GE set for PACS success after many years of attempts

GE set for PACS success after many years of attempts

Vendor looks to transfer Lockheed Martin's government success to private sector

GE Medical Systems has attempted for years to replicate in the PACS market the success it has achieved in its vaunted modality business. After changing direction several times in the last decade, the medical imaging powerhouse finally appears to be on course.

The 1997 acquisition of Lockheed Martin Medical Imaging Systems (PNN 5/97) gave the vendor a PACS product line and a staff that has experience in large-scale PACS implementations in the military and Veterans Affairs markets, most notably with the groundbreaking Medical Diagnostic Imaging Support (MDIS) and Baltimore VA Medical Center sites. GEMS is looking to transfer those LMIS successes into the private sector, an achievement that eluded the defense manufacturer for years prior to its acquisition by GEMS.

GEMS officials believe the difficulties encountered by LMIS were not related to the quality of the vendor's PACS technology, then called Vantage PACS. Instead, civilian customers were seeking to purchase PACS technology from a vendor with which they were familiar and which they were confident would be around in the future, said Anthony Lombardo, global general manager for the Mount Prospect, IL-based Integrated Imaging Solutions division. Lombardo previously headed up LMIS before being hired by GEMS to take over IIS in June 1996.

"The big hurdle for a Lockheed Martin or any of these other defense companies is that fundamentally their charter is to build something else," Lombardo said. "Their core business is Department of Defense work. The commercial customer base, which is now finally getting into the PACS world, wants to buy from companies that they can leverage in other ways, that they've had long-term relationships with, and that they feel comfortable with."

GEMS now has 40 PACS installations, with 15 comprising large-scale PACS environments. GEMS is also making inroads into the private sector, either installing or scheduling installation of high-end purchases for clients such as Methodist Hospital in Houston, the Mayo Clinic in Rochester, MN and Scottsdale, AZ, the University of Pennsylvania Medical Center in Philadelphia, and Alaska Native Medical Center in Anchorage.

Shifts in focus

The vendor's approach to PACS has experienced some twists and turns over the years. In the mid-1980s, GEMS targeted the PACS market through a partnership with IBM in order to develop a comprehensive PACS line called Integrated Diagnostics. That project ended after five years without a product reaching market, however.

In 1992, GEMS shifted gears, and decided to participate in the PACS market as a network provider and systems integrator for end users. In addition to offering some PACS components such as diagnostic and review workstations, GEMS sold PACS equipment provided by OEM clients. The vendor also emphasized its commitment to the ACR-NEMA and the DICOM standard, making sure all its equipment was DICOM-compatible.

Prior to the 1994 Radiological Society of North America meeting, the company formed its Network Products and Services division, which generated over $30 million in worldwide sales in 1995. In 1996, the division was renamed Integrated Imaging Solutions.

IIS took a modality-cluster approach to PACS, with GE's Advantage Windows workstations provided for reviewing images from modality scanners and other components like teleradiology links supplied by third-party partners. GE evidently believed that a more comprehensive approach to the market was necessary, however, and the company began exploring the acquisition of LMIS in mid-1996. After months of on-again off-again talks, GE and Lockheed Martin finally completed the deal in April (PNN 5/97).

GEMS has moved Lockheed's Hoffman Estates, IL office to an 80,000 square-foot manufacturing and engineering facility in Mount Prospect, IL, which will now house 95% of IIS staff.

LMIS integration

As part of the integration effort between Lockheed's PACS product line and prior PACS technology from GEMS, the vendor's Advantage Windows modality workstation and computed radiography quality assurance workstation for Fuji's CR technique are being integrated into the PACS network. That engineering work is expected to be completed by the end of the year, Lombardo said.

Since all internal PACS database development was halted by GEMS when the company decided to acquire the assets of LMIS, not much technology previously developed by IIS had to be discarded, he said. In fact, some elements, such as patient matching algorithms were kept and incorporated into the LMIS PACS, Lombardo said.

GE PACS is based on Sun SPARC server architecture and features an Information Storage Unit (ISU) for storage management and an Information Management System (IMS) database for workflow management. Short-term archiving is undertaken with redundant arrays of inexpensive disks (RAID) in configurations up to 256 gigabytes. Long-term archiving is performed on 14-inch platter optical disk jukeboxes.

GE PACS offers Macintosh-based workstations for either diagnostic or clinical environments. The diagnostic workstation is available in two-or-four-monitor configurations, with resolutions of 1.5K x 2K or 1024 x 1280. Clinical workstations are available in one or two monitor configurations, with a resolution of 1150 x 880.

In addition to its own PACS software, GEMS partners with other companies to fill out its product line. Ultrasound miniPACS is provided by ALI Technologies of Richmond, British Columbia, in which GE bought an equity stake earlier this year. GEMS also plans to add some low-cost archiving options from ALI into GE PACS.

Access Radiology contributes teleradiology software, and Lumisys provides film digitizers. Other vendors also add some software components (see box).

GEMS is also in the final stages of acquiring a European radiology information systems vendor. Since a RIS is typically the first point of PACS entry for European customers, the purchase will solidify the company's European PACS presence, according to Lombardo. There are no plans, however, to bring that product to the U.S., he said.

Future plans

At this year's RSNA meeting, GEMS will feature a number of new technologies, including a multimedia, Web-based data repository, and workstations that are focused on radiology productivity improvement tools in areas such as transcription. Some Windows NT-based workstations will be also be displayed, and the vendor will show servers that will allow for online storage of over a terabyte of images.

In addition to its standing as a highly regarded player in the modality business, GEMS should also benefit from the commercialization of its x-ray flat-panel digital detector technology, called Apollo (PNN 9/97). The technology, which is still in development, may potentially offer speedy integration of conventional radiography studies into PACS networks. The Apollo technology will be installed along with a PACS at several clinical sites, including Duke University, Lombardo said.

Although GEMS has struggled over the years to garner PACS success, the vendor now appears to be on the right path, thanks to the acquisition of LMIS. With the technological and marketing knowledge GEMS can bring to the PACS market, the company appears primed to be a formidable competitor in the coming years.

GE MEDICAL SYSTEMS
800 Business Center Drive
Mt. Prospect, IL 60056
847/704-8500
fax: 847/704-8560
www.ge.com/medical

Management
Anthony Lombardo, global general manager
John LaLonde, global engineering manager
Tom Kennedy, global product manager
Mike Battuello, global service manager
Brian Neal, operations manager
Varda Peskowitz, global marketing manager
Dave Mahoney, sales manager

Product distribution
Direct sales

Selected large-scale PACS customers
Baltimore VA Medical Center in Baltimore, MD; Hammersmith Hospital in London, UK; Samsung-Seoul Medical Center in Seoul, South Korea; Brooke Army Medical Center in San Antonio, TX; Madigan Army Medical Center in Tacoma, WA; Travis Air Force Base in Sacramento, CA; Tripler Army Medical Center in Honolulu, HI; Alaska Native Medical Center in Anchorage; University of Pennsylvania Medical Center in Philadelphia (in progress); Mayo Clinic in Rochester, MN (in progress); University of Illinois at Chicago (planned); Mayo Clinic in Scottsdale, AZ (planned); Methodist Hospital in Houston, TX (planned); M.D. Anderson in Houston, TX (planned).

PACS partners
ALI Technologies (ultrasound miniPACS), Access Radiology (teleradiology), Lumisys (film digitizers), Mitra and DeJarnette (toolkits), Medical Software Integrators (integration software, master patient indexes), Eastman Kodak (long-term archives) and Software Technologies Corporation (DataGate interface engines).

PACS strategy
To achieve market dominance by offering scalable PACS solutions ranging from low-level implementations to enterprise-wide environments. GE also views PACS in the context of a radiology informatics model, and focuses on improving the utility of PACS workstations by providing productivity tools as well as access to other healthcare information systems.