Web-based imaging network links radiologists with multiple facilities

Flying under the radar, virtually unseen by the industry at large since its founding in 1999, Neurostar Solutions, a PACS and teleradiology provider in Atlanta, has installed its network at more than 200 sites in the U.S.

About 70% of its revenues come from facilities that need remote radiology reading or want to convert to digital image management. The remaining 30% comes from radiology groups that want to increase their productivity, expand their coverage, or offer teleradiology services. Most of the company's revenues - up to 85% - come from fee for service.

Neurostar typically structures these arrangements on a fee-per-study basis with a flat minimum monthly rate. But the goal, according to cofounder Arman Sharafshani, goes beyond that. The company hopes to assemble a vast network that facilities and radiologists will plug into whenever they want to work together.

"We are the plumbing that makes remote radiology reading happen," Sharafshani said.

The Web-based system run by Neurostar pulls data from hospitals and imaging centers onto remote servers. The system, called the Virtual Radiology Network, manages the flow of data to and from the servers.

Virtual Radiology Network draws images directly from DICOM-compatible imaging equipment, teleradiology, and PACS installed at individual facilities. This is accomplished using remote agents - black boxes - that are part of the network's MediCom component. These agents self-configure to the onsite equipment and Virtual Radiology Network, then compress, encrypt, and send data to Neurostar's servers.

"We can literally send in these remote agents (MediCom boxes) through overnight mail or drive them to the site and get them up on the network by just plugging in," Sharafshani said. "There are radiologists online who can take over the reading that's needed. Or if they have a group they want to send images to, we can set that group up just as quickly as we did the facility."

Radiologists query the servers using a Web-based software package called MediView, which is optimized for viewing images and other patient data. MediView runs on virtually any workstation.

"Radiologists can have a RadWorks or eMed workstation or our own Neurostar Viewer, whatever they want," said Willie J. Tiller, the other cofounder of the company. "The point is that they have a common workplace where they can read images from multiple sites."

System integrity is managed by a component called SecureMed, which maintains audit trails, authenticates users, and allows appropriate access. Customers have the option of long-term data storage as part of the image archiving subsystem, or MediArch.

This technology is ideally suited to teleradiology, linking multiple sites to a remote radiology group, for example. But it is not constrained to just this purpose. Virtual Radiology Network can be used for enterprise-wide image distribution, archiving, or disaster recovery services.

Current subscribers have been drawn to the network mostly by word of mouth. Sharafshani and Tiller plan to go beyond that in the months ahead with advertising, partnering with radiology groups, and conducting other marketing activities aimed at expanding the network. By spring, the two entrepreneurs hope to begin evolving their Virtual Radiology Network into what they describe as a kind of radiological eBay, matching radiologists wanting to read with facilities needing radiologists.

It will be an ambitious undertaking. Neurostar must ensure, for example, that radiologists wanting to provide the service are properly licensed.

"We will have to provide a number of auxiliary services to make this work smoothly," Sharafshani said.

From each match made and reading provided, Neurostar would extract a transaction fee, similar to what eBay earns by bringing together buyers and sellers. Radiologists seeking an easy way to hook into multiple clients would be attracted to the network, as might small, midsize, and maybe even large, radiology groups.

"They might want to get more market share," Tiller said. "And that could be through us."