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Image Medical moves image management onto the Internet


Image Medical moves image management onto the InternetNetwork offers online access, distribution, and archivingSeveral PACS vendors are turning to Web-based technologies to develop and implement cost-effective enterprise-wide image access

Image Medical moves image management onto the Internet

Network offers online access, distribution, and archiving

Several PACS vendors are turning to Web-based technologies to develop and implement cost-effective enterprise-wide image access and distribution. Others have developed products that utilize the Internet for remote reads and off-site archiving. But Palo Alto, CA-based start-up Image Medical is working to offer a full spectrum of image-management and archiving capabilities via the Internet, and at a price many hospitals and radiologists may find hard to resist.

The software development firm made its debut at the RSNA meeting in November, where it launched its first product, PracticeBuilder, and its Web site, imagemedical.com, which serves as the backbone of the company’s Internet-based image-management service. PracticeBuilder is a modular software package that runs on any Web-enabled PC with an Intel platform and incorporates several industry standards, including DICOM, HL-7, and TCP/IP. The Diagnostic Viewer provides radiologists with high-resolution image display and processing on standard desktop computers, while the PracticeBuilder Archive offers off-site, long-term image archiving with unlimited capacity and quick retrieval.

Once installed, PracticeBuilder operates over an existing LAN/WAN infrastructure to provide secure, enterprise-wide access to studies and reports. Working in conjunction with imagemedical.com, the existing network is extended to allow controlled, secure access to studies and reports, both within and outside of the hospital. PracticeBuilder also features a universal work-list/workflow capability to ensure that every study goes to the right place at the right time. The PACS and all associated patient data actually live on the imagemedical.com network, which Image Medical manages through its data centers on both the East and West Coasts.

“What we offer is not just enterprise-wide image distribution but something that serves all referring physicians as well, regardless of whether they are associated with the hospital or not,” said Bill Caswell, president and co-founder of Image Medical.

At the heart of PracticeBuilder are more than 25 proprietary technologies developed by Caswell and his engineering team. These include predictive streaming wavelet algorithms, workflow and universal work-list tools, and an eight-layer, customizable security system that includes e-commerce-level encryption, bilevel password authentication, and rules-based user access down to the patient record level. Much of this technology was originally developed for other industries requiring real-time information management, including aerospace and computer companies and the military, according to Caswell.

“If you want to use the Internet for mission-critical applications, you need to come up with methods behind the scenes that make it very robust and very usable,” he said. “We do this with smart-server technology and predictive streaming, which allows your garden-variety PC to perform as quickly as a high-end workstation and squeeze large amounts of data through the network at dial-up speed.”

Image quality is not an issue because every pixel in the system is available at all times, Caswell adds. As with the Web-based imaging technologies developed by Stentor (PNN 11/99) and RealTimeImage (PNN 12/99), low-resolution versions of a study are provided in seconds; while the software continues to run in the background, the user can zoom in on the most critical information in the initial images and decide whether to call up a full-resolution version of the image.

“Our predictive streaming wavelet technology tries to anticipate what data you want to look at and get it to you before you ask for it,” Caswell said.

Image Medical’s cost model also makes this image-distribution service attractive, especially for smaller hospitals that are hesitant to invest in a full-scale PACS installation. Because PracticeBuilder is both a software product and an application service provider, there are no up-front capital equipment costs. Customers are charged on a fee-per-study basis of $12 for each medical transaction, which includes taking the image from the modality and moving it out to the radiology workstation and beyond.

In addition, Image Medical manages and archives all images and multimedia reports for the life of the study, and they remain accessible to users via imagemedical.com. Image Medical is joining with several large back-end storage providers for off-site long-term archiving, which further reduces the cost to the customer.

“We can offer much more competitive pricing because we are buying storage space in such large quantities,” Caswell said. “So we are providing a much more robust solution and can do it cheaper because the costs can be amortized over a much larger world than a single hospital. So the cost per study comes down dramatically.”

Image Medical also plans to offer PracticeBuilder as a platform for third-party vendors to integrate their products into the imagemedical.com network. The company plans to publish a third-party development toolkit and is already in negotiations with vendors who want to add such applications as Web-based scheduling and consult requests to the Image Medical platform.

“Some of the patented technologies we have allow us to integrate (other vendors’) technologies into our platform without them having to do any recoding or new programming, which drastically reduces the barriers to integration,” Caswell said.

Image Medical currently claims two installations, St. Joseph Healthcare Center in Bryan, TX, and Arkansas Radiology Group in Searcy, AR, both of which have been up and running since last fall. PracticeBuilder is also undergoing investigation at Stanford University Medical Center, which is using the system as part of a controlled trial for very large CT studies.

© 2000 Miller Freeman, Inc., a United News & Media company.

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