Cloud hosted PACS Solutions Help Address Medical Staffing Shortages

Access to radiology reports can help eliminate barriers and enable collaboration

Close-up of surgeons hands holding surgical scissors

The number of new innovations in health IT can be overwhelming. Hospital CIOs and administrators must help evaluate new software for referral management, applications for improved transparency, and analytics software. How can HIT directors and hospital administrators decide which technologies are worth investing in? Answer: start with the ones – like cloud hosted PACS solutions – that solve a real problem – like radiology staffing shortages.

Nicola Strickland, head of the Royal College of Radiologists, made a convincing case to The Observer in 2016 for “how the crisis in radiology recruitment will break the entire NHS system in Britain”. And in January 2017, AuntMinnie Europe painted a dire picture of how a hard Brexit would further strain the lack of radiology resources.

Other parts of Europe, especially rural areas, face a similar problem. The shortage of radiologists and other health professionals is driving medical providers with no formal or previous affiliations to find ways to pool their resources and collaborate among their sites.

Fortunately, cloud based services and teleradiology are toppling the geographic barriers. An increasing number of medical health providers in Europe are installing PACS – Picture Archiving and Communication Systems – and hosting them in the cloud. For example, Spire Healthcare, one of the largest private healthcare groups in the UK, enabled cross site reporting using the Carestream cloud. Using different cloud services from Carestream, Spire Healthcare can store and archive data to enable cross site reporting and then distribution of the reports and associated images. Continue reading

Outlook: mHealth Apps, Advances in X-ray & Expanded Role for Radiology

Radiology journalist says new developments will support goals of improved accuracy and reduced risks

Miguel Ángel de la Cámara is one of the most active Spanish journalists in the field of radiology. With a goal of constantly increasing knowledge in radiology between professionals and patients, he combines his daily work as a radiology technician at Talarrubias Hospital (Extremadura Health Service) with his curiosity as a multi-skilled Illustration-of-mobile-phone-and-radiographyreporter. His work has distinguished him as one of the top influencers in healthcare in Spain . Everything Rad asked his opinion about the 33rd Congress of the Spanish Radiology Society held in Bilbao and the future of radiology.

What would you highlight at the Bilbao Congress from the viewpoint of professional radiology?

I think some important developments are emerging, such as the collaborative construction of knowledge. In radiology, everything is connected. Although radiology reports are the main value, we’re also creating value in many processes that were previously not so visible, such as the security culture or complex post-processing. I think we’re going far beyond radiology reports, although we’re forgetting, for example, about the enormous amount of radiology activity within primary care. Radiology is not only used in hospitals.

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CIO Perspective: IDC Predicts Virtual Care Will Become Routine by 2018

Nearly 15 million Americans used telehealth services in 2015

Telemedicine conceptual illustration.

Telemedicine, telehealth, virtual care, teleradiology, telepsych – some of these terms we’ve been learning about for years, others are newer. And if the researchers at International Data Corporation (IDC) are right, we’ll all experience them ourselves, as patients, for years to come.

IDC recently released its healthcare IT predictions for 2016, and among them is a prediction that virtual care will become routine by 2018. Virtual care is defined as the ability to connect with physicians on an anytime, anywhere basis, such as a video visit with your doctor.

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Telemedicine Growth Points to Increased Adoption of Teleradiology

On-site or cloud-based teleradiology can provide effective patient care.

An on-site or cloud-based teleradiology system can connect radiologists to reports, images, and patient history to provide efficient and effective care.

If venture funding is any indication, we are in store for another year of impressive growth for telemedicine. It was the fastest growing category in digital health last year, increasing 315 percent with nearly $300 million in aggregate funding. This included funding for both new companies and current companies in the space.

In the U.S., licensure and reimbursement are the two key issues that surround telemedicine practices. A statement from the American Telemedicine Association said:

“The fact that every state medical board decides on their own what they believe best practice in medicine is, which is going to vary from state to state, presents a real problem.”  – Jonathan Linkous, CEO, American Telemedicine Association.

While this, and restrictions within Medicare and Medicaid, have limited the use of telemedicine within some U.S. states, it is promising that patients are responding favorably to the technologies.

Meanwhile in Europe, the telemedicine market is growing at a healthy rate every year. It is predicted that by 2019 the European telemedicine market will almost triple to $12.6 billion at a CAGR of 12.82%.

What does this growth in telemedicine mean for teleradiology?

As telemedicine expands, so will the need for images to be included in exams and patient diagnoses done via broadband.

The biggest area that is contributing to teleradiology’s growth is in rural areas. Last year at ECR, Russian presenters explained how teleradiology is contributing to providing care and analyses to sparsely populated areas in the county. While there are still a number of needs that must be addressed such as improving network infrastructure, training, and expertise, the country is devoted to expanding its use of the technology.

Adding on to rural areas, hard-to-reach locations also benefit from the ability to transmit medical images from one place to another. One example was when MSC Cruises became the first cruise line in the world to offer a multilingual pediatric teleradiology service on board, so care could be provided while out at sea.

It is becoming clear that as telemedicine offerings expand, teleradiology is expanding alongside. The technology is able to provide a vital service to many who may not have access to quality care, particularly those living in rural or hard-to-reach areas.

To provide people with the high quality of care we all deserve, it goes beyond the need of technology. It extends into the realm of building quality broadband infrastructure to provide the access, and appropriate training for medical professionals to use the technology. With these three areas fulfilled, teleradiology will only continue its growth as an important component within telemedicine.

Cristine Kao, Healthcare IT, CarestreamCristine Kao is the global marketing director for Carestream’s Healthcare Information Solutions business.



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

VNA storing and sharing information

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

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

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

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

2) Five Health IT Pieces of Congress Agenda for 2015

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

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

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

4) Physicians Take on Telemedicine to Bolster Care Delivery

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

5) Five Healthcare Megatrends that May Prove Costly in 2015

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



Diagnostic Reading #7: 10 Most Popular Blog Posts from the Second Half of 2014

CARESTREAM Touch Ultrasound System - 1Carestream has worked hard to provide content of value throughout 2014. We have used our blog to deliver information about Carestream technology, address major industry trends, and inform readers about the medical imaging and IT fields. In this edition of Diagnostic Reading, we look at our most read blog posts since July. The topics include, the recent unveiling of our newest technology, industry infographics, image quality, digital 3D mammography, and dose reduction.


Carestream unveiled its newest technology in Chicago at RSNA 2014. The CARESTREAM Touch Ultrasound System officially moved the company into the ultrasound market. This post contains information about the new technology, including images that explain its features and capabilities.


This infographic follows radiology reporting throughout history. It covers traditional hand written reports, transcribed reports, and voice recognition. Pros and cons of these types of report are listed. Ultimately, the evolution brings us to multimedia reporting and highlights its benefits.


Since being FDA approved earlier this year, radiologists are 58% more confident in their ability to read chest x-rays with bone suppression software. Since the software produces 2-D images rather than 3-D images, it also reduces the typical dose for patients receiving chest x-rays.


This Q & A with Marty Pesce asks questions about his experiences as an applications engineer for Carestream. The interview discusses the nature of a job as a radiologic technologist. Pesce also had the opportunity to answer questions about his personal experiences in the radiology field.


El Camino Hospital in Mountain View, California, has taken measures to dramatically track and decrease patient dose. The hospital attributes this success to their transition from CR to DR technology. It claims that better imaging software leads to less repeated imaging.


This post emphasizes the importance of Digital Breast Tomosynthesis (DBT), or 3-D mammography for women with dense breast tissue. Numerous studies are noted by the author, including a JAMA study that found that by using DBT, there was a 41% increase in the detection of possibly lethal cancers.


With hospital mergers becoming prevalent, this post suggests that interoperability will continue to be a challenge. The adoption of software such as CARESTREAM Vue Connect could ease the transition. Combining data allows for both institutions to access their own information, as well as having access to new patient information.


Seventy-eight percent of office based physicians use some sort of electronic health record system (EHR). This post addresses the possibility of  radiologists and physicians working together using RIS and PACS to document patient records. There are inevitable challenges, but ideally this could mean “one patient, one record.”


In a time when Americans find it difficult to afford medical bills, radiologists must be conscientious about cost. Inappropriate imaging exams and lack of quality drive up costs, this post discusses how imaging appropriateness and effective reading of images can reduce costs in the field of radiology. Additionally, the post addresses other ways that health IT can help lower imaging costs.


Innovative Radiology adopted CARESTREAM Vue Motion. Since the implementation, efficiency has been higher. Additionally, Vue Motion connected Innovative Radiology with more than 40 sites in early 2014.

Radiology and Macro Healthcare Trends Part III: Quality Care

On-site or cloud-based teleradiology can provide effective patient care.

An on-site or cloud-based teleradiology system can connect radiologists to reports, images, and patient history to provide efficient and effective care.

Part II of this series explored how radiology can impact cost effectiveness at healthcare facilities.  In this final post, we will look at delivering quality care in our new healthcare environment.

New regulations, controlled costs for facilities and patients, and technological innovations have given healthcare providers the ability to more easily provide patients a high-quality level of care. Particularly in radiology, we see significant advances in the products and software that support the capture and delivery of images.

Patients expect that the care they receive will be of the highest quality.  To contribute to this, radiologists should think about the following:

  • Streamlining Communication
    • Making sure that getting to images and results is easy for technologists, doctors and patients. One way to do this is leverage new technology that provides a platform from which this is possible.  Doctor and patient portals are becoming more and more popular – and standard functionality – across many types of healthcare facilities.
  • Playing a Role in Patient Communication
    • Instead of seeing radiology outside of the healthcare continuum, facilities and radiology professionals can work to see how imaging has a direct impact on the quality of patient care. This understanding must be facility-wide so that radiologists have the support they need to become part of the continuum and to be educated on how to communicate with patients.

Technological advances such as reporting platforms that offer native voice recognition, RIS or PACS integration, and advanced reporting, support internal and patient communication.  Having a strong, integrated reporting system contributes to reducing delays in processing and produces better, more contextual reporting.

One area in which streamlining communication and patient communication is having a greater impact is in the area of telemedicine.

Telemedicine, and to be more specific, teleradiology, has not entirely come to fruition because of laws and payment systems that are more encouraging for face-to-face doctor-patient visits. In the U.S., doctors are licensed by states, but the rules follow where the patients live, so doctors must also be registered in their patients’ states too. In the European Union, doctors are licensed by country and have the free reign to practice throughout the union, no matter where their patient lives.

While the U.S. may seem more conservative with telemedicine laws, telemedicine practiced within a state has its advantages. It can be difficult for those living in rural areas to have access to quality care. With a broadband connection, telemedicine can provide rural populations with high-quality care that many in more populous areas have access to. This is certainly the case in China, where it is spending billions on healthcare reform with an emphasis on teleradiology.

What do you think? Are you seeing radiology become an integrated, vital component of quality healthcare? Are there other trends to keep an eye on? 

Carestream CMONorman Yung is the CMO for Carestream. His series about macro trends in healthcare is being published in three parts. Part I was posted in September and Part II was published in October.


Diagnostic Reading #3: Five Must-Read Articles from the Past Week


On-site or cloud-based teleradiology can provide effective patient care.

An on-site or cloud-based teleradiology system can connect radiologists to reports, images, and patient history to provide efficient and effective care.

This week’s Diagnostic Readings include updates on meaningful use, analysis of telemedicine growth, tips about dose management and more. Check out our weekly series, “Diagnostic Reading,” for news and updates in healthcare IT and radiology.

1) Survey Indicates Telemedicine Adoption Growth among Healthcare Executives

This post presents the results of a survey taken by 57 healthcare executives. The findings explore the extent to which health care systems are adopting telemedicine and electronic health records (EHR). The author explores the the channels of telemedicine that are the most popular among this sample group.

2) Enterprise Imaging—Walking the tightrope: Optimizing radiation dose management 

Since the 1980s, the annual per-capita radiation dose from medical exposure has risen from 0.53 mSv to 3.1 mSv. This article from the November edition of Applied Radiology explores the challenges and solutions of moderating dose. The author discusses how the balance of radiation dose management can be optimized.

3) AMA Urges CMS to Drop Meaningful Use Penalties

This article addresses the existing meaningful use criteria and the difficulties that some medical centers may encounter. This piece discusses that reasons outside of a physician’s control may be the reason for their lack of interoperability. Due to these difficulties, the American Medical Association has asked the Centers for Medicare & Medicaid Services to “suspend all penalties to physicians and healthcare facilities for failure to meet meaningful use criteria.”

4)  It’s Time for Radiology to Take Peer Review Seriously

This post discusses the importance of knowing your diagnostic accuracy rate in radiography. The author writes about comparing accuracy rates to bench marks and national standards. These ideas could lead to more accurate readings and more industry-wide credibility.

5) To Improve Mammography Reading Accuracy, Follow Through with Workups

This article discusses the correlation between reading high volumes of mammography readings and accuracy rates. The study conducted at the Group Health Research Institute in Seattle found that radiologists with higher numbers of annual workups had higher screening sensitivity and cancer-detection.

[eBook] The Three-Phase Process to Implement a PACS-Driven Teleradiology Service

A PACS-driven workflow has proven to be beneficial in offering teleradiology services, while still allowing referrers to use the HIS/RIS they prefer.

The story of Innovative Radiology is a common one experienced in the diagnostic imaging sector. The organization was experiencing an increasingly busy workload serving over 40 Houston-based hospitals, physicians’ offices, clinics, and imaging centers, which totaled about 300,000 procedures per year.

For about 10 years, Innovative Radiology was linked electronically to referring physicians through a single RIS to create multiple registration centers. Physicians had to manually register patients in the RIS and workflow was guided by it since the images and patient information went right to the radiologist. This was arduous and required an immense amount of coordination and system integration. On a given day, thousands of images would be sent to the organization from dozens of different systems. Since reporting was not integrated, the radiologists would have to log on to the RIS, select the study, then log on to the PACS to read the cases.

It was the adoption of Meaningful Use that forced Innovative Radiology to move away from its RIS and look for a PACS-driven system. By accomplishing this, the organization now has options—a referrer can still communicate with Innovative Radiology with its HIS/RIS, but it is no longer mandatory.

On-site or cloud-based teleradiology can provide effective patient care.

An on-site or cloud-based teleradiology system can connect radiologists to reports, images, and patient history to provide efficient and effective care.

To implement the PACS-driven teleradiology system and services, Innovative Radiology needed to partner with Carestream to go through a three-phase transition process, which is outlined in the eBook, “Increased Capabilities: Do More with Vue for Teleradiology”:

Transition Phase #1: Innovative Radiology’s use of teleradiology began August 4, 2013. Phase 1 lasted two weeks during which two radiologists at Innovative Radiology were connected with two low-volume sites. About 40 studies from up to seven referring physicians were read daily. All involved digital radiography (DR). Report request order entries were created at Houston Medical Imaging (HMI) using Carestream’s Vue Motion. Report distribution was by fax. There was no email distribution and neither billing nor interface with the Houston healthcare information exchange (HIE) was possible.

Transition Phase #2: Continuing for two weeks, there was a leap forward in both study volume and sophistication. About 25 studies, including DR, PET, CT and ultrasound, were interpreted daily by three radiologists at Innovative Radiology. Studies were referred by 16 physicians from a single site, Oncology Consultants. Report request order entries using Vue Motion were created at the client site. Emails notified referring physicians that results were available via fax and Vue Motion. Billing and HIE HL7 interfaces were established.

Transition Phase #3: During this phase, the network was expanded to include about 30 client sites, including HMI and other large imaging centers. Within one week, 14 radiologists at Innovative Radiology were filing between 300 and 400 DR, PET, CT, ultrasound, MRI and nuclear medicine reports. Any of up to 2,000 physicians were referring studies for interpretation.

Today, Innovative Radiology uses a teleradiology solution that allows for an increase in study volume, workflow, and overall productivity. In early 2014, more than 40 sites were connected to Innovative Radiology via the teleradiology offering from Carestream.

For more information about Innovative Radiology’s story, and Carestream’s Vue for Teleradiology service, you can download this eBook, “Increased Capabilities: Do More with Vue for Teleradiology.”

What do you think about teleradiology? How is it improving care for the patients while also benefiting the providers that offer it? Did you experience roadblocks when implementing a teleradiology service? If so, what were they and how did you overcome them?

Kiran Krishnamurthy, Worldwide Product Line Manager, HCIS, CarestreamKiran Krishnamurthy is the Worldwide Product Line Manager for Carestream’s HCIS business.


Video: How an Organization Uses Teleradiology to Become Independent from RIS

Innovative Radiology covers a couple of hospitals, and Houston Medical Imaging, which is its primary medical imaging facility. The organization also provides readings for about 30 other facilities, which adds up to about 250,000-300,000 readings per year.

The video below is a case study on how Innovative Radiology uses teleradiology to become independent from specific RIS vendors. Now the organization can work with various RIS vendors, creating an easier, more efficient workflow.