Amicas plans to introduce advanced PACS platform at RSNA meeting

Worklist-driven Web-based architecture promises efficiencies

PACS vendor Amicas plans to unveil a "visionary" technology at the RSNA meeting. While the new technology is built on past successes, the Vision Series PACS will add another dimension to the Web-based transmission and archiving of medical images, according to executives at the Boston-based company.

The comprehensive nature of the Vision Series will distinguish it from competitors, said Amicas CEO Hamid Tabatabaie. Billed as an end-to-end Web-based PACS platform, the Vision Series is an integrated collection of strategic clinical tools that together allow enterprise-wide PACS and image management. Tying these tools together is an on-demand real-time worklist, which Tabatabaie describes as the key to its functionality.

As with any well-designed PACS, the Vision Series provides access to images across the installation, whether it is an imaging center or a network of several hospitals. But the Vision Series does more than that.

"It allows radiologists to accomplish two tasks that they cannot accomplish with legacy PACS," he said. "First, it allows them to handle workflow internal and external to the department. Second, it allows them to communicate the result of their work as a report and set of images to an expanding base of clients."

The Vision Series is built around a corporate philosophy to develop and provide scalable, feature-rich PACS that meet the healthcare needs of organizations of all sizes, Tabatabaie said. The latest demonstration of this philosophy, the development and integration of a worklist achieved with the Vision Series clinical tools, drives workflow by tracking and reporting patient status to healthcare providers.

"We are delivering the equivalent of a FedEx tracking system," he said.

After ordering a radiology exam, a referring physician typically has to telephone the radiology department or imaging center to determine the status of the exam. The Vision Series automates this process, offering status reports to any healthcare professional.

"Let's say the ER orders an exam," Tabatabaie said. "On a screen in the ER, staff can see when the patient has been received in the CT suite. They will see when the images are taken, how many are taken, that the radiologist has evaluated the images, and that the report has been rendered."

This is a visionary approach, he said, because it transforms workflow from a departmental concept to a universal one. The Vision Series PACS is empowered to provide workflow information to anyone in the healthcare process who needs it.

The goal is to improve productivity and increase convenience for radiologists and other clinicians while creating cost and healthcare efficiencies. The Vision Series represents the culmination of an effort begun seven years ago with the founding of the company, according to Tabatabaie.

"We started Amicas seeking to demonstrate the viability of the Web and of Internet technology for a complete image management system in an enterprise," he said. "Vision completes that by having all its components based on the Web and by working on a standards-based Web architecture."

The Vision Series is built on a scalable but centralized architecture. The product comes with modules for different departments, such as the ER, ICU, cardiology, and orthopedics. Data are accessed through Web-based workstations. LightBeam serves the diagnostic radiologist, LightView supports clinical review, Personal Amicas serves the remote reviewer.

The Vision server family, configured with a fault tolerance and load-balancing module called Atlas, supports long-term archiving. A CD-burning capability replaces film jackets with compact disks. Key images--or even 3D movies--can be burned on a CD at the facility. Each disk includes PC-compatible software for viewing the images.

"The diagnostic quality depends only on the monitor," Tabatabaie said.

A range of capabilities built into specific packages with different price points, from $40,000 to $1 million, provides choices for different types of customers. Each is named after the groups for which they are tailored. Imaging Office is for imaging centers and small radiology departments within hospitals that are just getting started in PACS. Radiology Office is designed for radiology groups and hospitals of greater size. The Enterprise package is meant for extensive implementation of PACS across distributed healthcare institutions. Enterprise Enabler allows customers with a PACS already installed to distribute data outside the radiology department.

The packages are flexible enough to handle different configurations of technology. One may be installed initially to handle only MR and CT. It can later be expanded, however, to accommodate the addition of CR or DR or an upgrade from single- to multislice CT.

Amicas offers combinations of software and hardware but has kept the hardware at arm's length, focusing instead on the development of software. Through a strategic alliance, Dell Computer provides the servers that run Amicas software, Tabatabaie said. This approach helps keep costs in line for Amicas and its customers, while allowing Amicas to provide turnkey solutions. To minimize problems that could arise if one vendor provided hardware and another software, Amicas is taking responsibility for the integrated operation of Vision Series.

"We will provide end-to-end implementation and first-call support," Tabatabaie said. "So whether it is a hardware or software failure, Amicas has 24/7 support and can handle the problem.

This sense of commitment has helped make Amicas one of the most successful providers of PACS. Of the 150 medical facilities running Amicas products, all but four are in the U.S. Among Amicas' clients are Intermountain Health Care, New York-Presbyterian Healthcare System, and Massachusetts General Hospital.