Digital Breast Tomosynthesis Brings Benefits to Patient Exams

Digital Breast Tomosynthesis (DBT) provides higher quality mammography images and is becoming more vital to breast exams. At RSNA we spoke with Dr. Harmindar Gill, Medical Director of Premiere Women’s Radiology in Bonita Springs, Florida, about the benefits of DBT and what patients get out of having it as part of their exam. Being the first office in Southwest Florida to offer DBT as part of breast exams, Dr. Gill noticed a decrease in patients’ recall rates and found that it’s easier to spot small lesions that go unnoticed by traditional mammography exams.  The video below provides more insight on Dr. Gill’s practice and DBT discussion at RSNA.

[youtube=http://www.youtube.com/watch?v=LNBHr_Sxaec&w=560&h=315]

What does the Power of Partnership really mean?

The theme of RSNA 2013 was “The Power of Partnership,” and it didn’t take long to discover that theme throughout the halls among vendors, and in the educational sessions. Greg Freiherr of Imaging Technology News took some time to speak with us at RSNA and provided some insight on what partnership means in the medical imaging space, and the trends he saw at RSNA, as well as what he expects to see heading into 2014. Cultural development in the healthcare environment and the mission to bring the radiologist further into the medical process is what Freiherr saw as being the ultimate goal behind the theme. The video below provides the complete interview that expands on the RSNA theme, and how it was put on display and practiced throughout the week.

[youtube=http://www.youtube.com/watch?v=92iAV_xg2vU&w=560&h=315]

RSNA 2013: Preparing for the Annual Feast

Cheryl Proval, Vice President, Publishing, imagingBiz, and Editor of Radiology Business Journal.

Cheryl Proval, Vice President, Publishing, imagingBiz, and Editor of Radiology Business Journal.

When viewed over time, the themes that have marked the annual meeting of the Radiological Society of North America might be seen as signposts indicating the way forward for radiology. From Personalized Medicine in 2010, to Celebrate the Image in 2011, and Patients First in 2012, we can witness radiology moving from an internal focus to a more outward-facing stance.  In 2013, the RSNA signals an even greater transition ahead with its Power of Partnership theme.

Expect the theme to recur throughout the meeting, with several keynotes exploring the potential of clinical partnerships both within and outside the specialty, to improve, optimize, and perhaps even revolutionize patient care.

As medicine grapples with the transition to new payment models on the business side, I see partnership (and its corollary, collaboration) as one of the most potentially transformative concepts working in medicine today.

The trend is evident in the consolidation occurring across the health-care landscape, as former rivals become partners in community health. Not all of these partnerships involve the integration of assets; some simply entail shared mission and IT resources, proving that there are multiple ways to partner.  How well diverse organizations work togethRSNA2013_RGB_Logo_Dateser to deliver health care more effectively and efficiently has great bearing on the future viability of our hospitals.

The same principles likely are at work in the vendor community, which is subject to many of the same forces that are reshaping health care providers: regulatory change, diminishing reimbursement, the need for economies of scale and better access to capital, and the emergence of new, disruptive business models.

Aside from the above pressures, radiology practices are experiencing the additional threat of commoditization.  Everyone who works in radiology understands that there is tremendous variation and complexity involved in the practice of radiology, hardly a ripe environment for commoditization—one would think. Nonetheless, the perception is real, and there are limited clinical quality metrics to counter that belief.

How practices employ the “power of partnership” to combat this perception and to weave themselves into the fabric of care at every level will determine whether the specialty continues to prosper. I see inspirational examples of radiology practices working with other specialties to develop clinical care pathways and standardize imaging protocols. I hear encouraging stories about how practices are working in partnership to develop external as well as internal peer evaluation and other methods of cross-practice quality collaboration. I think that radiology has a great deal to offer its partners in care.

While I often sit on the sidelines and make observations on subjects that others must grapple with, the issue of partnership is one that I will actively live and explore in 2014. The company I work for, imagingBiz, publisher of Radiology Business Journal and a portfolio of digital journals, has merged with TriMed Media, publisher of Health Imaging, and other publications. I have a head start, as I have grown to respect my new partners over the years: We have worked together beneath one banner in the past and competed for business under separate banners more recently.

If radiology does not exactly resemble the Peaceable Kingdom, that is nonetheless a lovely image to take into the Thanksgiving holiday and on to Chicago, as we all investigate partnership and collaboration as a means to succeed, prosper, and meet health care’s new challenges in the year, and years, ahead.

RSNA 2013: Understanding the Importance of Dose Evaluation and Reporting

Sam Richard, PhD, Senior Research Scientist, Carestream

Sam Richard, PhD, Senior Research Scientist, Carestream

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

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

CSH_Comparison_Chart

Source: www.radiologyinfo.org

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

[slideshare id=27300817&doc=primerdosereportingcaresteam20131015-131017105038-phpapp01]

A Systematic Approach to Pediatric Low Dose

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

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

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

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

One size does not fit all…image gently

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

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

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

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

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

New low-dose, small-format DR detector.

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

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

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

Combating the Challenges of Portable Imaging

Rafael Fernandez, DMS Product Specialist, Spain, Carestream

Rafael Fernandez, DMS Product Specialist, Spain, Carestream

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

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

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

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

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

SPANISH TRANSLATION

Los Retos de la Imagen Portátil

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

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

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

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

[slideshare id=27181442&doc=presentacionrevolutionaradiologos-131014152159-phpapp01]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

JFR2013 3D picture

A rendering of the Carestream booth at JFR 2013

FRENCH TRANSLATION

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Providing Pediatric Patients with a Safe X-ray Experience

Helen Titus

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

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

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

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

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

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

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

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

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

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

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

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

Detailed and Precise Measurement with Lesion Management

Larry Ray

Larry Ray, CTO R+I Volume Image Processing, Carestream Health

Precise lesion measurement is important for reliable evaluation of metastatic disease and faster assessment of the patient response to cancer treatment. 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 costly dedicated workstations. Lesion Management is an embedded application tool in our Vue PACS that provides native oncology follow-up capabilities. The precision of the tool can help provide physicians with clearer and more detailed imaging exam results in less time, enhancing their productivity and efficiency to make a diagnosis.

There are several reasons oncology follow-ups are one of the most time consuming and challenging tasks for radiologists:

  • Relevant priors may not have been acquired by the same modality, thus making it difficult to compare as most PACS cannot correlate with different exam types
  • Identification, localization and measurements of lesions are often manual, time consuming and inconsistent
  • Often times lesion management and tracking is performed on a separate workstation or application, without integration to PACS

The lesion tool reduces the need for visual measurement by providing semi-automatic tracking and segmentation of lesions, which can help provide a faster and more consistent means of determining the size and estimating the overall volume of the lesion. The result has the potential to provide a better gauge of disease progression. Typically, when a radiologist first gets a case they mark the lesion and report on it before the data is stored. At a follow-up visit a second set of images with added lesions is read, often by a different radiologist. The lesion management software matches between the two reports and immediately generates a spreadsheet of the patient’s information. The data can be viewed and evaluated on a single exam basis, or a per lesion basis for comparison purposes.

 

When a patient is diagnosed with cancer it’s really a team effort between them and their care providers to choose the best possible treatment plan. Today, we have access to information almost immediately; questions get responses pretty quickly; we have better tools to fight these diseases. The lesion application is one of those tools. It allows for clearer, more meaningful communication and collaboration between radiologists, oncologists and referring physicians which is a vital step in providing the patient with the best care possible.

Editor’s Note:  The Lesion Management application, created by Larry Ray, Edward Gindele & Rick Simon, was a finalists for the Digital Rochester Great Awards in the Optic, Photonics and Imaging Technology category.

Learn more about Carestream’s Lesion Management application:

[youtube=http://www.youtube.com/watch?v=On1kCle17do&w=640&h=360]

NYMIIS: Medical Imaging and Meaningful Use – It is No Longer an Option

Rich Pulvino, Digital Media Specialist, Carestream

Rich Pulvino, Digital Media Specialist, Carestream

With the creation of RIS, PACS and speech recognition, radiology once led the technology revolution in the healthcare industry. Unfortunately, now it is a sector of that industry that has fallen behind, on account of it lagging in the adoption of Meaningful Use (MU) criteria. But just because radiology is behind does not mean adoption is impossible.

This was the discussion presented by Dr. Keith Dreyer at New York Medical Imaging Informatics Symposium (NYMIIS) in New York City on September 16. In fact, MU adoption is picking up in the industry, but not as fast as the rates among physicians and hospitals. The numbers say that as of 2013, about 14% of radiologists are involved in the MU stages, while 50% of physicians are participating. Dr. Dreyer explained that this gap exists because of the silos and compartmentalization that exists between radiology practices and other departments in health facilities. RIS/PACS currently function separately from the EHR, and while progress is being made is alleviating this issue, there is still much to be done.

Ordering, scheduling and communication between physicians and patients are improving, but there remains a vital need for workflow and interpretation of studies. Between the information housed in the RIS/PACS and the EHRs, this is essentially two programs doing practically the same thing in terms of the information stored. Convergence is necessary if workflow and interpretation are to be improved.

Dr. Dreyer explained the fact that only 14% of radiologists are involved in MU is troubling considering that 90% of radiologists are eligible for the incentives. But the growth is promising—while 450 radiologists participated in MU in 2011, that number increased by 3,500 in 2012, and is predicted to increase by 6,000 in 2013, and by 8,000 more in 2014. Growth is occurring, but radiology is still going to be playing catch-up to the rest of the healthcare sector.

To provide guidance, Dr. Dreyer outlined a 10 step plan to help radiologists work their way through MU:

  1. Understand the MU program—the deadlines and responsibilities.
  2. Understand your organization’s plan for MU of eligible professionals (EPs)
  3. Gain institutional acceptance for participation in the organization’s MU/EP plan
  4. Understand and identify the certified EHR technology (CERHT) to be used for compliance
  5. Determine MU measures that are available and required in your practice
  6. Decree MU policies for activities, interpreting the regulations specific to your radiology practice
  7. Create a comprehensive set of MU compliance documents
  8. Review compliance documents with institutional stakeholders (CMIO, CIO, etc.)
  9. Review MU compliance documents among radiology staff
  10. Implement the strategies early with the appropriate dashboard to measure successes

Following the run-through of these 10 steps, Dr. Dreyer then went on to provide advice for radiology departments of different sizes—small practice/imaging center, medium practice/single hospital and large practice/multi-hospital system/imaging centers. The larger practices are the ones more likely involved in MU because these are the organizations that either already installed their own CEHRT or are able to access the health system’s CEHRT. Because of this, Dr. Dreyer went into more detail about the two smaller categories.

With the small practices and imaging centers, Dr. Dreyer recommended investigating the technology that is common across all centers similar to this size. This should provide some essential background information on the most appropriate solutions to implement. Based on the research collected, he said that it is possible for smaller practices to install a stand along CEHRT solution.

For the single hospital and medium practices, he recommended using existing CEHRT for program compliance. These smaller practices should convince hospital leadership to expand their MU program to include radiologists, since it is most likely focused only on physician EHRs. Much of the data entry will be performed by others, which makes it difficult to take advantage of special exclusions, and may require a pack for use of the technology.

To wrap up his talk, Dr. Dreyer reiterated how MU is marking a new era for radiology. He said that once that complete execution could help and hurt some depending on financial costs and ability to properly maintain the data. Overall, there is no denying that imaging health records are beginning to play a great role in the healthcare space. So much so that we are now beginning to see patients access their images, which is not required until MU stage 3. The MU pace of adoption is speeding up, and radiology cannot afford to be fall behind any further than it already is.