HIMSS06: Clinical Information Systems News

Learn what’s new from: BRIT Systems, Cerner Corp., DR Systems, Eclipsys Corporation, Emageon, FUJIFILM Medical Systems USA, Guardian Technologies International, Inc., Merge eMed, Misys Healthcare Systems, NovaRad Corporation, peerVue, LLC and AMICAS, ScImage, Siemens Medical Solutions, Swearingen Software, Inc., Varian Medical Systems, Inc. and Witt Biomedical Corp.

Although clinical information systems aren’t the main focus of HIMSS, the systems did manage to grab some of the spotlight. PACS – and a more intelligent flavor that adds patient information management to image management – for the ‘ologies’ was the buzz among vendors and presenters (see/link PACS More Than Just One Use). New and upcoming offerings will transcend radiology and even cardiology. In the not-too-distant future, PACS will routinely store and manage non-DICOM images like pathology slides and photos. The trend to integrate advanced visualization into the PACS workstation was apparent on the show floor. And while vendors touted improved RIS/PACS integration, the line differentiating the two systems is blurring. It won’t be long before vendors are marketing a single solution that blends the capabilities of both systems. Finally, vendors discussed the emergence of the EMR and the need for an integrated, not just interoperable, image-based solution.

BRIT Systems launched Roentgen Burner and debuted enhancements to the Roentgen RIS, including an advanced RIS/PACS synchronization and bi-directional HL7 engine at HIMSS 06 last week in San Diego.

        Roentgen Burner is a DICOM-compliant, automated solution for producing custom-labeled CDs and/or DVDs that contain medical images and BRIT’s image viewing software. The solution combines BRIT’s production server with one of Rimage’s CD and/or DVD production systems. The Roentgen Burner accepts studies from any DICOM device via DICOM Store and facilitates creation of the media (CD-R or DVD-R). BRIT’s Radiology Workbench for Windows image viewer is burned to the media along with selected images. Data is verified by the system while a specific and detailed order file containing unique information about the user, patient, specific modality and images is produced.
        For sites already using BRIT’s archive system, BRIT Roentgen Files, users with proper privileges can request a CD and/or DVD without the loading the studies into a workstation. From the workstation, multiple studies or subsets of exam images can be included. All annotations and key object notes are included with saved and burned images. Users can select from several Rimage CD and/or DVD production systems: Protégé II, Amigo II, Autostar II and the newly released Endeaver, designed specifically for lower-volume environments. The Rimage 1500 and 4500 desktop models and the 2000i are also available.
         The advanced RIS/PACS synchronization and bi-directional HL7 engine for The Roentgen RIS enables the synchronization of patient images, studies and reports throughout the healthcare enterprise. Synchronization tools within The Roentgen RIS auto-route all studies to a peer or central server where all changes to study information is sent. All order and report information is sent as database objects along with user information, management report and modality information.
        Also new to The Roentgen RIS is an Order Creation and Scheduling feature that allows online referring physician scheduling requests, procedure modifiers and default exam duration and report management, editing and distribution. Facilities can create patient orders and schedule exams by room, date and time. Through a web-based client, referring physicians can view and schedule their own patients’ radiographic services. The Roentgen RIS’ extensive management tool generates daily room schedules and reports. Referring physician offices can be provided a privilege to “hold” schedule slots pending final approval by the hospital or imaging center. With this solution, physicians have complete and secure electronic access to patient information by interfacing to hospital and clinic ADT, Billing, Dictation and Transcription systems by adherence to the DICOM and HL7 standards.
            Roentgen RIS manages radiology exam workflow by tracing exams from source to completion according to the facility’s requirements. The application also provides many user editable tables that can modify the default workflow and solution. Business continuity and disaster recovery is assured by BRIT's Roentgen Files Central Server, which supports all applications on the local server that allows the implementation of a distributed environment with central control and management.

Cerner Corp. highlighted RadNet RIS, Cerner ProVision PACS and ProVision Web, and it unveiled Multi-Media Foundation at HIMSS 06 last week in San Diego.

         Workflow enhancements to Cerner’s unified RIS/PACS are designed to facilitate the transition to a filmless, paperless environment. New features include capabilities for viewing scanned documents, bookmarking of images and the association of voice files and enhanced role based design. Cerner also showed its Visual Desktop Integration (VDI) solution for integration of RadNet with a third-party PACS Solution.
        Multi-Media Foundation provides the framework for integrating medical images and video, audio and signal data with patient information to offer a truly comprehensive electronic medical record. Multi-Media Foundation manages storage of and access to digital objects for departmental and enterprise utilization, streamlining workflow. With access to both images and vital clinical information from the EHR at the time of interpretation, radiology clinicians are improving outcomes and increasing efficiencies. MMF addresses the third dimension of images—non-DICOM images, said Hemant Goel, vice president.
         Cerner emphasized its commitment to patient safety, decreased waste and errors and streamlined implementations. Goel glanced into the crystal ball and predicted that the line differentiating RIS and PACS will disappear in three years. A single radiology solution will replace the two systems, said Goel. 

DR Systems exhibited multiple new RIS/PACS features at HIMSS 06 last week in San Diego.
            DR System’s unified Dominator RIS/PACS platform provides a single-vendor solution for Web-based scheduling, document scanning, voice recognition, digital dictation, automated reporting and output to billing systems. The integrated approach enables hospitals to avoid the costs, complications and frustrations of working with multiple vendors.
             New features of the DR Systems RIS/PACS shown at HIMSS include:
            • WebLaunch, for easy single sign-on integration capability with other HIS’s or EMR’s. Caregivers can log on to             their HIS to access a patient’s record and launch images with appropriate documents or notes and hear an audio summary.  
            • Extended scalability with the capacity for at least one million immediate online records, as well as millions more records available within seconds.
            • Enhanced patient management tools for the RIS, including Web-based scheduling for referring doctors, patient tracking, output to billing systems, film tracking and new management reports.  
            • Connectivity features for participation in regional health information
organizations (RHIOs).
            • Expanded Web-based capabilities through DR’s Web Dominator for complete remote reading, montage creation and transcription.
            • Full integration of mammography PACS capabilities with new diagnostic reading tools.
            • Improved integration of Barco’s VOXAR, Vital Images Vitrea 2, Orthocrat’s TraumaCad, MRS QAPlus and other third-party products.

DR Systems technology is designed for easy deployment, maintenance and
monitoring throughout a large healthcare enterprise, and  it can be scaled to a single modality imaging center.
                DR Systems touted the low cost of ownership of Dominator RIS/PACS. “Many long-term sites report that their total expense per exam for all service, support, equipment, upgrades, and expansions – minus the depreciated value of the existing hardware – ranges from $1.20 to $3.50 per exam,” said Murray Reicher, MD, chairman and cofounder of DR Systems. DR Systems brings other benefits as well, added Douglas Dill, director of marketing. Dill said the company’s toolkit for interfaces to third party EMRs streamlines the interface process. In many cases, the process takes 30 days or less.

Eclipsys Corporation showcased at HIMSS06 last week in San Diego its clinical, financial and administrative software and professional services that connect the healthcare team with evidence-based content and transform care delivery. The company launched Sunrise 4.5 XA enterprise clinical software and End-to-End Medication Management Solution.

          Sunrise 4.5 XA advanced clinical suite provides approximately 1,500 new or enhanced capabilities for documenting care, creating orders, reviewing test results and coding for maximum reimbursement — on a single clinical platform to deliver interdisciplinary, evidence-based content within the clinician’s workflow. The system transforms evidence-based knowledge from traditional, static sources, such as medical libraries and peer-reviewed journals, into accessible, dynamic solutions that enhance — rather than disrupt — everyday practice. It encompasses inpatient healthcare, emergency departments, ambulatory and critical care medicine. Eclipsys embeds up-to-date clinical knowledge, representing the clinical expertise of healthcare leaders, into Sunrise Clinical Manager and other advanced clinical solutions through pre-defined order sets, alerts, online references, clinical documentation templates, flowsheets and patient-education materials. Clinicians receive just-in-time knowledge in the context of what they need for their specific patient in a specific situation. Delivering information to the physician accelerates treatments and correlates with shorter length of stay and quality outcomes, said Eclipsys Chief Medical Information Officer, Rick Mansour, MD. The next level of the technology will allow users to view images and information from the patient chart, and Mansour identified inclusion of non-DICOM images like pathology slides and echo studies in the chart as a future advance. 
          Eclipsys displayed its End-to-End Medication Management Solution, which integrates the workflows of physicians as they place orders, pharmacists as they verify and dispense medication orders, and nurses as they administer medications to the patient to provide benefits in efficiency, accuracy and patient safety.

Emageon debuted System Release 5.30.1 at HIMSS06 last week in San Diego.

           The new release provides improved administrative tools, enterprise workflow and open standards support. Integrated Administrative Toolset provides Web Administration tools including a rules-based QC Workstation. Enhanced Enterprise Workflow tools manage exams and increase productivity. Native Volume Rendering with OpenGL graphics manipulate 3D volumes with real-time, high-quality ray-tracing. “The next release will focus on enterprise themes, shared reading lists, on-call folders and personal content management,” shared Allen Scales, vice president. Scales also predicted stronger integration of advanced visualization features and linked CAD with structured reporting and decision support to improve treatment.

FUJIFILM Medical Systems USA shared the latest developments of Synapse Comprehension and Obliquus 3D solution at HIMSS06 last week in San Diego.

             Comprehension is Fuji's strategy to replace individual RIS and PACS with one expanded system. Synapse Comprehension will deal with the spectrum of radiology clinical and business processes as a single, complete, intelligent system. At HIMSS Fuji highlighted information visualization tools that cover functions traditionally owned only by RIS and other departmental information systems. The company demonstrated an extended information model capable of managing the patient workflow from order though results, in a flexible, innovative, Web-enabled way, in order to embrace all of the evolving requirements of the radiology domain. Users can visualize this information from all parts of the complete system, in order to improve the workflow of the department in new ways.
              In addition to Information Visualization, Synapse Comprehension will also include a works in progress Volume Exploration component. During HIMSS, Fuji showed a works in progress Obliquus, 3D capabilities developed internally by Fuji and designed directly into Synapse. Obliquus provides MIP and MPR diagnostic tools as an integral part of Fuji's Synapse PACS, available anywhere on the network where Synapse is available. It provides interactive performance and diagnostic image quality, using industry-standard hardware, as well as the same consistent user interface as Synapse. The component was designed to reduce the need for Synapse users to require the integration of a third party vendor's 3D solution for basic, commonly-used functions.
            While individual features of Comprehension will be made available as they are developed, the first official worldwide release of the product is anticipated for 2007. Obliquus is currently available to Fuji customers worldwide that are using Synapse version 3.1.1 or higher. 

Guardian Technologies International, Inc. shared Intelligent Imaging Informatics (3i) technology, advanced development work based on its threat detection technology at HIMSS06 last week in San Diego.

              The technology consists of a series of image processing algorithms that could improve the diagnostic characteristics of medical images to potentially result in easier and speedier diagnoses, decreased misreads and greater workflow efficiency for the diagnosing physician. The technology, built on Guardian’s 3i core imaging analysis engine, is able to detect and distinguish different types of organic compounds contained in images from a wide array of sources, including x-ray, CT and hyper spectral data types. Guardian said it has initiated research and development activities focused on the implementation of its new Intelligent Imaging Informatics (3i) technology in three healthcare related areas: Extended Visualization Imaging Tools, Multi-Modal Synthesis/ Image Fusion and CAD.
               The first commercial application could be image clarification/segmentation, said Rich Borelli, vice president. The image enhancement technique will be migrated to Guardian’s FlowPoint PACS “soon,” said Borelli. The technique could enhance workflow and improve diagnosis, particularly in cases where the imaging study currently does not point to a clear diagnosis. Borelli stressed that 3i is part of an integrated solution rather than an isolated technology.

Merge eMed, a Merge Healthcare company, showcased at HIMSS06 last week in San Diego its FUSION RIS, FUSION Matrix PACS and FUSION RIS/PACS MX and shared new integration and information management solutions from Cedara Software, a Merge Healthcare company.

                FUSION RIS is a completely integrated business workflow solution, which includes navigation, worklist management, group practice deployment, integration capabilities and security features that allow clients to accelerate productivity from scheduling through billing, reporting and distribution of results. FUSION RIS offers several optional modules including: Embedded Document Management, Embedded Digital Dictation and Mammography Tracking. The optional Referring Practice Portal allows for instant online viewing of reports and images, as well as real time patient status. Practice Analysis functionality enables users to analyze, report and make decisions with simple mouse clicks. Finally, customers can opt for a complete billing solution from scheduling to receivables management.
                FUSION Matrix PACS allows radiologists to perform their jobs more effectively by efficiently displaying images, providing needed information clearly and facilitating results generation. The PACS incorporates smart client architecture, provides relevant clinical information at the radiologist’s fingertips, facilitates easy peer communication while reading and enables efficient distributed workflow. A Learn Wizard optimizes viewing protocols and enables the user to start reading faster. New 64-bit processing enables radiologists to simultaneously load, view, compare and manipulate more images.
                The FUSION RIS/PACS MX solution integrates information workflow from FUSION RIS and image visualization of FUSION Matrix PACS to unify RIS, PACS, Dictation, Document Management, Web-enabled distribution of clinical and business information and Billing and Practice Analysis workflow.
            The Merge booth also featured new integration and information managementdevelopments from Cedara Software, a Merge Healthcare company. Clinical Control Center, or C4, will allow OEMs to more quickly integrate systems, said Merge. aXigate technology is a connectivity tool that incorporates clinical information
like lab values and medication. 

Misys Healthcare Systems launched Misys CPR 5.0 and Misys Connect 1.0 and showed Misys EMR and Misys Radiology at HIMSS06 last week in San Diego.

                Misys CPR 5.0, the newest version of Misys’ Electronic Health Records (EHR) solution and a member of the Misys Optimum family of clinical products and Web-based technologies, is designed to share patient data across all medical care venues. Misys CPR 5.0 helps clients by transitioning to a browser-based solution that is easily deployed, reduces costs for healthcare facilities and allows easy and intuitive access to patient clinical information. It features advanced decision support capabilities, quality reporting module and secure browser-based access to patient clinical information. The EHR solution also incorporates an integrated CPOE process employing a single database, as well as a rules engine that spans all health venues. Misys CPR 5.0 provides interoperability to allow physicians, nurses and pharmacists to offer collaborative, patient-centric care with a truly integrated medication management function.
               Misys Connect 1.0 embraces the standards of the Integrating the Healthcare Enterprise (IHE) initiative for the sharing of a patient's clinical information across vendor solutions to give physicians a single, secure source to view patient data instantly from any location or clinical system. The data sharing solution gives physicians, other hospital clinicians, home care and long-term caregivers the ability to access patient information from a Web-based portal, increasing caregiver productivity and patient safety.
                The company shared Misys Connect 2.0, which will be released later this year. The next version will allow a physician to produce medical summaries using the Cross-Enterprise Document Sharing standards to communicate with other clinical systems within the Misys Optimum family. The product is built on a service-oriented architecture and utilizes Internet protocols, including HTTPS and XML, to provide access to enterprise and community-based electronic patient health records.
              The company also displayed Misys EMR and Misys Radiology. New features on Misys EMR connect physicians to patient data throughout the healthcare network while working seamlessly with practice management and billing systems. The latest version of Misys Radiology includes enhancements in the areas of structured reporting; PACS integration; voice recognition support and medical necessity checking.

NovaRad Corporation introduced NovaRIS and showed NovaPACS at HIMSS06 last week in San Diego. NovaRIS is a web-based, open standards RIS that generates reports, analyzes exams, measures profitability and facilities paperless management of patient records. It maximizes productivity by tracking exact reimbursement costs, which insurance companies paid for what and which procedures are currently making or losing money. The system features voice recognition and transcription and contains specialized worklists and interfaces for administrative assistants, technologists, radiologists, transcriptionists and billing specialists. NovaRIS also incorporates scheduling, auto fax and auto e-mail, HIPAA logging, HL7 interfaces, electronic signature for radiologists, audit trail and seamless integration with NovaPACS or other third-party PACS or HIS. NovaRIS was developed on the same platform as NovaPACS. Together, the systems enable fast retrieval of images and information from any web-enabled computer.  
                NovaPACS is an enterprise level, scalable PACS solution. It offers 3D imaging, fast image retrieval, a full-feature viewer with intuitive interface, brokerless integration and all-inclusive support. It features tools for referring physicians, 24-hour remote support, a seven year on-site archive, off-site emergency backup, completely customizable hanging protocols and integrated RIS, ortho tools, cardio viewer, MPR and dictation.

peerVue, LLC and AMICAS demonstrated peerVue’s digital teaching file solution integrated to the AMICAS PACS in the AMICAS booth at HIMSS06 last week in San Diego.
                The vendors collaborated on integration between the AMICAS Vision PACS and peerVue’s caseVue digital teaching file solution. The workflow enabled by the integration provides radiologists with the ability to quickly and easily create dynamic teaching files with little to no interruption in their normal interpretation process.  The resulting teaching file cases may be shared and exchanged via the caseVue-web solution. The solution is based on AMICAS XML-based application protocol interface (API) for third party integrations.

ScImage at HIMSS06 last week in San Diego announced its new PicomRIS, a fully web-based, IHE compliant Radiology Information System as a compliment the company’s flagship web-based enterprise-wide PACS, PicomEnterprise. Built to scale for smaller acute care facilities and imaging centers, PicomRIS will come either as a stand-alone RIS or fully integrated RIS/PACS, the company said.
        PicomRIS will provide tools for exam ordering, scheduling, film tracking, reporting and billing. The standards based system leverages DICOM and HL7 to satisfy IHE requirements for interoperability with any number of clinical information systems.
        In combination with PicomEnterprise, the RIS will be capable of providing a fully integrated clinical and business workflow system with a single database for a single point of entry for patient data and other information.
        The database is designed to reside on the same server which could produce substantial hardware savings, integration fees and cut down on implementation time.

Siemens Medical Solutions touted REMIND – new data mining tool at HIMSS06 last week in San Diego. The data collection and analysis tool garnered an “Inventor of the Year” award for inventor R. Bharat Rao, Ph.D., senior director, Engineering Research Development, Computer-Aided Diagnosis and Therapy Group, Siemens Medical Solutions.
                Rao was recognized for his pioneering work in developing REMIND (Reliable Extraction and Meaningful Inference from Nonstructured Data), which enables caregivers to utilize disparate healthcare information to personalize patient care plans and enhance patient outcomes. “Much of the data in the healthcare system is not in a format that can be readily accessed or applied at the point of care,” said Rao. “For example, key clinical information is stored as written text in patient records, discharge summaries, progress notes and radiology reports.”
                Without requiring any manual entry or change in workflow, REMIND integrates patient data with medical information and current treatment guidelines. Through a sophisticated algorithm, REMIND then analyzes the data and extracts key nuggets of information that will help clinicians make more informed treatment decisions. This information can be utilized for applications such as alerts, case management and adherence to treatment guidelines. Rao aims to organize the vast amount of diagnostic images, patient records, best practices and treatment outcomes to help personalize care. According to Rao, REMIND will provide ways to review years of data to find patterns of treatment, as well as identify people eligible for clinical trials.  
                REMIND has been successfully rolled out to a number of healthcare facilities and can be applied at all levels of complexity, from simple practice administration to patient management systems in large clinics. REMIND is currently deployed across multiple disease areas for more than five million patients in the United States.

 Swearingen Software, Inc. shared new RIS features last week at HIMSS06 in San Diego.
                The company has added a DICOM modality worklist manager and an electronic claims billing module for clinics. Currently, Swearingen Software is focusing on the development of worklist and workflow dashboards for radiologists and technologists. The technologist dashboard will be available in March, followed by the radiologist dashboard in April, said President Randall Swearingen. The company has started analyzing the EMR and considering its impacts on the RIS world, said Swearingen. EMR adoption and proliferation creates the need for new RIS tools like CD creation for patients, said Swearingen.

Varian Medical Systems, Inc. launched the ARIA Oncology Information System at HIMSS06 last week in San Diego.

                ARIA provides comprehensive solutions that streamline clinical, financial and administrative processes in cancer care, making radiation and medical oncology departments more efficient and cost-effective. It combines the benefits of an electronic health record (EHR) with guideline-driven care, workflow management and decision support. Designed to meet the unique needs of the oncology treatment process and ongoing patient care, ARIA integrates medical and radiation oncology treatment delivery. The system can be used to manage comprehensive cancer treatment centers as well as stand-alone radiation oncology or medical oncology departments in hospitals and clinics. ARIA provides a complete chemotherapy management system including clinical trials administration and outcomes assessment tools, and it enables implementation of all the latest radiation oncology treatment techniques. Built using industry standards and an open architecture, ARIA provides enterprise-wide connectivity that supports multi-vendor clinics. It can easily share information with other HIS and PACS, while enabling treatment centers to comply fully with patient privacy regulations.

Witt Biomedical Corp. was fairly quiet at HIMSS, holding off on the announcement of its next generation image and information software until the American College of Cardiology meeting in March.
                “The new system will migrate to Cqual database structure, and it features a new graphical user interface that lends itself to easier navigation,” shared Ruth Hurley, vice president. The new product should be available by the end of the second quarter.