PACS/IT vendors continue focus on integration, ease of use

Vendors at the RSNA meeting addressed the need for improved workflow and productivity, highlighting the continuing integration of PACS and RIS with other information technologies amid new visualization technologies aimed to handle the ever-increasing size of image data sets. Product enhancements also focused on users' specific roles and preferences, spawning a new term for the PACS/IT industry: "role-based tools." These tools acknowledge the diversity of professionals using IT and the complexity of orchestrating healthcare information.

The need to satisfy the multifaceted IT community has led many companies over the past year to enter collaborations or make acquisitions. Among those most prominent were Philips Medical Systems' acquisition of Stentor, Merge Healthcare's purchase of Cedara Software, Agfa HealthCare buying Heartlab, McKesson acquiring Medcon, SmartPACS entering into a joint venture with Infinitt, and EMC forming a partnership with Siemens.

Agfa HealthCare

Agfa highlighted its Impax Enterprise integrated workflow solution, which combines the Impax 6.0 PACS network, Impax RIS, Solution Monitoring and Management Services (SMMS), Impax Reporting, and Impax Auditing and Integration Services.

• The Web-deployable Impax 6.0 handles workflow requirements of multiple users and improves planning, capture, interpretation, distribution, and archiving of images throughout an enterprise. Addressing individual user preferences, it was built around common work behaviors of six identified target user groups: healthcare administrators, radiologists, PACS administrators, technologists, clinicians, and IT specialists.

• Integrated with Impax RIS, Impax 6.0 optimizes clinical and IT efficiencies. A single workflow-based system serves users inside and outside a facility, consolidating management of patient images and information.

• SMMS manages and monitors its applications, hardware, operating systems, and databases throughout the enterprise. It identifies trends that indicate possible future conflicts and helps track and resolve the problems.

• Impax Enterprise increases workflow efficiency, as users can access scheduling of radiology, cardiology, mammography, and other clinical exams via the Internet. A Web browser displays reports, images, and the entire electronic medical record on a PC, PDA, or cell phone.

Amicas

Amicas showcased its Vision Series, which includes Vision Series PACS version 4.1, featuring enhancements and advanced workstation tools such as new pediatric features and expanded support for MIP/MPR and 3D imaging, customizable workflow, next-generation Java technology, and expanded compatibility and integration with third-party applications. Other PACS applications on display included:

• Amicas Imaging Dashboard, embedded within the Vision Series PACS, a real-time customizable digital tool for complete visualization of patients, images, and key metrics of facility operations.

• Amicas Vision Watch, a monitoring tool that constantly provides real-time metrics, letting users immediately see staff productivity trends, bottlenecks, and potential improvement areas.

• The Lightbeam Web-based workstation with capabilities including spine labeling, embedded 3D and voice clips and the Integration Platform with tight connectivity to Dictaphone's Powerscribe for radiologist reporting and TeraRecon's AquarisNet for 3D and 4D Web-based imaging applications.

• The latest version of Vision Series RIS, 2.10, targeted to imaging centers and radiology practices. The Web-based product features scheduling, check in/check out, exam tracking, film tracking, mammography tracking, clinical reporting, administrative reporting, transcription, and charge-out modules.

Candelis Technology

Candelis introduced its ImageGrid 1000 server appliance, an affordable digital imaging storage solution that meets the needs of imaging centers and clinics. Based on a DICOM and appliance architecture, ImageGrid speeds image access, simplifies management, and protects patient images in a reliable HIPAA-compliant server and archival system. ImageGrid 1000 specifically addresses the growing need to archive large image files generated by high-resolution imaging modalities such as multislice CT and MR systems.

Cerner

Cerner displayed ProVision PACS, a unified RIS/PACS with workflow and role-based tools for the radiology department, as well as the whole enterprise.

• The ProVision PACS Diagnostic Workstation offers advanced visualization tools and a unified radiologist desktop.

• The MultiMedia Foundation software provides an enterprise framework to integrate multimedia objects into a comprehensive EMR, enabling inclusion of diagnostic images, ECG waveforms, fetal monitor strips, photographs, video images, etc.

• The ProVision Web image viewer offers enterprise-wide access to comprehensive EMR information.

Cerner also displayed its Millennium RadNET, a unified RIS that supports workflow improvements and features an automated critical results notification that supports the latest Joint Commission on Accreditation of Healthcare Organizations patient safety initiatives.

CoActive Medical Business Solutions

CoActive previewed its next-generation Exam-PACS, which provides new features including a Modality Worklist Service Option and brokerless HL7 Interface, a new back-end database, and enhanced scrolling speed. HL7 capabilities enable bidirectional HL7 communications to any HL7-capable application at a reduced cost. CoActive also unveiled its Exam-PACS-Ortho, an orthopedic version of Exam-PACS. The new software features a fully integrated copy of the OrthoView's Orthopedic Templating application, which includes the new Pediatric Assessment toolset.

DeJarnette Research Systems

DeJarnette displayed version 2.01 of its PACSware Intelligent router technology, which includes an improved GUI for configuring specialized routing rules and provides intelligent routing between dissimilar PACS products. The company also highlighted its PACS Migration Gateway technology, used by partners such as Amicas, Fujifilm, InSiteOne, McKesson Information Solutions, and Siemens Medical Solutions.

Dynamic Imaging

Dynamic Imaging showed its IntegradWeb RIS/PACS, an integrated single-desktop RIS/PACS featuring end-to-end Web-based workflow. The system builds on the Web-based architecture of its predecessors to address ambulatory settings. The IT package includes RIS, PACS, billing, document management, and digital dictation. The product, scheduled for release in early 2006, is targeted to radiology and multispecialty group practices, single imaging centers, and distributed imaging center chains. A billing module shares the same user interface and database as the RIS, which allows a complete view of the patient visit record without the user having to exit the application. The company also showed the 3.5 version of its IntegradWeb PACS platform, which includes expanded integration with third-party applications such as Dictaphone PowerScribe speech recognition software and OrthoTools powered by Orthocrat TraumaCad orthopedic templating and planning software.

Eastman Kodak

Eastman Kodak demonstrated new CareStream solutions designed to deliver improved workflow and information sharing among its entire portfolio of medical imaging and information management products. CareStream Information Management Solutions services include Enterprise Information Management, Hosted Information Management, and Regional Information Management.

• CareStream PACS work-in-progress features include user-centric architecture to support individual preferences from any workstations inside or outside the institution. This provides greater flexibility for users who no longer need to use a specific workstation at a designated location to access tools required to perform certain tasks.

• CareStream RIS offers new functionality to maximize utilization of personnel and equipment and increase radiologist productivity. New features include scheduling enhancements, single-click generation of normal reports, workload indicators for single-click access to studies in different stages of completion, the ability to interrupt and resume report dictation, remote diagnostic dictation, and report signing through a Web module.

EMC

EMC demonstrated technologies and solutions that allow healthcare organizations to accelerate digital transformation by deploying an intelligent information lifecycle management (ILM) infrastructure. ILM supports clinical and business applications while protecting, managing, sharing, and archiving rapidly growing amounts of healthcare information.

• EMC Centera Four-Node Configuration provides small to midsize hospitals with a lower cost and lower capacity enterprise archiving solution, addressing challenges around disaster recovery and compliance.

• Next-generation Documentum Enterprise Content Management Platform creates a robust infrastructure foundation that manages the collaboration, creation, review, approval, archiving, and ultimate disposal of information.

• EMC CLARiiON with new iSCSI (Internet small computer system interface) support, including the new CLARiiON AX100i, CLARiiON CX300i, and CLARiiON CX500i models. These low-cost storage area network systems help reduce storage costs, consolidate IT infrastructures, and deploy an ILM strategy regardless of the size or type of environment.

Fujifilm Medical Systems USA

Fujifilm announced the release of Synapse version 3.1.1 software, the eighth upgrade of its Synapse PACS. Features include immediate access to pretranscribed reports using digital voice files, report integration with other systems, user-specified canned notes, flashing STAT notification and enhanced sorting capabilities with Synapse work lists, additional support for viewing multipage documents, and automated presentation of scanned orders. Fujifilm also highlighted specific design criteria for Synapse Comprehension currently in development. Comprehension is Fujifilm's strategy for expanding Synapse to deal with radiology clinical and business processes as a single, complete, intelligent system. Expanded Synapse would replace individual RIS and PACS systems.

GE Healthcare

GE spotlighted Centricity Radiology Business Intelligence Dashboard software, which provides detailed reports for radiology business and workflow. The software evaluates a department or imaging center by comparing current performance to previously established benchmarks, reviewing the use of resources. Administrators receive real-time feedback on patient wait times and radiology staff performance. GE touts the dashboard as a means to improve efficiency, enhance workflow, and improve return on investment. The portal is part of the Centricity PACS 3.0 package. Workflow and clinical tool enhancements include the addition of voice clips that can be integrated with GE's Exam Notes functionality. GE also highlighted advancements in its Advantage Workstation (AW), which include Volume Share, an integrated visualization and analysis package comprising DirectConnect, Search Advantage, and FilterViews. The new AW RemoteAccess lets users apply AW functionality in any location through a PC or laptop.

Guardian Technologies International

Guardian highlighted its developing technologies including PinPoint, a patent pending approach that uses algorithms implemented in software to extract information not discernible to the human eye from a digital image. According to the company, the methodology increases the detection capability for a wide range of input and scanning devices. It also provides rapid automatic detection of specific types of objects, materials, and anomalies. Guardian highlighted new software for its FlowPoint RIS/PACS product that can optimize workflow in radiology departments and provide new imaging tools for analyzing difficult-to-read images.

IBM

IBM emphasized its new release, the Express Storage Platform for Medical Imaging, also called MI Express, a scalable, prebundled archive infrastructure solution that stores imaging data for retrieval by PACS. The affordable, flexible platform addresses unique storage demands of small and medium-sized organizations. The MI Express takes IBM's storage platform solution into the realm of multispecialty imaging. It offers integrated disk and tape storage and preloaded Tivoli Storage Manager software. It provides centralized data management for both online disk storage and offline tape storage, intelligent data movement to help reduce data transfer sizes and times required for backup and restoration, and policy-based automation tools to help provide automated data protection.

InSiteOne

InSiteOne debuted InDex Service, a data migration service that optimizes storage and archiving of medical images for healthcare facilities transitioning to filmless digital imaging. The Web-enabled service is an affordable and versatile solution for short-term storage, retrieval, and long-term archiving of DICOM and non-DICOM medical images. It integrates with any PACS or modality as well as hospital networks and information systems. The services include a new partnership with DeJarnette Research Systems.

InStar Systems

InStar introduced its next-generation RIS product, RIS NET, and the InStar Practice Scheduler, a new scheduling product for small clinics. RIS NET incorporates advanced capabilities such as patient scheduling, registration, order entry, pending appointments tracking, charge capture, billing transcription/report production, electronic signature, report distribution, and management reporting, as well as tracking preauthorization of the exam, its performance, and the deposition of images. It is built on the .Net/SQL platform and allows freestanding outpatient facilities, imaging centers, and enterprise hospital locations to manage patient records and exams while obtaining fast turnaround of reports. Practice Scheduler incorporates advanced capabilities such as patient scheduling (drag and drop), registration, order entry, pending and canceled appointments tracking, preauthorization tracking, and capture of preliminary billing information. Practice Scheduler does not require extensive IT infrastructure, servers, or database software. It is targeted to small outpatient centers and practices seeking scheduling and electronic medical record functionality or unable to afford a full-featured RIS.

McKesson

McKesson spotlighted its Horizon Radiology Manager RIS, Horizon Radiology integrated RIS/PACS products, and Horizon Cardiology integration. Horizon Radiology Manager can be integrated with McKesson's Horizon Medical Imaging PACS. Earlier this year, McKesson acquired Medcon, which provides Web-based cardiac image and information management solutions.

• Building on technology developed by Medcon, Horizon Cardiology includes two modules: Horizon Cardiology Imaging and Horizon Cardiology Manager. It combines all cardiology information sources in one patient-centric information system that manages the diagnostic process.

• Web-based Horizon Radiology Manager reduces the complexity of radiology department clinical and administrative workflow by removing unnecessary steps. It tracks and manages patients, films, and supplies in all types and sizes of facilities. Software provides integrated dictation and transcription, a department-level resource scheduler, complete management reporting, and HIPAA auditing. The solution offers a range of application modules for acute care and outpatient radiology departments, including order management, mammography, electronic signature, film management, claims preparation, system administration, and management reporting tools. Horizon Radiology Manager is available as a stand-alone unit or a component of Horizon Radiology, McKesson's image-enabled enterprise medical image and information management suite.

MedWeb

Medweb showed its Advanced 3D Web PACS, which increases access to many 3D imaging functions and has features previously available only on dedicated 3D workstations. It lets users working on a standard PC employ 3D templating and autosegmenting of image data from spiral CT scanners. This product introduction extends 3D templating and sculpting tools to surgeons, oncologists, and other physicians. Advanced 3D Web PACS enables distribution of multislice studies in a manageable 3D volume that can be easily displayed and navigated. The solution enables isolation, sculpting, zoom-in, and rotation of images. It also provides MIP, MPR, and various measurement and 3D cursor functions alongside conventional 2D image windows. Autosegmentation tools isolate bone, blood vessels, and other tissues via simple template buttons or customizable settings.

Merge eMed

Merge eMed introduced its Fusion RIS and RIS/PACS Version 3.0. Fusion RIS was designed with the help of clients to replicate radiology workflow best practices in imaging centers and radiology departments. It integrates information and automates traditional manual or paper methods related to scheduling, patient registration and tracking, document management, dictation, report turnaround, billing, claims processing, and other mission-critical operational functions. It helps practices reduce bottlenecks, maximize profits, and increase revenue through practice analysis tools. Its Practice Analysis Module turns raw data into decision-making information, and it allows users to set up benchmarks to track and compare performance on select criteria. The optional Web-based Referring Practice Portal enables real-time access to reports and associated images from within Fusion RIS/PACS or just reports from FUSION RIS.

NeuroStar Solutions

NeuroStar's Virtual Radiology Community Web site provides a platform for sharing imaging services, resources, and information for users of its Virtual Radiology Network image management solution and other imaging professionals. The Web site offers a subportal for imaging businesses that want to outsource reading and a similar area for offsite reading service providers as well as a platform to connect these two communities. The service is complemented by PACS-In-A-Flash, which enables physicians and patients to download and carry relevant medical images with them for viewing on any PC.

Philips Medical Systems

Philips presented version 3.5 of the iSite PACS radiology software, which came to the company via its acquisition of Stentor, as well as ViewForum multimodality workstations.

• iSite PACS operates on a pay-per-study business model to fit customer needs. Its core technology, the iSyntax, enables on-demand, enterprise-wide delivery of full-fidelity images to standard PCs and workstations using existing information technology infrastructure. Philips also demonstrated the integration of Xtenity RIS with Xtenity Enterprise, Philips PACS, and SpeechMagic.

• The latest iteration (Version 5.1) of ViewForum debuted as a means for handling large and complex CT and MR studies. It reduces time to results through adequate work lists, clinically tuned review protocols, and role-based access, which presents only the information that the user requires. It also features a number of enhanced advanced clinical applications: CT colonoscopy, volume inspection, and cardiac MR.

Siemens Medical Solutions

Siemens focused on its syngo suite of products, which integrates PACS, RIS, and postprocessing. The suite includes syngo Imaging, syngo Imaging XS, syngo Workflow, and syngo Dynamics. The syngo Imaging radiology PACS network features Smart Select, a navigational tool that supports the daily work of radiologists. The syngo Workflow product supports traditional RIS functions, handling radiological workflow from order entry to image and report distribution.

SmartPACS/Infinitt

The joint venture between SmartPACS and Infinitt, finalized in October, led to a new product line branded Infinitt. The Infinitt RIS/PACS network, which includes 2D and 3D imaging and navigation and advanced 3D visualization and analysis, debuted with a Web-based service and user interface. The software features protocol-based 3D postprocessing and an advanced work list for searching and easier customization. It provides both PACS-based and 3D-based hanging protocols, a multimedia report employing structured reporting, and 3D viewing functions and manipulation tools. The introduction will be followed by dedicated 3D packages for cardiac, PET/CT fusion, CT brain perfusion, brain angio subtraction, CT colonoscopy, advanced vessel analysis, and advanced segmentation applications.