Whirlwinds of Change — What Can We Anticipate?

Digital Imaging and Healthcare IT Challenges: Advances & Trends for 2016

Part One

It’s that time of year again – when industry publications, websites and blogs roll out their predictions on the imaging and IT trends that will be most influential in the coming year. As always, the changes are coming at us with ever-increasing speed.

For this post, I surveyed a range of respected industry sources and condensed many of their predictions for quicker reading. If you’d like to explore any of the viewpoints here further, the link to the complete article is always listed.

  • Healthcare IT Advances Set to Fuel Explosive Market Growth

Rajiv Leventhal reports in Healthcare Informatics that while the global digital health market is already valued at over $55.3 billion, it’s projected expected to continue expanding by a compound annual growth rate (CAGR) of more than 21 percent by 2020, according to a report from P&S Market Research.The report attributes this surge to the growing demand for an advanced healthcare information systems and growing investments by health IT players. Electronic health records (EHR), mobile health (mHealth)  and telemedicine will fill a pressing need for more efficient diagnosis, treatment, care and rehabilitation. Improved patient-provider communication via mobile devices and apps will support reduced medication errors and provide better overall care.

More details here.

  • Transitioning From Interoperability to Advanced Interoperability

Gary Palgon, VP of Healthcare of Life Sciences Solutions at Liaison Technologies, writes in Healthcare IT News that compliance with the Medicare and Medicaid EHR incentive program’s proposed rules for Stage 3 Meaningful Use will require enterprises to make a greater investment in connecting internal and external systems. With fundamental levels of interoperability largely achieved, the focus will now shift to advanced interoperability – seamlessly pulling together data from connected systems to present a holistic, uniform view of the patient’s health. This is crucial, as without advanced interoperability, there’s no way to bridge the gap between more data and meaningful data. More details here.

  • Stretching Budgets With Refurbished Equipment

AuntMinnie.com reports that the market for refurbished medical equipment will be worth $9.37 billion U.S. (8.3 billion euros) by 2019, according to a new report by MarketsandMarkets. Medical imaging equipment categories covered in the survey include x-ray, ultrasound, MRI, CT, nuclear medicine, and others systems such as C-arm and mammography devices. This trend is being driven by a growing demand for lower-cost medical devices due to financial constraints, the need to achieve more economical specialty exam capabilities and increasing privatization in the healthcare sector.

There is some resistance among public institutions regarding the purchase of refurbished medical equipment due to a perceived lack of standardization of policies governing its sale and use. Even so, MarketsandMarkets stands by their projections for this trend. More details here.

  • Progress to Come Gradually For the Less-Than-Half of Managed Care Organizations Without Access to EMR Data

Healthcare Economics recently reported on the results of a Digital Trends Study by Precision Advisors. Based interviews with 145 managed care executives, the study concludes that while Managed Care Organizations (MCOs) are aware of the benefits big data and predictive analytics, they are not able to fully implement them. Specifically, only 46 percent of MCOs currently have access to EMR data. And, while 73 percent of MCO executives surveyed expect to see this increase by 26 percent over the next several years, the specifics of this progress have yet to be seen. Survey respondents cited interoperability challenges as a key barrier to integrating EMR data. More details here.

Part Two will be posted on 12/29/15

JianqingBennettBWJianqing Bennett, President, Digital Medical Solutions, Carestream Health

Guess the X-ray – December’s Image Challenge

To end 2015 on a high note we’re offering up another round of our radiology image contest, and in the holiday spirit we’re including 2 images this time!

We welcome radiologists, technologists, RAs, MDs, PAs – or anyone who thinks they’re up to the challenge – to guess either subject in this educational X-ray quiz. Please leave your answer in the comment section below.


Sorry Carestream employees – please sit this one out.

Guess The X-Ray – September’s Image Challenge

Happy September everybody! Time for a new Image Challenge. Last month we had a clock radio, and we think we have another good image for September.

This month’s image is below; please leave your guesses below or on our Facebook page. The challenge will run until September 30, or until the first person correctly names the image. Good luck!


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

September Image Challenge

The Top 10 Reasons for Veterinarians to go Digital

Heidi McIntosh, Marketing Manager, X-ray Solutions, Carestream

Heidi McIntosh, Marketing Manager, X-ray Solutions, Carestream

Radiography is a jargon-heavy environment filled with terms and acronyms that can be hard for anyone to follow. The last thing you want to worry about is being confused while taking care of your patients. There is no doubt that technology is changing the way we work and many facilities are upgrading from film-based radiography to digital, but some are still on the fence.

A veterinary practice on the coast of Southern England recently showcased the advanced medical care now available for beloved pets and their owners. Raddenstiles Veterinary Surgery upgraded to digital to deliver access and management of high-quality imaging studies for the 3,500 patients the practice sees each month. Going digital has enabled the practice to engage in remote consultations to better treat their patients.

In a recent case, a Jack Russell Terrier fell off a 150-foot seaside cliff and was rescued by the Coast Guard. The veterinarian at the local practice determined the dog had a broken hip and digitally transmitted the images to the on-call vet at the Raddenstiles practice. There, they were able to devise a treatment plan and successfully repair the injury once the dog was stable and fit for surgery.

An Inside Look: A magazine for veterinarians from Carestream about radiology trends.

V-Inside: A magazine from Carestream about veterinary radiology trends.

There are many benefits that come from making the move to digital from both a business and patient-care perspective. Here are 10 of the best ones:

  1. Speed: Imaging exams are faster and smoother than ever before. X-ray images are displayed almost instantly, enabling veterinarians to accept or retake an image if needed, adding up to faster diagnosis and early treatment.
  2. Quality: Digital imaging provides superb quality, which can mean a higher level of confidence in the diagnoses and potentially, an increased standard of care.
  3. Waste: No more film, storage, toxic chemicals, fumes/odors, or long processing times.
  4. Versatility: Flexible and versatile software enables veterinarians to capture both soft tissue and bone detail in the same image, eliminating the need for multiple exposures with film cassettes.
  5. Sharing: Digital imaging supports increased clinical collaboration because images can be quickly and easily shared electronically.
  6. Application: Digitally captured exam images can be enhanced and manipulated to aid in interpretation.
  7. Space: Save valuable floor space since there is no need for a dedicated darkroom or storage for files because all images can be archived digitally.   
  8. Savings: Advancing technology is making the initial cost of digital systems even more affordable. Over time practices can enjoy a lower cost of ownership and operation.
  9. Transition: The transition is smooth and easy with little to no disruption. Digital imaging fits into existing workflow with an easy-to-use interface, minimizing training time.
  10.  Intuitive: This state-of-the-art technology can differentiate practices from the competition and enhance professional image.

The latest edition of An Inside Look magazine further discusses how Raddenstiles Veterinary Surgery benefits from going digital, along with “RAD 101: Know Your Modalities,” and a closer look at the TDR Detector. You can read the latest edition of the magazine here and subscribe to never miss a new version here.

How can going digital help your veterinary clinic be at its very best?

A Mobile Imaging Efficiency Showdown: CR vs. DR

When it comes to medical imaging it is no secret that every second counts. The modern healthcare environment can be incredibly fast-paced and medical imaging professionals demand, and deserve, the best when it comes to time-saving technologies.

We wanted to compare the efficiency of DR compared to CR using the DRX-1, and with the support of Queen Elizabeth Hospital in Birmingham, UK we were able to record a speed test. In the video, wireless DR is almost twice as fast as standard CR mobile imaging–an impressive performance that could make a big difference in terms of productivity and patient care.

The Top 5 Everything Rad Posts From the First Half of 2014

top 5The first six months of 2014 have proven to be quite eventful for all of us in the world of medical imaging and healthcare IT. As we look forward to the second half of the year, we wanted to take a look back at the five most popular posts of the first half of 2014.

1) Five Ideas the Medical Imaging World will be Implementing in 2014

This post gives a preview of the five big trends that we thought would affect the medical imaging world in 2014.

2) Preparation and Support is Key to Safe Imaging with Pediatric Patients

There are many components of medical imaging that can intimidate or scare children. Learn about how hospitals employ child life specialists to support children and their families before, during, and after their radiology appointment.

3) ACR on CNBSS Mammography Study: “Deeply Flawed and Widely Discredited”

This post highlights the American College of Radiology’s (ACR) response to a study which claimed that mammograms offered no advantage in detecting breast cancers that were too small to feel. The ACR found many serious design flaws in the study, and found no reason to dismiss the importance of mammograms.

4) Q&A: Digital Breast Tomosynthesys

Ron Muscosky, Worldwide Product Line Manager, HCIS provides answers to some of the common questions health care organizations are asking about Digital Breast Tomosynthesys.

5) [Whitepaper] How can Bone Suppression Improve Chest Radiographic Images?

This whitepaper takes an in depth look at Carestream’s bone suppression software, which helps radiologists interpret chest images by removing the ribs and clavicle from x-rays.

Not a Typical Day at the Office: Application Engineers Taking Steps to Improve Customer Experience

Laurie Cesar, Application Engineer, DMS, Carestream Health

Laurie Cesar, Application Engineer, DMS, Carestream Health

Jenn Thwaits, Application Engineer, DMS, Carestream Health

Jenn Thwaits, Application Engineer, DMS, Carestream Health

Customers have never had more access to information than they do today. Everything they need is at their fingertips- product reviews, testimonials, competitor information. It’s a key factor driving companies to deliver stronger incentives to their customers because if they can’t provide them with what they want, someone else can and will.

Staying at the forefront of technology in this day and age is almost impossible as it seems to change daily, but keeping your customers happy is a lot simpler. How? By just listening to them. Communication barriers no longer exist between consumers and big companies making it easier than ever to connect with each other.

As application engineers, we’re involved in the design and implementation of products, training, troubleshooting, and product enhancement. Much of our product enhancements come straight from our customers. We gather their feedback and information about their needs and work with our team to develop and enhance our products with our customers in mind.

It’s not every day that we get to be on the sidelines at an NFL game or X-ray an African Guinea Pig, but we’ve had some pretty interesting days outside of our four walls and it was all to better our customers experience with our products. Here are some of our most memorable moments:

*JT (Jenn Thwaits) & LC (Laurie Cesar)

  • (JT & LC) Buffalo Bills: We announced our partnership with the Bills back in August 2013 and installed the DRX-Ascend System and DIRECTVIEW CR System at Ralph Wilson Stadium. They’re not using our equipment every day like facilities are; they’re using them every Sunday. We were present on the sidelines for the first three games of the season to ensure their radiologist tech, Gary Celotto, knew how to work the equipment in order to properly treat a player because if someone gets injured, Celottoneeds to get to them so that the trainers can immediately assess their injuries. During the pre-season game against the Lions, We ended up X-raying about five players (ribs, knees, feet, etc…) but luckily none were seriously injured.
  • (JT & LC) Spurwink Farms We partnered with Idexx to develop image processing for veterinary DR (digital radiography). We worked on equine image processing at Spurwink Farms in Maine and were able to acquire all imaging needed by X-raying three horses. When you get image data off a CR/DR plate there are so many shades of grey that the human eye cannot distinguish the details in an image. Image processing enhances the darkness, contrast, sharpness and noise to optimize the image so that the eye can differentiate the bone structure and soft tissue, etc. Image processing is an intense task that requires lots of images to do well, which is why it took us multiple horses in order to get the correct images for our software.
  • (LC) Animal Kingdom: While I was working in the field as an Applications Consultant I had the opportunity to go behind the scenes at Disney’s Animal Kingdom. We were developing an early version of our vet product. I was tasked to optimize the existing human image processing that was in the current product to make it work for animals – large, small & exotic animals. The novelty of being in an unusual environment made the trip very interesting. It also provided an opportunity to see how medical care is provided in an environment different than the one I’d worked in for all those years.
  • (JT & LC) URMC MorgueIn order to receive FDA clearance for a new product you must demonstrate substantial equivalence to a legally marketed product to ensure it’s as safe and effective (or more so) as one that is already in clinical use. This is often established by taking images acquired from both the previous and new product. Since it’s not a good idea for people to have two x-rays when one is sufficient for their diagnosis, cadavers [those who agreed to donate their bodies to science] are often used. When the 2530C detector first came out, we wanted to ensure both specifications were met. We contacted one of our research partners access their morgue where we were able to acquire pairs of anatomical images using two receptor types. Once we confirmed the intended improvements of the new detector we were able to file the appropriate paperwork with the FDA and received clearance for the detector.

Highlights from the MDCT 2014 Workstation Face-off

Menashe Benjamin.gif

Menashe Benjamin, Vice President, HCIS, Carestream

This year marked the 12th annual International Society for Computed Tomography’s (ISCT) Workstation Face-off at Multidtector-row CT (MDCT) 2014. Doctors representing four vendors (Siemens, Phillips, TeraRecon and Carestream) worked on four different cases with the vendor’s workstation to put each system to the test in terms of speed and accuracy of diagnosis. Once again, Carestream was the only vendor that used a PACS workstation to complete all the cases, while the other vendors used highly specialized, dedicated 3D workstations.

All cases were complex and required advanced and fast image processing, measurement and reporting capabilities. The cases included:

  • Following a lesion in the abdominal wall across four time points based on two PET-CT and two CT studies;
  • Segmenting two lesions in the liver and segmenting the whole liver into nine segments according to the Bismuth classification;
  • Providing a set of measurements from a CT scan to plan a transcatheter aortic valve replacement; and
  • Highlighting multiple rib fractures of a severely injured man following a motor vehicle accident.

Dr. Michalle Soudack, Head of Pediatric Radiology at the Safra Children’s Hospital in Israel, was our experienced representative on the Carestream Vue PACS system. As always, she demonstrated the various applications in a clear, concise and precise manner, all within the allotted time.

Three areas that stood out in this year’s face-off:

  1. Polling. These were not scientific, official polls, but questions were posed to the audience and they could text in their answers.  The questions and results are below and these findings, while not conclusive, are interesting in terms of the audience makeup at MDCT 2014. For instance, the first poll question, 11 respondents say they have never been asked to measure liver volume and, surprisingly, 10 respondents answered “Yes” to the fourth poll question. This is a promising sign that collaboration and cooperation are gaining ground in the medical imaging space.MDCT
  2. The case results. These differed widely among the vendors in the second case, where the competitors were asked to measure the whole liver volume and the tumor burden per liver segment.


While the judges did not provide an official answer on which vendor was the most accurate, they did comment that validating the reproducibility and accuracy of automatic measurement results is an important factor in assessing workstation segmentation performance.

3. New product and application. During the presentation of the fourth case, Dr. Soudack was able to provide a look at two of Carestream’s newest technologies for radiology IT.

 a. The first was a work-in-progress called radial view. Dr. Soudack worked through a case focused on rib fractures and showed a new view that more clearly depicts the fractures, as can be seen below:

MDCT Radial View

Radial View is a special form of MIP (Maximum Intensity Projection) showing the ribs spread out as if they were looked upon from inside the body.

b. The second and more important new technology demonstrated by Dr. Soudack was a complete workflow highlighting Vue Reporting as a key tool for communicating findings and promoting collaboration between all radiology stakeholders. Vue Reporting brings radiology reporting into the rich, multimedia and interactive world. This new technology allows radiologists to couple findings and images into a single interactive report, as well as to inject into the report measurements and calculations created during image interpretation, thus helping to minimize chances for errors. Dr. Soudack demonstrated features such as live hyperlinks that enable instant access to live images and complete patient portfolios from the web, including validated mobile devices such as iPad and iPhone (for which Carestream has FDA clearance).


As always, the workstation face-off was a thrill to watch because we were not only able to see expert radiologists maneuver throughout the different platforms, but we were able to see how the workstation technologies and applications are evolving. These advances are being made with the purpose of helping create a more efficient and error-free work environment for the radiologist, which can in turn provide better care to patients. The unique design of Carestream Vue PACS, with its unified backend and data model, strives to expand this environment to ALL radiology stakeholders, addressing the needs of referring physicians, administrators, and patients as well.

Where do you see PACS workstations in the future? Are there applications you hope to see added to your system down the road?

[eBook] From Trust to Use and Beyond: The Road to Clinical Decision Support

Diana Nole, Carestream Health

Diana L. Nole, President, Digital Medical Solutions

Healthcare is in store for its biggest transformation over the next few years. Between the evolution of technologies and laws, facilities are looking at a new age of patient care—one that is involves interaction, and is proactive thanks to the vast increases in patient data physicians have access to.

We created an eBook titled, From Trust to Use and Beyond: The Road to Clinical Decision Support to show how industry thought leaders are currently addressing or have addressed today’s IT issues

Information technology in healthcare is already playing a vital role in this change. Electronic medical data is moving past petabytes. Analytic tools and distributed platforms provide real-time access. The environment is ripe for this data to positively affect the quality of care provided to patients, but providers have hit a wall. Reporting has shifted to focus on the need to screen and manage the information flow to clinicians, while the value of information extends to what we make available to patients and how they can interact with their physicians about it.

The first chapter of From Trust to Use and Beyond: The Road to Clinical Decision Support focuses on fostering clinical trust via data. The chapter contains remarks from Maureen Gaffney, MHS, PA-C, RN, senior vice president patient care services and chief medical information officer, Winthrop-University Hospital, in Long Island, NY.

Gaffney explains how the facility achieved HIMSS Electronic Medical Record Adoption Model (EMRAM) Stage 6 recognition with a hybrid environment and is working its way to becoming entirely paperless.

We hope you find chapter one to be beneficial and please be on the lookout for chapter two, which will be released in the coming weeks and focus on overcoming clinical resistance to anything that changes the existing workflow.

Access and download the first chapter, “Building Trust,” in the eBook From Trust to use and Beyond: The Road to Clinical Decision Support.

Click the image to access the first chapter of the eBook, From Trust to Use and Beyond: The Road to Clinical Decision Support.

Click the image to access to eBook, From Trust to Use and Beyond: The Road to Clinical Decision Support.

Guess the X-ray–June’s Image Challenge

Happy June! A new month means a new Image Challenge.

Last month we had another difficult image–eye makeup–but congratulations to the person who guessed it correctly. Below is the image for June’s “Guess the X-ray”. Please leave your comments below or on our Facebook page. The challenge will run until June 30, or until the first person correctly names the item in the image.  Good luck!

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

June Guess the X-ray Challenge