Innovative Tools To Improve Clinical Quality: Montage Signal

At RSNA 2012 there was a subtle shift in emphasis from radiologist productivity to clinical quality, no doubt driven by greater quality reporting and pay-for-performance requirements.  Shown as a prototype in the Carestream booth, Montage Healthcare Solutions demonstrated Montage Signal™, a new software capability that flags report inconsistencies during radiology report dictation and identifies errors in real-time that can degrade clinical quality and reduce reimbursement.

Montage selected Carestream Vue Reporting as a proven radiologist workflow platform for demonstrating Signal. Signal is an extension of the Montage search-driven radiology business intelligence and clinical quality analytics tools that help practices understand and improve productivity and clinical quality. Visitors to the Carestream booth saw Montage Signal flag reports containing laterality and gender errors, critical test results and incomplete billing documentation—all before report finalization.

Montage search provides access to the unstructured clinical information in radiology reports, enabling radiologists to answer complex clinical questions without disrupting reading workflow. The result is clinical quality improvement and continuous learning because report creation can now occur in the context of prior clinical findings.

Woojin Kim, M.D.,  Interim Chief of Division of Musculoskeletel Imaging at the Hospital of the University of Pennsylvania and  Co-founder of Montage Healthcare Solutions, stopped by our social media broadcast lounge at RSNA to share his thoughts on the next step in clinical quality improvements and the importance of integrating tools into the reading workflow:

What other ways can we prevent errors before they come part of the clinical record?  What analytic innovations did you see at RSNA? 

RSNA 2012 PACS Conversation with the University of Pennsylvania Health System

Kim Chan, Director of Radiology IT at the University of Pennsylvania Health System, talks to us at RSNA 2012 about the workflow challenges of radiologists reading reports from a variety of different hospitals with disparate PACS systems.  Chan shares why the University of Pennsylvania Health System is upgrading their picture archiving communication system to CARESTREAM Vue PACS, which will allow radiologists to read from multiple hospitals on a single PACS workstation.


Live Interview from RSNA: MidCentral District Health Board in New Zealand

Diane Orange, Radiology Department Manager, MidCentral District Health Board in New Zealand, traveled a far distance to attend RSNA this week in Chicago, but it has been well worth the trip. A highlight for Di has been the opportunity to see how her radiology department is at the forefront of many of the themes discussed as imperatives for radiology like expanding the reach of diagnostic imaging into other clinical specialties and innovative approaches to image exchange.

In the video interview featured below, Di  shares how an integrated RIS/PACS system from Carestream has reduced report turnaround. Orange also offers feedback on the new technologies she’s seen at RSNA, including the DRX-Revolution and Carestreams CS 9300 conebeam CT system. Also hear her vision for the future of image sharing.

RSNA ’12 Preview: Digital Breast Tomosynthesis and PACS Integration

Anne Richards, Carestream

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream

When RSNA opens on Sunday, we can expect digital breast tomosynthesis (DBT) to dominate the attention of providers and radiologists interested in women’s imaging. A scan of the scientific and educational sessions featured in AuntMinnie’s “Road to RSNA 2012: Women’s Imaging Preview” highlights the early evidence of increased cancer detection and lower recall rates, which is driving interest in DBT in spite of lingering questions about reimbursement.

For providers who have adopted or on the cusp of offering DBT, however, we expect the discussions in the exhibit halls to extend beyond potential clinical benefits to the IT considerations raised by DBT early adopters. For example, reported earlier this Spring on a KLAS report that highlighted the PACS integration challenges of DBT:
“Doctors are reporting interruptions in their day because not all PACS accept tomosynthesis studies. “It has created a workflow concern for radiologists who have to leave their office or reading room and come out to the tomosynthesis workstation to read the study,” said Monique Rasband, author of the report, Women’s Imaging 2012: Tomosynthesis Makes a Splash.” The doctors do say, however, that this extra time seems worth the effort because of the procedure’s effectiveness, she said.
While capturing the best breast images possible is important, it is just one piece of the care continuum. For DBT to succeed the reading environment must help radiologists make a fast, accurate diagnosis with minimal disruption to the diagnostic workflow.


At RSNA, we’ll be demonstrating our Digital Breast Tomosynthesis (DBT) Module for our CARESTREAM Vue Mammo Workstation that lets radiologists read all procedures from a single desktop. The workstation displays digital breast tomosynthesis studies, traditional mammograms, breast ultrasound, breast MRI and general radiology exams to help equip radiologists to work efficiently from a single desktop.


Here a quick video overview of how it works:

Comparison tools enable radiologists to use personalized hanging protocols for DBT exams along with other procedures. Specialized tools can further enhance productive reading: automatic positioning of DBT and mammograms eliminates manual manipulations; automatic “same sizing” of DBT and mammograms aid in comparing changes in anatomy; and concurrent magnifying glasses provided close-up comparison of pathology across multiple views and procedures. DBT exams can be viewed in cine mode or by scrolling.

If digital breast tomosynthesis is on your agenda at RSNA, swing by the Carestream booth (#2636) to get hands on with our DBT module or schedule your appointment now. 

From Departmental Silos to Streamlined Patient-Centric Workflow

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

A recent Auntminnie article spotlights the challenges of storing documents in PACS or RIS and encourages healthcare facilities to instead turn to vendor-neutral archiving (VNA).

As the world’s second largest supplier of vendor-neutral archiving (InMedica Report, April 2012), Carestream manages more than 2 petabytes of managed data and 80 million studies managed at 10 data centers.  We’ve seen interest in VNAs grow as they offer the ability to collect images and data from a variety of departmental systems to create a cohesive patient portfolio that contains imaging exams, lab and pathology data, video files, and JPEG images. A VNA can provide the patient’s clinical record via the Web or existing EHR/HIS virtually anytime, anywhere – no matter where images, documents and data originate or are stored.

radiology information lifecycleHowever, it’s important to note that healthcare providers will understandably favor data storage platforms that deliver information access without the need to migrate existing archives. Integrating or replacing legacy RIS/PACS or Archive systems can be costly. One option is to select a platform that synchronizes multi-vendor and multi-site RIS+PACS  to create a streamlined multi-site workflow to leverage your existing investment. Solutions like Vue Connect allow you to:

  • Synchronize patient data from multiple sites in real time, including metadata, with or without image data
  • Handle DICOM and non-DICOM images, regardless of vendor platform, age, location or network speed
  • Manage multiple patient IDs via MPI systems; accommodates IHE profile compliance such as XDS repository
  • Permit retention of autonomous, single-site reporting while allowing the  referring community to view all patient data, regardless of originating site
  • Automatically retrieve studies from their most accessible locations
  • Expand the system organically as new sites are added to your enterprise

Eliminating departmental silos of information is an urgent goal for healthcare providers worldwide. Meaningful use requirements and the desire to offer access to patient data through an EHR are both spurring the implementation of both vendor-neutral archives AND alternative platforms that can help deliver a cohesive, patient-centric view of medical data within your budget.

Schedule an appointment at RSNA 2012 to speak with our healthcare IT solutions architects about vendor-neutral archives and synchronizing multi-vendor and multi-site RIS+PACS.

National Institutes of Health Lesion Management Presentations at RSNA 12

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

Precise lesion measurement is critical for reliable evaluation of metastatic disease and faster assessment of patient response to cancer treatment. This topic is heavily featured at RSNA next month, where National Institutes of Health (NIH) researchers are giving three RSNA presentations that involve use of Carestream’s new lesion management application:

  • “Comparison of Tumor Size Measurements in Simulated Metastatic Lesions on Serial CT in a Phantom”   (Tuesday, Nov. 27, 11:20-11:30 AM, Room S104A)
  • “Semi-Automatic Target Lesion Localization, Segmentation and RECIST Measurements on Serial CT Studies” (Tuesday, Nov. 27, 11:30-11:40 AM, Room S402AB)
  • “Optimizing Efficiency and Consistency of Metastatic Disease Treatment Evaluation Using CT Semi-Automated Lesion Analysis” (Tuesday, Nov. 27, 11:40-11:50 AM, Room S104A)

For radiologists and oncologists, simple quantitative comparisons of historical exams – especially those imported from disparate PACS or modalities – have been a challenge in a traditional PACS, causing many to turn to dedicated workstations.

Our new lesion management application, used by NIH in their research studies, is an embedded application in Vue PACS that enhances assessment of oncology patients by:

  • Providing lesion management as a native PACS clinical tool
  • Accepting prior exam results as baseline images from 3rd-party PACS and from numerous modalities
  • Helping boost  radiologist productivity by simplifying segmentation and analysis
  • Delivering volumetric data with PowerViewer to simplify the comparison process between different data sets
  • Supporting oncology follow up with bookmarking and tracking of general anatomy over time
  • Helping reduce the cost associated with dedicated Workstations

If you are at RSNA the NIH presentations shouldn’t be missed.

Unable to attend NIH’s lesion management presentations at RSNA?  You can see a quick video demonstration below that illustrates how the tool is designed to help to provide faster localization, measurements, and follow-up that could help minimize subjective variation and enhance consistency.

How would consistent, standardized oncology image reporting impact communication and collaboration between physicians at your facility? 

Reading Digital Breast Tomosynthesis Exams From a Single Desktop

Anne Richards, Carestream

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream

A recent article in the Wall Street Journal on 3-D mammography discussed the potential for digital breast tomosynthesis (DBT) to enhance the detection of cancers. I was reminded of how important it is to not only capture the best breast images possible, but also to have an efficient and effective system that helps radiologists make an accurate diagnosis.

As I revisited the accomplishments our team has achieved in designing a new module that displays DBT exams on our mammography workstation—while also displaying digital mammograms, breast ultrasound, breast MRI and general radiology exams from a single desktop—I was struck by how easy it is (or could have been) to add yet another dedicated workstation to the radiology reading environment and then falsely believe we have actually improved the diagnostic workflow.

We resisted that path. Our team has long demonstrated our commitment to supporting multiple digital breast imaging modalities on our mammography workstations, and we have fiercely resisted the temptation add new, single-use workstations that might seem alluring because of their “dedicated” nature—when in fact they add costs and create inefficiency. Supporting multiple breast imaging modalities—as well as general radiology exams—enables radiologists to deliver a faster diagnosis to referring physicians and can ultimately enhance patient care.

Our smartly designed tomosynthesis module streamlines workflow by allowing healthcare providers to store, route, display and query/retrieve DBT exams from DICOM-compliant acquisition devices, so radiologists have all the tools they need on one workstation. Comparison tools enable radiologists to use personalized hanging protocols for DBT exams along with other procedures, especially the 2D mammograms. In addition, specialized tools that further enhance productivity include: automatic positioning of DBT and mammograms that eliminates manual manipulations; automatic “same sizing” of DBT and mammograms that aid in comparing changes in anatomy; and concurrent magnifying glasses that provide close-up comparison of pathology across multiple views and procedures.

With our advanced sys­tem, radiologists can quickly and easily read exams from all modalities and vendors at a single workstation. And working smart is an important element in improving patient care.

How do you view or plan to view digital breast tomosynthesis? What do you think about 3D breast imaging?

Webinar: IT Strategies for Imaging Growth & Quality Outcomes

Mary Tierney

Mary Tierney, VP, Chief Content Officer, TriMed Media Group

Earlier this month CMIO Magazine unveiled a new name, Clinical Innovation + Technology, and website, Our new focus mirrors healthcare’s technology-fueled transformation where C-suite executives are tasked with blending clinical and technological innovations to deploy new care processes and practices, evidence-based medicine and decision support, and enhancing communication and information access  across the care continuum through interoperability of clinical devices and IT systems.

Next week in a free Webinar, sponsored by Carestream, we’ll be looking at how this new environment – spurred by the convergence of reform and big data – is impacting the CXO’s approach to operational design in medical imaging.

You’ll hear from:

Kristina Kermanshahche, Chief Architect of Health for Intel Corporation

Maureen Gaffney, RN, the CMIO at Winthrop University Hospital in Mineola, New York


Dr. Eliot Siegel, Professor and Vice Chair University of Maryland School of Medicine Department of Diagnostic Radiology and Nuclear Medicine, and Chief of Imaging at VA Maryland Healthcare System in Baltimore.

Our panelists will detail how CXOs can collaborate with radiology and IT on intelligent IT strategies that do far more than improve department or hospital productivity and efficiency. These strategies must also facilitate image exchange, mobile access and patient empowerment, while unlocking new financial models for growth and scale and supporting imaging’s inclusion in health reforms like meaningful use Stage 2 and the position within the broader picture of health IT.

Please join us and participate in our live Q&A on September 18 at 2 p.m. EST.  Register for the event today!

New Dashboards Designed to Streamline Workflow Can Also Expedite Meaningful Use Reporting

Rick Sera

Rick Sera, PACS/RIS Administrator, Valley Presbyterian Hospital, Van Nuys, Calif.

One of the biggest changes for PACS administrators is the amount of reporting that’s now required to meet meaningful use initiatives. In the past, most administrators generated individual reports from each system—including RIS, PACS and EHR/EMR—to monitor data on patient exams, equipment and personnel utilization, delivery times/methods for radiology reports and other service parameters.

Meaningful use regulations demand collecting and reporting data on specific areas related to the quality and timeliness of service delivery. This creates a burden for PACS administrators because required data is typically collected by different systems and is not always easy to access, since current reporting systems were designed long before meaningful use initiatives were even on the horizon.Vue Beyond

I spend hours each month compiling data to generate required reports, but fortunately help is on the way. New radiology dashboards not only offer a real-time view of how the department is functioning (and bottlenecks that need attention) but some also have comprehensive reporting capabilities. These systems allow users to design reports and then collect desired information from multiple systems and build the report to order.

This next generation dashboard could quickly become a PACS administrator’s best friend. It can collect and track required data, present  create accurate presentations of real-time workflow, and save dozens of hours spent on tedious reporting tasks every month.

From my perspective, this new technology couldn’t have come at a better time.

Editor’s Note: Do you already have a method that collects and automates meaningful use reports? Are you in the market for a more efficient way to generate reports? Come talk to us at  AHRA 2012 about real-time business intelligence and departmental reporting.  

Spire Healthcare Gives Clinicians On-Demand Access to Imaging Data

Robert Ashby, Carestream

Robert Ashby, European Communications Manager, Carestream Health

The IT director and Imaging Manager at the UK’s second largest private healthcare provider, Spire Healthcare, had an interesting challenge. How do you use technology to provide better service for both patients and referring physicians, who have a choice of where to go for care, when your 37 hospitals are on different PACS platforms?

To differentiate their services, Spire sought a secure, PACS and archive-agnostic image viewer that would be accessible from almost any device—predominantly iPads and other tablets—running a Web browser with no local installation or download.

Since January, Spire has been using Carestream’s Vue Motion viewer to allow radiologists and referring physicians to see PACS images from all 37 sites in the Spire network—on the way to the operating room, at the patient bedside or even from home.

I recently had the opportunity to sit down with Stephen Hayward, IT Director, Andrew Milne, Imaging Manager, and Dr. Qaiser Malik, Consultant Radiologist, to talk about their experience with Carestream Vue Motion:

Three professionals with different views on the value of freeing images from the PACS workstation.

IT Director, Stephen Hayward

“There is certainly a huge future in mobile health. Having access to care records and reports on a mobile device at the clinician’s finger tips will be a great boom going forward.”

Imaging Manager, Andrew Milne

“Our consultants can access the system remotely, download, and print without any interaction with my staff. This reduces the traffic into the imaging department and makes our service much more efficient. Staff is free to deal with other matters directly involving patient care.”

Consulting Radiologist, Dr. Qaiser Malik

“The clinician may come across a report and he may want to discuss it with me when I may not actually be there.  I can log in to the system wherever I am.  He can log in from the hospital and we can both look at the same images at the same time.”

At UKRC this week? Come see Vue Motion in stand 99.