Scottish IT firm adopts Groove-y approach to teleradiology interactions

Problems at island hospital spur global solution

Software development company Mysterian is putting a new twist on conventional ideas about teleradiology. The Scottish start-up is promoting a remote reporting solution that allows radiologists to view the same images and exchange opinions on diagnoses while working in different locations.

Mysterian's Radiology Manager is built on the Groove platform, a collaborative software platform developed by Lotus Notes creator Ray Ozzie. The software provides a secure location for individuals to access shared file space and communicate interactively. To ensure security, Groove employs always-on 192-bit encryption on users' hard drives and Internet transactions.

Groove's functionality and security are designed to meet future needs in radiology, said Dr. Neil Finlayson, technical director for Mysterian.

"The dynamics of the market, notably in the U.K., are such that radiologists are going to have to work for multiple institutions," he said. "We've seen the advent of virtual radiology companies, where radiologists work from home or small offices to provide services to the public and private sectors. The tools we are building are suited to that kind of scenario."

Radiology Manager is Mysterian's first venture into the medical imaging marketplace. The IT firm, in operation for just a year and a half, has touted collaborative software solutions to U.K. government agencies and addressed public sector educational needs, Finlayson said. But the company's long-term focus is on healthcare.

Mysterian initially developed the product as an off-hours reporting service for doctors at the Western Isles Hospital, Stornaway. The remote hospital on the Isle of Lewis off Scotland serves a community of 25,000 people but often struggles to find a qualified radiologist to cover evenings, weekends, and public holidays. Consequently, emergency patients had to be flown 150 miles to a mainland hospital for radiological diagnosis and treatment.

Trials of Radiology Manager at the island hospital began 10 months ago over the New Year holiday. They continued on weekends, when onsite reporting coverage could not be found. Western Isles radiographers uploaded CT scans onto a secure Internet workspace, then alerted a radiologist in Edinburgh via Instant Messaging that the images were available.

Dr. John Murchison, a consultant radiologist and honorary senior lecturer at Edinburgh Royal Infirmary, reported the first set of CT scans loaded onto a shared workspace while working from home on a PC.

"I typed in my report, which became available at once to anyone with access to that particular workspace. Staff at Western Isles could then read my report direct," he said.

Murchison was able to access the workspace via a URL contained within the secure alert. A report could then be input and medical staff at Stornaway alerted, when the report was compete.

"Groove brings people as well as content into the equation," Finlayson said. "A Groove workspace gives you the power of the Web, while adding collaborative abilities in a way that few other systems can match."

Mysterian and its partner hospital have been pecking away at problems. Some border on the mundane and are relatively easy to fix. Others require expansion of the underlying technology.

Because images are transferred over the Internet, the system is subject to the same bandwidth constraints as Web-based teleradiology systems. Radiographers at Western Isles solved this by installing a broadband connection to speed up data transfer, Murchison said.

Other improvements in productivity may come from the addition of interactive components. One might allow simultaneous reporting from multiple sites, as well as real-time discussions using secure voice messages or Instant Messaging. This virtual environment might also be enhanced to support training exercises, he said.

"The cooperative element has great potential," Murchison said. "Different people can look at the same image or report simultaneously, and there are possibilities for interactive communication."

The technology might be improved in other ways as well. The addition of voice recognition would eliminate the need to type reports, thereby speeding up the reporting process. A greater priority, however, is to implement full DICOM connectivity, according to Finlayson.

Mysterian is currently addressing a request from Western Isles to turn the off-hours software solution into a fully featured business-as-usual teleradiology reporting service. The company is also assessing its future business strategy. A number of radiology departments and institutions worldwide, including the U.S. Army, are already assessing a beta version of Radiology Manager, Finlayson said.

"The main channel to market is really companies that have been in this sector for quite a bit longer, and we are in negotiations right now with OEM partners. But we may begin selling our product directly in a year or two," he said.