Diagnostic Reading #17: Five Must Read Articles from the Past Week

Carestream logoThis Friday’s Diagnostic Reading includes articles from a busy week in radiology and health IT news. Topics this week include, the FDA and electronic medical records, improving patient safety, radiology IT downtime, outpatient imaging quality, and data security.

1) FDA Calls it Quits on Regulating Medical Device Data Systems– Radiology Business

The FDA has determined that technologies that receive, store or display data from medical devices do not need to be regulated. These medical device data systems are classified as Class I, which means they are low risk devices. The FDA noted that these devices are more important than ever and lifting regulations would be beneficial to achieving interoperability in healthcare systems.

2) Competing Hospitals Work Together to Share Data, Improve Patient Safety– FierceHealthcare

This article highlights the success that hospitals have had when collaborating to improve patient safety. From 2012 until 2015, a network of over 80 hospitals reduced serious safety occurrences in children by 70%. Hospital administrators note that safety is not a point of competition, but a necessity for every healthcare system.

3) Radiology IT Downtimes are Common, but Not Usually Serious– AuntMinnie

A study by the Journal of the American College of Radiology found that the use of several disparate machines and systems can cause downtime due to losing connection with each other. However, the study found that most IT issues can be dealt with in a timely manner and only 3% were considered to have a severe impact.

4) Outpatient imaging: Assessing the Performance of U.S. Hospitals– Health Imaging

Quality and efficiency are becoming points of emphasis in the imaging field. This article addresses the Hospital Outpatient Quality Reporting Program (OQR). The OQR is an incentive program that looks at the efficiency of healthcare systems when ordering certain imaging procedures. The author argues that it might be time for a new metric system—one that is better able to determine the quality of imaging.

5) Data Breach: What’s at Stake for Hospitals-Radiology Today

Thirty million patient records have been exposed through data breaches since 2009. While it is of utmost concern to eliminate data breaches, this article discusses important information for hospitals after experiencing a breach. Topics include notification requirements, financial repercussions and regaining patient trust.

A Closer Look at the New DRX-Evolution Plus System

Helen Titus

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

In an effort to live up to its name, Carestream has produced the next evolutionary stage of the CARESTREAM DRX-Evolution System: the CARESTREAM DRX-Evolution Plus.

The purpose behind these enhancements to the Evolution system was to meet the changing needs and budgets of radiologists and radiographers around the world. We have also worked over the years to enhance the options, functionality, and software of the system, while maintaining its proven performance. But with so many new features added in this stage, it made sense to offer the Evolution Plus as our next premier system.

The new DRX-Evolution Plus offers:

  • A sleek new design with LED lighting for enhanced functionality and aesthetics
  • Greater flexibility in high-ceiling rooms via an extended tube column
  • A new high performance generator designed by Carestream
  • An optional table to accommodate patients up to 705 pounds (320 Kg); and
  • Forward-looking design specifications to embrace future advanced imaging applications from Carestream as they become available.

Advanced capabilities of the DRX-Evolution Plus include:

  • An innovative wall stand Bucky-angulation feature that expedites cross table and other complex X-ray exams
  • Tube touch screen that allows a technologist to change techniques and view images from the tube
  • Pediatric capabilities including automatic technique and image processing for seven pediatric body size categories
  • Bone suppression software for optimized viewing of soft tissue
  • Fast, secure log-in process using RFID badges
  • A transbay option that enables fast tube movement across multiple trauma bays, which helps expedite treatment while minimizing movement of critically ill or injured patients
  • Automatic acquisition and stitching for long-length and supine imaging exams; and
  • IHE Dose Reporting to facilitate data sharing with a facility’s dose management system.

Finally, the DRX-Evolution Plus offers modular components, configurations and supports a choice of three DRX detectors, including two wireless cesium iodide detectors (35 x 43 cm and 25 x 30 cm) for imaging. For maximum productivity, the DRX-Evolution Plus can be configured with a 43 x 43 cm fixed detector in the wall stand, and one or two additional wireless detectors that can be used for table Bucky and tabletop exams.

Below are a number of photos that display the new DRX-Evolution Plus. The technology will be making its debut at ECR 2015 in the Carestream booth, Expo B, #210.

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Enterprise Distribution and Better Patient Care at Sunway Medical Center

Sunway Medical Center in Malaysia is a 350-bed medical facility with a large imaging department that handles more than 75,000 procedures every year and is expected to increase to over 100,000 per year in the near future.

The facility was looking to replace its legacy PACS system as it was hindering the efficient delivery of reports. With CARESTREAM Vue PACS, Sunway Medical Center was able to start using voice recognition, access prior patient data, and use clinical management and viewing tools.

With the installation of the PACS, as well as CARESTREAM Vue Motion zero-footprint image viewing, physicians were able to provide better patient care and discuss images right at the patients’ bedsides thanks to its approved use on iPads, iPhone 4s, Galaxy Note® and Galaxy S® III mobile devices.

Listen to the hospital’s complete story in the video below.

Diagnostic Reading #16: Five Must Read Articles from the Past Week

Carestream logoIt’s Friday and that means that it’s time for a new Diagnostic Reading. This week’s readings includes articles about hospital-physician interactions, radiology analytics, a road map for improving patient safety, and a discussion about imaging appropriateness.

1) Improving Hospital-Physician Engagement – Hospitals & Health Networks

Healthcare reform has made it more important than ever for administrators to engage with physicians. This article discusses the collaboration between health care leaders and physicians, and what can be done to improve their engagement. The author provides a road map of actions that can be taken by administrators and physicians in order to work better together.

2) Radiology Analytics: Bright Future, Dim Present – Diagnostic Imaging

This article addresses the current state of radiology and how the lack of analytics in the field has made it difficult to optimize patient care. Operational, financial and clinical analytics can be used to change the way that radiology is perceived and experts say that analytic tools can be the key to adapt to the new-look healthcare system. Additionally, it is noted that analytics can demonstrate the value that radiology brings to the table.

3) Global Patient Safety Improvement Effort Needed – FierceHealthcare

The World Innovation Summit for Health (WISH) released a report about preventable medical errors. Preventable medical errors are the third leading cause of death in the United States. This is also a global problem. WISH says that current safety initiatives are ‘too narrow.’ The report makes recommendations for global reform. These recommendations include developing a patient safety declaration and forming a committee, among others.

4)  Do Patients Really Demand Unnecessary Imaging Studies? – Radiology Business

According to a study published in JAMA Oncology, patients are not responsible for unnecessary medical imaging. The study found that even if patients request imaging or treatment, the physician most often acts as seen fit. In this study, physicians only complied with .14% of patient requests.

5) Fine Tuning Imaging Utilization – Health Imaging

This article talks about the issue of appropriate imaging. The author says that it is better not to take a broad view on imaging appropriateness. There is a disparity- some regions order less images than others. Rather, he says that interventions should be targeted at healthcare facilities with the highest rates.


Case Study: Clinical Collaboration Across the Enterprise

Reggio Emilia Hospital in Italy is an excellent example of an organized clinical workflow environment. With an annual IT budget making up 3% of total hospital management budget, the infrastructure it has connect 1,500 clients on the local-area-network (LAN), and serves of provide health IT wide-area network (WAN) made up of 1,800 additional clients.

Although it had a solid IT infrastructure, Reggio Emilia Hospital was still looking for a solution for an integrated clinical image repository and distribution system.

In the case study embedded below, you can read how the hospital worked with Carestream to implement an integrated clinical data repository, and how this solution was able to provide collaboration capabilities across the enterprise, no matter where the clinical specialty data was coming from across the network.

You can visit Carestream’s website for more information about our Clinical Collaboration Platform that Reggio Emilia Hospital used to bring a collaborative clinical workflow across the enterprise.

X-ray Pulse Duration and Anatomical Noise Studies at ECR 2015

In March, I will be presenting two papers at the European Society of Radiology’s 2015 European Congress of Radiology. Both papers are in collaboration with Dr. Narinder Paul, Division Chief of Cardiothoracic Radiology and his group at the University Health Network in Toronto, Canada. It is a pleasure to be able to report our team’s studies that take a look at lung nodules, and examine them in two ways:

  1. Measuring the influence of X-ray pulse duration on the module during digital radiography (DR) in a dynamic anthropomorphic chest phantom
  2. Observing anatomical noise and its impact on lung nodule conspicuity by comparing DR, dual-energy X-ray, and digital angular tomosynthesis (3D imaging)

The purpose behind the first paper was to observe the impact of cardiac motion on lung nodule margin. Lung nodule margin is an important component to the evaluation of interval change on surveillance imaging.  Patients that are breathless or anxious may have increased cardiac motion which may impact nodule definition.  As a result, we investigated whether shortening the X-ray pulse duration reduces the impact of cardiac motion on the sharpness of nodule margins for digital radiography.

The method and materials we used to collect our data included an anthropomorphic phantom that was modified to simulate breathing and cardiac motion. Two spherical nodules were placed in the left lung and images were acquired under a range of pulses while adjusting the mA to keep constant mAs. The cardiac rate was set to consistent rates and the exam was repeated 10 times for each ms setting. Ultimately, an algorithm was developed to locate the nodules and derive an average radial profile to yield a sharpness metric generated from the slope of the profile.

From this study, we discovered that pulse duration can impact lung nodule sharpness due to cardiac motion. As a result, care should be taken when assigning protocols for nodule screening.

reduced background anatomical noise in an X-ray

Illustration of tissue discrimination in x-ray medical imaging resulting in reduced background anatomical noise and improved feature conspicuity. DR – Digital radiography, DE – Dual-energy x-ray image.

The second paper that I will be presenting live at ECR, we will be focusing on background anatomical noise as it is a leading cause of reduced object conspicuity in digital radiographic (DR) imaging. Dual-energy (DE) imaging reduces the influence of anatomical noise via tissue discrimination, while digital tomosynthesis (DT) reduces anatomical noise via depth discrimination.

Our methods to the study involved an anthropomorphic chest phantom with a spherical nodule that was imaged with DR, DE, and DT with the same in-room system. DE images were acquired with fixed and differential filtration and DT images were acquired at three dose levels, while a chest DR provided a performance reference.

The study provided a method for comparing performance across X-ray modalities and some insight in terms of optimal acquisition setting for improved image quality and reduced x-ray dose.

The rest of the results for the study, “Anatomical noise and impact on lung nodule conspicuity: comparing digital radiography, dual-energy X-ray, and digital angular tomosynthesis,” will be shared on Sunday, March 8, as part of the Novel Digital Imaging Techniques session, scheduled between 10:30 – 12:00 at ECR 2015.

You can visit Carestream at ECR 2015 in Booth 210, in Expo B.

Sam Richard, PhD, CarestreamSam Richard, PhD, Senior Research Scientist, Carestream


Diagnostic Reading #15: Five Must Read Articles from the Past Week

Carestream logo1) Preparing Radiology For Alternative Payment Models

The Department of Human Health Services (HHS) made an announcement about alternative payment methods. One thing that the report stated was that in 2016, 85% of fee-for-service reimbursements from Medicare will be based on quality or value. The article  goes on to talk about possible problems with this shift and what radiologists should do.

2) Radiology in India: Trends in Medical Imaging Technology

The growth of radiology in India has become a topic of discussion throughout the industry. This article details the radiology market in India. India has high level facilities with top-level x-ray equipment, but there are also villages that do not have access to simple x-ray technologies.

3) NEJM: Are Breast Density Notification Laws Actually Helpful?

Breast density laws are becoming more and more common across the U.S. and for good reason. In an article that may spark debate, Dr. Priscilla Slanetz wrote in the New England Journal of Medicine about the possible downsides of breast density notification laws. Slanetz noted that while these laws may be well-intentioned, they can raise the amount of unnecessary imaging and false positives in patients.

4) Patient Engagement ‘Taking a Backseat’ to Other HIT Priorities

A report from Chillmark Research has found that patient engagement is not the top priority for many healthcare systems. Though developing EHRs is a priority for some healthcare providers, they are typically not very user friendly. Items that might be addressed ahead of patient engagement are defining clinician networks and building analytics capabilities, among others.

5) Obama Budget Heats Up the Issue of Site-Neutral Healthcare Payments

President Obama’s new budget has caused debate– it would equalize Medicare rates for services provided in hospital outpatient departments (HOPD) and physician offices. This article addresses the causes for debate and the reasoning behind the new budget.

Imaging Portals Drive Patient Engagement and Satisfaction

A survey of 1,000 U.S.-based patients revealed that 83% believed that there is value in being able to access their medical images via a secure portal.

This may not come as a huge surprise as patient portal adoption continues to grow in the U.S. and throughout the world, but medical images are often left out of the portal mix. The benefits to providing this access to patients are numerous, with the most obvious being that patients are rightfully provided with the ability to engage with their healthcare providers, effectively empowering them with control over their own care.

In the white paper embedded below that was originally hosted on Healthcare IT News, the study referenced above is explained in further detail. In addition to the 83% of patients who said they would use a patient portal to access images, 76.5% said they would recommend such a portal to their family and friends, and 79.3% said said that they would return for future imaging exams to facilities that offered such a portal.

These types of findings not only give providers an idea of how their patients want information delivered to them, but also gives an idea of how bringing medical images into the patient portal mix can provide value to the overall business with a high number of returning patients, as well as recommending such facilities that provide this offering.

To learn more about the study, you can read the embedded version below, or download Imaging Portals: Driving Patient Engagement, Improving Patient Experience and Satisfaction via the link.

Innovating Technology to Drive Collaborative Care

Dr. Richard Duszak, MD, FACR, Vice Chair of Health Policy and Practice, Department of Radiology and Imaging Sciences, Emory University School of Medicine, and Dr. Randall Stenoien, MD, CEO of Houston Medical Imaging, Founder of Innovative Radiology comment on how fragmented the healthcare delivery system is,  how collaborative care can combat this fragmentation and lead to better efficiency, and the need for radiologists to be an integral part of patient portals as more patients use and rely on them.

Diagnostic Reading #14: Five Must Read Articles from the Past Week

Carestream logoThe articles from this week’s Diagnostic Reading discuss the ONC‘s 2015 annual meeting, workplace management, necessary vs. unnecessary imaging, radiation dose limitation, recommendations HIMSS made to Congress, and an article about the growth of ultrasound in the imaging industry.

1) ONC’s 2015 Annual Meeting Roundup

About 1,200 health IT professionals attended the annual meeting, which was held this week in Washington D.C. Big announcements included: HHS investing in more HIE grants, more health IT cash available to providers, and the ONC will be getting more funding.

2) Lean Daily Management and the Gemba Walk in Radiology

This article describes Lean Daily Management (LDM) in hospitals and the benefits that LDM can bring to the workplace. Read about the gemba board, a method of noting and addressing current issues by using a simple, yet effective method.

3) Study Finds Growing Use of Emergency Imaging May be Justified

A study done by the Journal of the American College of Radiology has found that imaging has become more important to the emergency room because it can increase accuracy and efficiency. This article also attributes the increase of imaging, in part, to the increase of emergency patients in hospitals.

4) HIMSS Wants More Congressional Action to Spur Interoperability

The Healthcare Information Management and Systems Society (HIMSS) made four recommendations to Congress in order to move towards interoperability. These recommendations included, implementing standards for organization development, harmonizing reporting standards, enhancing privacy and security, and improving patient safety.

5) The Ultrasound Advantage

This article discusses the growing field of sonography. Ultrasound has broken into the imaging department with a variety of uses, with more uses being discovered. With ultrasound’s growth and adaptation, it is becoming an important tool in imaging departments across the world.