicine advantages by bringing data together under a single location.

A new year brings much in tow—new ideas to share, new trends to address, new technologies to install. While it is difficult to say exactly what will affect us the most as we begin 2015, there are certain trends that seem to leap out ahead of others. Here are five trends we expect to have a vital impact on medical imaging in 2015:

  1. 3D mammography. Digital breast tomosynthesis (DBT) has been a frequent topic in trade publications for a few years. As more studies are released touting the success of this technology in finding lesions and reducing recall rates, its popularity is only going to increase. Especially when top-tier media such as TIME names DBT one as one of the most important health advances made in 2014. Add to the equation the increase in states passing dense breast tissue notification laws, and DBT will only grow further as it has proven to be a technology that provides a more thorough exam for those with dense tissue. In Jan 2015, the Centers for Medicare & Medicaid Services (CMS) established two new add-on codes that extend additional payment when DBT is performed along with 2D digital mammography.
  2. Multimedia enhanced radiology reporting (MERR). Text-only reports are fading away. A study from Emory University and the Harvey L. Neiman Health Policy Institute found that 80% of respondents said MERRs “improved understanding of radiology findings by correlating images to text reports.” The study also found that the multimedia reports  provided easier access to images while monitoring progression of a condition, and saved time understanding findings without supporting images. While improving the radiology report, the multimedia-enhanced version also provides more financial value to radiologists. A recent study showed that 80% of respondents indicated an increased likelihood of preferentially referring patients to facilities that offer MERR, and 79% indicated an increased likelihood of recommending peers use facilities offering MERR.
  3. Wider adoption of cloud technologies. Radiology, along with the rest of the healthcare sector, is moving to the cloud, and it is happening fast. According to an article in Applied Radiology, the global cloud computing marketing in healthcare was valued at $1.8 billion in 2011, and is expected to grow at 21% at compounded annual growth rate (CAGR) of 21% to $6.8 billion by 2018. While initial upfront costs can vary between the intensity of building an organization’s own private cloud, or the ease and flexibility of using public cloud architecture, the process efficiency, financial predictability of paying for only what the organization needs, and long-term cost savings are making the cloud a worthwhile investment.
  4. Centralization of clinical data. Collaboration is a must for health facilities. No department can be left out of the patient experience equation. This means that department silos will have to be broken down—enabling personnel collaboration and the unification of clinical data. Vendor neutral archives (VNAs) are evolving beyond being a repository for radiology. The evolution is allowing the capability to store and exchange clinical content in DICOM and/or non-DICOM formats. This goes beyond the traditional capabilities offered by a VNA by embedding intelligent lifecycle management and meta-data management to optimize the efficiency of multiple archives. With this evolution, all clinical data is available, easily accessible and useable to provide enhanced patient care.
  5. Telemedicine. The global telemedicine market in 2016 is predicted to be $27 billion, with virtual health services accounting for nearly 60% of the total. Additionally, it is expected that by 2018, two-thirds of interactions with healthcare organizations will be conducted via mobile devices. Last year was an important year for telemedicine, as wearable technology became prominent. 2015 will be the year where we see significant growth in the telemedicine, as it is projected to grow at CAGR of 18% to $3.8 billion by 2019, according to Transparency Market Research. With virtual reading, diagnoses, and reporting now a possibility, expect telemedicine to bring together health facilities like never before—from large systems to those located in rural areas.

Today’s changing healthcare landscape places an urgent emphasis on improving the quality of patient care and reducing overall costs in health facilities.   Adoption of new technologies such as 3D mammography, cloud computing, and telemedicine will play a major role.  So will our ability to become smarter in how we utilize health information through centralization of clinical data and multimedia enhanced radiology reporting (MERR).   As the benefits from these five key trends in medical imaging become more widespread, we will see further adoption and improve care for a larger population of patients around the world.

Carestream CMONorman C.W. Yung is the Chief Marketing Officer at Carestream.



Managed Print Solutions: Helping Radiologists Focus on Patients

CARESTREAM Managed Print SolutionsAs a radiologist, your goal is to provide fast, accurate diagnoses in support of early treatment and positive patient outcomes. Anything that distracts you can be troublesome – such as ordering film and other supplies, tracking inventory, managing film and supply budgets, dealing with downtime and coordinating service and repairs.

An Advanced Solution

An effective solution for print management would track a facility’s laser-imaging film usage, remotely monitor inventory and automatically ship new film as needed.  The solution would supply hardware as well as consumables, eliminate capital outlay, save time, and allow consistent.

The bottom line?  Radiologists and their staff are free to focus their energy on providing superior care.  Best of all, the right print management solution can benefit everyone in the facility – from radiologists to rad technologists to the radiology manager, from procurement personnel to finance executives.

Significant Cost-Savings

Managed Print Solutions can help to achieve a lower cost of operation over time. Your price per print includes a laser imager, film, shipping and service.  This eliminates costly expedited shipments, unplanned costs for service requests and staff hours spent on repetitive PO generation.  It can also prevent unplanned expenditures for service requests and other critical parts replacements.

An Easy-To-Use Web Portal Can Simplify Management

An intuitive, properly designed exclusive web portal can eliminate surprises and the administrative overhead of managing film usage, inventory tracking, procurement and billing. For this portal to be effective and used efficiently, tracking equipment, film usage data by printer, size, or location information should be displayed on a dashboard accessible at any time, from anywhere.  The web portal should also allow you to reference contract and billing statements, inventory records and film shipment status – all the information you need to make informed business decisions.

Patient Privacy

More today than ever before, patient privacy and network security are critical issues.  To maintain privacy and secure communications, MPS vendors must employ globally accepted internet security protocols. Only trained and properly credentialed support specialists should be permitted to connect with your printer. An audit trail of printer access and activity must be maintained, and the latest, most advanced virus protection should always be in place.

Carestream has recently introduced CARESTREAM Managed Print Solutions (MPS), a print-management program in which we take responsibility for virtually everything – to save you valuable time and boost productivity.  Following a thorough analysis of your printing infrastructure, Carestream will present you with a strategic print-management plan.

How has MPS helped facilities achieve improved productivity and cost savings?

“Everything has become extremely simple and accessible to all our staff. I would definitely recommend this service to others involved in healthcare.”

– Dr. Pascal Hauet, Partner Radiologist, Paris Radiology Office of Dr. Hauet and Dr. Lunel, Paris, France

Read the full testimonial, Passionate about New Technologies


“I recommend MPS to all radiologists, whether they have their own printer or not. “

– Gregorio Mayor, of Mayor Gallego Radiological Clinic, Spain

Read the full testimonial, New Print Management System Eliminates Worries for Manager of Radiology Centers


“We are on track to save 20% a year with MPS and we have the added convenience of having one company to call. Our radiologists and physicians are also very pleased with the image quality.”

– Lee Gemmill, RT, (R), MR, The Community Open MRI Group, Indiana, USA

Read the full testimonial, The Community Open MRI Group’s Imaging Centers Save Time and Money with CARESTREAM Managed Print Solutions


“We are on track to save $10,000 a year in staff time. We have also improved our cash flow because we are not ordering film that is sitting on a shelf for weeks or possibly longer.”

– Martin Cox – COO Southern Radiology Group, Sydney, Australia

Read the full Testimonial,   CARESTREAM Managed Print Solutions Saves Time and Money for Southern Radiology Imaging Centres

You can visit our website for additional information on CARESTREAM Managed Print Solutions or you can watch this MPS video demonstration.

Abel Espinosa, CarestreamAbel Espinosa is Carestream’s  worldwide product manager for CARESTREAM Managed Print Solutions.



Diagnostic Reading #12: Five Must Read Articles from the Past Week

Carestream logoIt was a busy week in the fields of radiology and healthcare IT, here are some articles that you may have missed. This week’s readings include an update from President Obama’s State of the Union address, using cost, quality, and service to improve value in radiology, an outlook on 2015 from an industry journal, news about EHR systems, and the need to improve mobile apps in healthcare.

1) Obama Touts Cybersecurity, Personalized Medicine Efforts in State of the Union Address

President Obama addressed health IT topics during his State of the Union address this week. He stressed the importance of cyber security, citing pieces of legislation that calls for increased sharing of information on cyber threats. The president also talked about precision medicine, which is an innovative way to treat each patient individually.

2) Rethinking Our Value Chain

This article talks about the relationship between cost, quality, and service. It claims that if a value chain is optimized properly, these three components should complement each other. In an industry that is trying to establish the definition of value, it is important to optimize the value chain. By applying innovation and creativity, radiologists can improve these three areas.

3) 5 Things to Watch in 2015: Our Annual Look at the Coming Year

In its first issue of the year, Radiology Today takes a look at five topics in the radiology industry that will be popular in 2015. This article addresses issues such as value in imaging, breast density notification, and lung cancer screening.  It is noted that collaboration between physicians and radiologists could improve imaging appropriateness. Finally, the article questions whether or not ICD-10 will be implemented in 2015.

4) EHR Decertification Strategy Will Require a Careful Balancing Act

EHR systems face decertification if they do not meet the most recent Meaningful Use standards. The author discusses the potential consequences that come with decertifying systems that have been gaining momentum, including the slowing down the progress towards interoperability. Finally, the author addresses the balance of political interests and progress in the health IT industry.

5) Hospital IT Departments Making Inadequate Mobile Investments, Doctors Say

A study indicated that inefficient communication in hospitals drives up costs each year. While most physicians use tablets or cell phones, only 33 percent believe that they can access medical records from their mobile devices. More secure networks are needed so that doctors can communicate and view medical information from these mobile devices.

DR Continues to Prove its Worth as Market Matures

DRX-Revolution Mobile X-ray Unit

The Hong Kong study found that mobile X-ray images arrive in their PACS network 70% sooner using a wireless portable DR system rather than a mobile X-ray system using CR plates.

We have shown before how much faster digital radiography (DR) can be compared to computed radiography (CR) when it comes to capturing and displaying images, but now that efficiency has translated into the radiology IT world on PACS systems.

A recent study conducted in Hong Kong and published in the Journal of Diagnostic Imaging showed that radiologists could obtain mobile X-ray images in their PACS network 70% sooner using a wireless portable DR system rather than a mobile X-ray system using CR plates.

The difference in timing with DR and CR were drastic—it took 6.8 minutes for the PACS to receive the image after it was acquired using DR, and 23 minutes to acquire an image taken via CR. Taking this information and adding it to the efficiency displayed when capturing images, and DR continues to prove its worth.

In the Hong Kong study, the researchers used the CARESTREAM DRX-Revolution Mobile X-ray System, and experienced the benefits of being able to process, load, and send captured images across the facility’s wireless local area network (WLAN). Images maintain high image quality when transferred across wireless networks, all while productivity is increased.

Studies such as this prove that DR can be more efficient than CR, while it is becoming easier to make the switch. The maturity of the DR market is still growing, and as this continues, expect more to switch from CR to DR.

In an article for Radiology Today published in 2014, I stated:

“Expect to see continued growth in DR. Both the systems and software are not only becoming more versatile, but prices are coming down. Meanwhile, people are waking up to the benefits of its productivity, improved image quality, and dose reduction. Those elements drive the trend.”

The radiology field has known about the benefits of DR, and as adoption continues to grow each year, research such as what was published in the Hong Kong study provides further evidence to facilities about making the switch.

The fact remains that many facilities cannot make the conversion from CR to DR immediately, so it often happens piece by piece. For example, Carestream offers the ability to combine the DRX-Ascend and Vita Flex CR System to replace a film based X-ray room with digital imaging. Then, when the time comes to go to DR, the Vita Flex CR can be replaced with an Ascend DR upgrade to create a fully integrated digital X-ray room.

In the end, facilities must be able to weigh the benefits of DR technology against whether it is financially feasible. DR is continuing to be adopted by health providers around the world, and this growth is expected to continue as the technology advances and prices decrease as the DR market matures.

Helen Titus

Helen Titus is Carestream’s worldwide marketing director for X-ray solutions and Ultrasound.


What to Expect from the CARESTREAM Touch Ultrasound System

It has been almost two months since we announced the CARESTREAM Touch Ultrasound System (currently 510(k) pending) at RSNA 2014, and the excitement around the product has not dissipated.

Produced by Imaging Technology News (ITN), the video below includes Helen Titus, worldwide marketing manager for X-ray solutions and ultrasound, and Andrew Hartmann, general manager for X-ray solutions and ultrasound, discussing the all-touch control panel on the new ultrasound system, and what sets the technology apart from others in the field.

Titus and Hartmann also discuss how the Touch System is the premium version in what will become a portfolio of ultrasound technologies. The key being that once you know how to use one system, you can use the others in the portfolio.

Diagnostic Reading #11: Five Must Read Articles from the Past Week

Carestream logoThis week we take a look at topics such as whether there are too many practicing radiologists in the field, how radiologists can stay healthy on the job, how facilities are making the move to be data-driven organizations, and Meaningful Use Stage 2 adoption updates.

1) A Physician Shortage, But Too Many Radiologists

The medical job market is in an interesting place. According to the Association of American Medical Colleges (AAMC), there is a nation-wide physician shortage. However, there is a surplus of practicing radiologists. This article analyzed the reasons for these trends, as well as the possibility of a trend reversal in the near future.

2) Avoiding Occupational Hazards: Tips for Radiologists to Stay Healthy

The radiology field comes with some occupational hazards that are not related to the exposure of radiation. As a radiologist, the sedentary lifestyle of sitting and looking a screen, paired with high levels of stress, can have a costly affect on health. Here are some unconventional, yet helpful tips on how to stay healthy while living the high-stress lifestyle of a radiologist.

3) Making the Transition to a Data-Driven Organization

Sue Schade, CIO of the University of Michigan Hospitals and Health Centers provides insight on key elements in effectively using data in an organization. Schade talks about the different priorities between academic medical centers and community hospitals when it comes to the adoption of technology. Schade emphasizes the importance of having a strong informatics team for support during the transition.

4)Radiology: Choose Between Change or Trouble

This article reflects on the current healthcare system. The current system sees radiology as a sort of outsider. The author talks about the importance of radiologists to define quality in imaging to the rest of the healthcare world. With the definition of quality imaging, radiologist can return more consistent results and better fit the current healthcare model.

5) Meaningful Use Stage 2-Eligible Hospital Attestation Rate: 77 Percent

Meaningful Use Stage 2 is being reported at a high rate, according to figures presented at the January 13, HIT Policy Committee meeting. This article addresses some of the concerns about cooperation with Meaningful Use Stage 2, and why attestation has not been affected in the way that some thought it would.


The Future of the VNA: From Centralised Storage to an Information Exchange

VNA storing and sharing information

Many hospital organisations, particularly in Europe, are implementing VNAs to store non-DICOM content as well using the Cross-Enterprise Document Sharing (XDS) standard; the XDS standard also provides greater flexibility for storing and managing clinical content.

Hospital organisations throughout the world are increasingly turning to vendor neutral archives (VNAs) to manage and exchange medical images.  However, the growth of VNAs has generally depended on the incentives hospital organisations have had to collaborate.

In the US, hospital organisations have been reluctant to promote sharing medical images across organisational boundaries for a number of reasons, including cost, incentives, technology and competition.  Therefore, VNAs have largely been used to store medical images (particularly radiology or cardiology images using the Digital Imaging and Communications in Medicine [DICOM] standard) within a single hospital organisation.

Health care organisations in other regions, such as Europe and Australia, have had a longer history of sharing data and more incentives to collaborate.  Many organisations in these regions see VNAs as enablers for exchanging information.  In New South Wales, Australia, for example, more than 200 public hospitals and health centres exchange radiology images through a centralised VNA.  The state government invested heavily in e-health and implemented the VNA to improve access to care, particularly for patients in rural parts of the state who may otherwise need to travel several hundred miles to see a specialist in Sydney.

The VNA enables clinicians to share medical information regardless of the picture archiving and communication system (PACS) they use to manage radiology images.  Many hospital organisations, particularly in Europe, are implementing VNAs to store non-DICOM content as well using the Cross-Enterprise Document Sharing (XDS) standard; the XDS standard also provides greater flexibility for storing and managing clinical content.

Passage of the Affordable Care Act and the creation of accountable care organisations (ACOs) are changing incentives in the United States.   As more ACOs emerge in the US, a greater need will exist to exchange information between providers.  This will generate more demand for VNAs in the US.

With all of these changes occurring in different markets around the world, we’re seeing that the future of VNAs is taking shape in the following ways:

1)      Wider scope of content storage. VNAs will go beyond the traditional realms of storing radiology and cardiology DICOM images to become a hub for a wide range of content including non-DICOM images and scanned documents.  This content will be accessible even if stored in a remote location, thanks to the increasing use of the Cross-Enterprise Data Storage (XDS) standard.

2)      Changing roles and expectations for PACS.  The growth of the VNA and related technologies will challenge the traditional role of a PACS as a combined storage, viewing and workflow tool for medical images.  New tools will emerge to take on these functions.  Under this model, VNAs will play a major role in storing and managing access to content within and outside of hospital walls.  Universal viewers will provide a single solution for viewing and analysing medical images.  PACS will continue to play a strong role in workflow functionality, such as pre-fetching of radiology and cardiology images, and in image management, such as through a radiology information system (RIS).

3)      Greater linkage between VNA and electronic medical records (EMRs).    As this develops, clinicians will have quicker access to medical images and other clinical content within their EMR.  EMR vendors have taken note of the wider scope of content stored and managed by VNAs, and have begun to work with VNA vendors to achieve this goal.

Tony Perry The Advisory Board CompanyTony Perry is a Senior Research Analyst, Research and Insights, for The Advisory Board Company.



Multimedia Enhanced Radiology Report Improves Referring Behavior and Patient Communication

Cristine Kao, Healthcare IT, Carestream

Cristine Kao, Global Marketing Manager, Healthcare Information Solutions, Carestream

Understanding the value of Radiology Report for referring community and patients is an important topic for Carestream. At RSNA 2014, we partnered with Gelareh Sadigh MD, of Emory University School of Medicine, and Richard Duszak, Jr. MD, the vice chair of Health Policy and Practice in the Department of Radiology at Emory University , and the chief medical officer at the Harvey Neiman Health Policy Institute, to demonstrate the value of using Multimedia-Enhanced Radiology Reporting (MERR),  and were pleased with the study results.

The poster that Dr. Sadigh presented at RSNA 2014 is embedded below with highlights of the findings, as well as details behind the study processes. Some examples of key findings include:

  • 80% believed MERR would represent an improvement over current format of radiology reports
  • 67% believed using MERR, they would be more likely to review report text and images with patients
  • 65% believed using MERR, they would be more likely to provide patients access to report text and images

Most surprising, was the significant increase in perceived value as 80% indicated an increased likelihood of preferentially referring patients to facilities that offer MERR, and 79% indicated an increased likelihood of recommending peers use facilities offering MERR.

Along with these benefits came some concerns from participants, who said that MERR could be time intensive, and that it may not fit within clinical workflow. Those concerns, along with quotes, can be found on slide 17 of the presentation.

While concerns were to be expected, it is clear to us that the benefits outweigh them—allowing reports to provide more context around patients’ histories, and also improving the referral rates for facilities.

The complete study will be published in an upcoming issue of the Journal of American College of Radiology.

Diagnostic Reading #10: Five Must-Read Articles from the Past Week

VNA storing and sharing information

Technologies such as a VNA can provide telemedicine advantages by bringing data together under a single location.

Being the end of the work week, it is time to share a few articles from the medical imaging industry that you may have missed. Last week, we took a look at what 2015 might hold for healthcare, as well as articles about breast density and health information exchanges. This week’s readings cover more possible trends for 2015, industry news, health IT, and patient engagement. These articles include insight on the Congressional agenda for 2015, educating patients and physicians about breast density, how to use mobile health apps and telemedicine to ensure better patient care, and a Forbes article that addresses some potential monetary trends for healthcare in 2015.

1) Patient Engagement Isn’t Easy When mHealth Apps are Subpar

Patient engagement remains a major topic in 2015. This article discusses the need for mobile platforms that patients view as helpful. Healthcare providers should use reliable portals from recognized healthcare software developers. In order to best engage customers, the author says that healthcare professionals need to understand what patients want from the mobile experience and promote interaction between patients and healthcare providers though patient portals.

2) Five Health IT Pieces of Congress Agenda for 2015

With the changes that the U.S. elections brought to Congress in 2014, we may see some actions taken in healthcare legislation. This article addresses the policy changes that might be fought for in 2015. Topics include FDA corrections, telemedicine, EHR and data interoperability, meaningful use, and privacy and data policies.

3) Half of California Primary Care Doctors Unaware of Breast Density [Notification] Law

Though radiologists are required to inform women of dense breast tissue during mammograms, many primary care physicians are not familiar with the law. The law was put into place in 2013 so that radiologists would encourage women to begin conversations with their doctor. This article attributes the lack of knowledge to several factors, including patients that do not know the significance when they are informed that they have dense breast tissue.

4) Physicians Take on Telemedicine to Bolster Care Delivery

This article discusses the impact of telemedicine on the healthcare industry. The AMA details important aspects of telemedicine that will ensure better patient care. These elements include enabling appropriate payment, reporting and coverage as well as other topics surrounding telemedicine and patient care.

5) Five Healthcare Megatrends that May Prove Costly in 2015

Forbes details trends from 2014 that could potentially have an adverse affect on the financial side of the healthcare industry this year. These trends relate to the expanded coverage of health insurance, the cost of technology and the impact that big data will have on the industry this year.