Technology platforms battle for control of desktop imaging

Technology platforms battle for control of desktop imaging

PACS vendors jockey for position in software business

As interest in enterprise-wide image distribution grows, several PACS and modality vendors are responding with PC-based software products they hope will attract the attention of referring physicians and others outside the radiology department who want access to diagnostic images and information. For these companies, the idea is to create a standard desktop application-development and workflow environment that simplifies the process of accessing and manipulating patient images and information.

The concept is not new; Cedara Software (formerly ISG Technologies) has been supplying its Imaging Applications Platform (IAP) software to the medical imaging industry since 1991. IAP is an open-architecture application development toolkit used in MR, CT, nuclear medicine, ultrasound, advanced postprocessing, and PACS products. It is deployed in more than 6000 sites worldwide by nearly 40 PACS and modality vendors, including Philips, Picker/Marconi, Siemens, Toshiba, eMed Technologies, Image Devices, ADAC, and McKesson HBOC. The company claims to have generated $100 million in revenues from the sale of IAP since the product was first introduced.

“It has taken us a long time to build our business. To get yourself into a position where you supply something to people that are competing, that defines what a platform is,” said Ian Fine, director of marketing for Toronto-based Cedara. “It appears to us that we are the only independent company focused on designing a platform for the industry as a whole.”

Despite Cedara’s apparent domination of the software side of this industry, however, companies such as Siemens, Agfa, and Analogic have opted to develop their own PC-based technology platforms that offer various levels of applications development and integration for image and information systems and modality devices.

Siemens, for example, is promoting its new Syngo product as a potential software standard for image viewing and workflow applications (PNN, 1/00). Syngo is a customizable, Windows NT-based user interface and interconnectivity platform that allows for the development of specific image- and information-management applications. It comprises a set of software modules, programming interfaces, and libraries written in C++ and Java that can be integrated into a modality or workstation product to achieve a variety of functions, including connecting an application to the Internet, gaining DICOM or HL7 connectivity, or linking to a printer or archive.

In addition to facilitating architecture-independent connectivity, Syngo defines a uniform way to operate a variety of medical imaging equipment through its universal operator interface and universal symbolic language. A simple configuration panel allows for user-specific settings for different tasks.

Syngo works in conjunction with Siemens workstations, PACS, CT and MR scanners, and nuclear medicine products, but the company hopes it will be incorporated into competing products as well. In fact, Syngo was designed to be more than an internal standard: Siemens intends to make the components available to other vendors to facilitate system compatibility and help shorten the time to market for new products and services.

“If many vendors used Syngo, interoperability in digital hospitals would increase tremendously because all would enjoy the same DICOM model and communications mechanisms,” said Siegfried Bocionek, general manager of medical image management for Siemens Health Services in Erlangen, Germany. “And since Siemens made a big investment in Syngo, we definitely want to earn some money back by selling the development kit to interested partners.”

The company is also interested in back-licensing applications if Syngo is used by third parties to develop software that Siemens could use itself.

“Syngo was designed to facilitate integration with third-party products,” said Rik Primo, director of Siemens’ IS/PACS division in Iselin, NJ. “So with Syngo, we are becoming less dependent on third-party software for integrating applications. The software is becoming more of a commodity, and it doesn’t make sense for us to source all of these products anymore.” However, Siemens does plan to continue its OEM relationship with Cedara for Cedara’s 3-D image reconstruction technology and other potential high-end applications.

It is unclear, however, whether other companies will embrace Syngo when they already rely on broader application-development standards or have developed their own technology platforms that they too want to sell to other vendors. For example, while Agfa’s Impax software product was originally designed for internal use, Impax is also being sold to third-party modality vendors through Impax Technology, the software development company established jointly by Agfa and Mitra (PNN 5/99). Current OEM partners include Acuson and Toshiba, which launched a line of modality-specific miniPACS products called SimPACS at the 1999 RSNA meeting (PNN 1/00). But Agfa envisions a consortium of vendors one day using Impax technology as the primary platform for their PACS offerings.

“The core components of Impax offer application intelligence for workflow and image management that you can package and make available to modality vendors,” said Dean Kaufman, director of strategic marketing for Impax solutions. “We find that people want the workflow intelligence.”

As part of its effort to expand its presence in the PACS industry, connectivity and components firm Analogic debuted a desktop technology platform called iWorks at the 1999 RSNA meeting (PNN 1/00). iWorks is designed to serve as a universal workstation and DICOM image-management tool for PACS and digital radiography. It features a Web-enabled client/server architecture that permits customers to choose functionality from a range of tools.

iWorks comprises three core application modules designed to provide a flexible platform to configure multiple products for PACS applications. The data acquisition module allows the iWorks platform to receive data from multiple sources, including DICOM, film digitizers, CR plate readers, and other acquisition modalities. The data management module provides a configurable menu of tools and capabilities that enable manual or automatic operation of specific tasks and functions, including specialized image processing and compression algorithms, DICOM-to-DICOM data conversions, and integration with radiology and hospital information systems. The image distribution module is an output engine that integrates with a hospital’s DICOM network.

Nonplatform approachesOther PACS and modality companies are choosing to rely on existing standards-based technologies to facilitate system integration and connectivity with their products.

For example, Philips Medical Systems believes that rather than creating a customized application development platform, it makes more sense to use an open standards-based approach. Thus, its PACS and image management products are all based on DICOM, HL7, and other broad-based application-development tools rather than proprietary libraries, according to Milan diPierro, product manager for enterprise PACS at Philips Medical in Shelton, CT.

“If we use the same environment that the Palm Pilot and other hardware devices are already using, the pool of resources for applications development is much, much larger,” diPierro said. “And so many other technologies are using that environment for plug and play that it allows us to leverage many platforms that are already being developed.”

Fuji believes its internally developed PC-based Synapse PACS has a number of advantages over competing systems, including what the Stamford, CT-based firm calls “cascadable architecture,” a client-server technology where the archive and servers are distributed across a network, rather than residing on a central server. Synapse also provides on-demand information access and integrated Web technology that serves as the basic interface for all Synapse workstations.

“We are using all industry-standard components to access the data and information through standard user interfaces in the Windows environment,” said George Sledd, national marketing manager for image and information networks at Fuji. “So from a functionality perspective, as long as the user is familiar with Windows, we believe this is the approach to take.”

Despite the obvious advantages for both end users and manufacturers in going to a desktop-based environment for enterprise-wide image distribution, it is apparent that software providers have just begun to battle for control of this new environment.

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

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