PACS pioneer Amicas builds on Web technologies

ForeverPriors will be focus on RSNA floor

The ability to use off-the-shelf personal computers, Web-based browsers, and standard phone lines has invigorated wide area image distribution. The trend has prompted every major imaging and PACS vendor to add standard browsers and other Web-based capabilities to their products. It has also created a new market for companies specializing in software-only PACS.

Amicas is at the forefront of this new breed of vendors. What began as an on-call teleradiology business in 1995 has grown into an established image management company. By year’s end, Amicas’ Web-based medical image distribution and archiving systems at 100 client sites will have handled more than six million images, said CEO Hamid Tabatabaie.

At the RSNA meeting, Amicas will introduce a suite of software that capitalizes on the functionality of its cornerstone product, ForeverPriors. This Web-based medical image archive system provides radiologists and other authorized physicians with immediate access to all digital imaging studies, current and prior, without the need for prefetch algorithms.

Amicas, based in Watertown, MA, has released discrete components of ForeverPriors and associated products over the past two years. Starting at this year’s RSNA meeting, however, the entire suite will be available as a package.

“There are fewer hurdles to migrating to a digital environment than ever before,” Tabatabaie said. “Regardless of the size of your organization or where you want to start deployment, the solution is available and it’s standards-based. We’re the most affordable system on the market, with a product that costs 30% to 70% less than that of any of our competitors.”

ForeverPriors uses the DICOM and JPEG 2000 standards to provide a vendor-neutral software product. Consequently, ForeverPriors is compatible with existing workstations and medical record viewers.

“Most modalities already use DICOM,” Tabatabaie said. “We’re also using JPEG 2000, because it is the latest standard in the industry that allows images to be stored and distributed irrespective of the type of connection that the user has to the network.”

The product will be available in three configurations: Personal Office, Radiology Office, or Enterprise. This allows for scalability from solo users to hospital- and campus-wide, he said.

“The Personal Office series is a single-user PACS for the individual or very small group,” he said. “You can capture images directly from the modality, use a work list, have multiple diagnostic

workstations, and forward the images to your office or home.”

ForeverPriors incorporates a feature called “wireless work list,” which allows clinicians or radiologists to be alerted via their cell phone or handheld digital assistant about the availability of reports or images on a certain patient. These images can be forwarded using the same devices, or by logging on to a secure Internet Web site, to the physician’s home or office computer.

“Even if nobody is home, so long as the PC is turned on, the Amicas server delivers the images so that by the time they arrive home, the images are there,” he said. “The physician isn’t at the mercy of the speed of the Internet connection.”

Personal Office offers tailored uses for referring physicians and is most likely to be deployed by emergency rooms, ICUs, and other hospital departments that demand immediate access to images. Radiology Office extends the same functionality to include broader workflow capabilities specific to radiologists. It also provides a larger capacity in regard to study volumes.

The Enterprise has the functionality of both products, but beyond that it offers scalability to allow access to images by hundreds of concurrent users. The system has undergone substantial road testing at Massachusetts General Hospital, where 800 unique users per day access images using the Amicas system, Tabatabaie said.

The product suites can be purchased on a per-procedure basis or as an upfront capital investment. The per-procedure costs range from 50¢ to $3, depending on image volume. The lower-end cost applies to image distribution without radiology-specific functionality. The higher-end cost applies to full functionality.

But end users can implement the system at whatever level they desire and pay accordingly. If at some point they choose to expand from Personal Office to Enterprise, the software to do so already exists on the system and an “instant upgrade” can be performed.

“Any moment you decide to expand, all you have to do is alert us,” Tabatabaie said. “All the software you need is already residing on your desktop. We just have to turn on the expanded features so that they can be accessed.”