PACS Packs the Choices

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Facilities in the PACS market will find a dizzying array of choices a RSNA 2004. Vendors are starting to key into the smaller hospital and imaging center PACS markets, and there are a number of products specifically tailored for these markets. Look for tighter integration across modalities and departments, specialized PACS for mammography and cardiology as well as souped up 3D capabilities. A number of vendors are also touting IHE support.



GE Healthcare (Booth #2700) is unveiling what the company describes as "uncomplicated, plug-and-play" PACS with the Centricity SE. The new solution simplifies and makes PACS more accessible for community hospitals (in the 100 to 400 bed range) and imaging centers. Centricity SE creates a fully filmless work process, with fast storage, and completely integrates into RIS. The fully integrated Centricity SE allows facilities to literally plug in and go live and avoid complicated installation. The modular, 'All-Images-Online' solution helps reduce operating costs, and improve radiology productivity and increase diagnostic confidence, GE said. Centricity SE features a state-of-the-art design with the power and functionality of GE's fully featured Centricity PACS scaled to meet the needs of community hospitals and imaging centers.

GE also will showcase the Centricity AW Suite, which streamlines modality workflow and puts all the tools onto one PACS. The Suite is designed with modality and PACS workflow in mind, fusing these technologies together to create one product to enhance diagnostic confidence, improve workflow, reduce cost and provide advanced tools for radiologists. AW Suite allows radiologists to acquire information, manage and store it, review, analyze and report it, then distribute all in one workstation - putting the power of advanced applications on any networked PACS PC.



IDX Systems Corp. (Booth #1936) is showcasing its Imagecast for Radiology solution. The Imagecast integrated RIS/PACS uses a totally web-based architecture that incorporates advanced workflow and image distribution technologies for each unique user from a single integrated database. Real-time, bi-directional communication is provided with more than 1,500 modalities, making filmless and paperless workflow a reality. IDX also is showing phase one of a new user interface strategy, an enhanced interpreting provider worklist and a prototype of the Imagecast for Cardiology solution.



Siemens Medical Solutions (Booth #2729) is highlighting its SIENET Cosmos fully integrated, web-enabled RIS/PACS driven by a RIS workflow engine. Features of the system that debuted earlier this year include single sign-on, Siemens syngo common user interface, integrated digital dictation and voice recognition, image post-processing applications for general radiology, orthopedics, neurology, neurosurgery, oncology, vascular and cardiology and fast-transfer protocol for multislice CT. In addition, the system's open architecture supports IHE, DICOM and HL-7 standards. Through the integration of Siemens Soarian clinical data repository and SIENET Cosmos, providers will be able to access relevant information anywhere, anytime, streamline workflow in departments and across the enterprise, track and monitor outcomes of procedures and processes and view images and reports via web-enabled image distribution.

Siemens also is demonstrating KinetDx specialized PACS for cardiology and radiology ultrasound. Ultrasound image presentation options include quick comparisons of new views and previous studies. The clinical reporting features enable rapid report automation including XML upload capability to brokerless HIS/RIS systems. Measurements, calculations, annotations and many other features are dedicated to ultrasound imaging with special emphasis on maternal fetal medicine (MFM). KinetDx's strength in cardiac ultrasound provides fast performance while imaging the motion of the heart. KinetDx can share storage infrastructure and web distribution of images and reports with Siemens SIENET PACS product line.



Fujifilm Medical Systems USA Inc. (Booth #7732) is showcasing its Synapse PACS and is demonstrating technologies to extend Synapse into new areas of the radiology practice and provide users with new methods for achieving consistent, clinical outcomes and positive business metrics. Fuji also is demonstrating its patent-pending reading protocol technology that contributes to the efficient navigation and interpretation of increasingly complicated exams.



McKesson Information Solutions / McKesson Provider Technologies (Booth #4902) is featuring its next-generation integrated solutions for image and information management that automate workflow and digitize the patient record, demonstrating solutions for radiology, cardiology, endoscopy and other clinical specialties across the enterprise. Horizon Radiology, McKesson's web-based integrated RIS/PACS solution, provides seamless management of images and information for gains in workflow productivity from order entry to report distribution. Horizon Medical Imaging (PACS) and Horizon Radiology Manager (RIS) are available as an integrated RIS/PACS, or standalone RIS or PACS using standards-based methods and the IHE framework to interface with other systems. Features include integrated billing, claims optimization, necessity checking, distribution and reporting functionality. Horizon Radiology provides cost-effective scalable solutions for the workflow needs of imaging and outpatient centers, as well as small hospitals or mid to large multi-site, enterprise facilities.

New Horizon Medical Imaging features include a web-based single viewer workstation for efficient distribution and access to all studies from any clinical department across the enterprise. The workstation provides new viewing options and the ability to handle very large volumes of data for storage and display to meet the needs of CT and MR scanners. Enhanced integrated tools for nuclear medicine, PET/fusion images, orthopedic templating and 3D imaging from everyday to high-end options improve workflow support and productivity. The system uses Oracle 10g grid and Linux to improve cost, speed, performance and scalability and incorporates new features in disaster recovery, including offsite data warehouse recovery and 24-hour system operation in case of complete hardware destruction as well as cross-site image replication, multi-MPN support and enterprise storage integration for multi-site locations.



Misys Healthcare Systems (Booth #5359) is showcasing its Misys Image Management system, powered by eRad/ImageMedical developed technology. The system delivers, manages and stores medical images, reports and associated data throughout the healthcare enterprise. Its hierarchical architecture is scalable over any TCP/IP network using high-speed LANS, WANs or low-bandwidth modems, the internet or VPN, providing centralized and distributed data management across multiple servers. Misys Image Management is designed to integrate image, voice and radiology information to deliver a fully integrated desktop workflow environment.



DR Systems (Booth #6533) is showcasing the latest upgrade of its fully integrated PACS and RIS that covers the entire radiology lifecycle, including physician order, patient registration, scheduling, procedure order, image acquisition, diagnosis and report, archiving, web distribution and billing interface. This solution provides a filmless and paperless approach suitable for both imaging centers and hospitals. Integrated into DR Systems' PACS/RIS are advanced image processing; optional voice-recognition; and automated web distribution of the report, image montage and audio clip. The company said it is easy to generate new orders and add-on orders in the system, as well as modify existing orders and transmit updates to the HIS. The system's "Smart Client" technology combines the best of thin and thick client approaches, with the ease of thin-client deployment and maintenance, plus client servers' robust applications.



SmartPACS (Booth #8549) is highlighting its StarPACS. Designed for radiology, orthopedics and dental applications, the system features an integrated voice recognition module, enhanced DICOM structured reports and GSPS (Grey Scale Presentation State) functions, real-size printing on film or paper, CD Creation, embedded security, improved 'Key Image' note function, advanced hanging protocols, a digital mammography mode, background DICOM service processing and roaming user profiles.

StarPACS Orthopedics includes a joint wizard function that automatically finds the optimal digital templates, a wide range of orthopedic templates, a total hip replacement module, a total knee replacement module, scaling, a planning wizard, templating, a template file manager and orthopedics report creation.

The company also is launching Infinitt RIS/PACS, which provides RIS/PACS fusion, a web-based interface, standard compliance, security, customization and statistical report generation tools.

A final highlight at the SmartPACS booth is Infinitt 3D PACS, a works-in-progress. The system comprises a fully integrated viewing workstation with advanced 3D functions.



Amicas, a VitalWorks company, (Booth #8520) is demonstrating the latest version of Amicas Vision Series PACS, Version 4.1. Through its RealTime Worklist, Amicas Vision connects all enterprise users and integrates numerous applications - RIS, cardiology PACS, orthopedic templates, document imaging, 3D and dictation. Some of the new features for version 4.1 include: integrated 3D study cropping with targeted review, Amicas ThinView for referring physicians, LightBeam and LightView 2X speed enhancements, Vision Watch Study Status Awareness and customer branding with personalized logos and skimming tool.



RealTimeImage (Booth #2603) is introducing at RSNA its iPACS Prism v.5.0, a scalable web-based PACS featuring an image-streaming solution and advanced, easy-to-deploy digital image analysis, management and archiving tools. iPACS Prism's advanced radiology workstation features include hanging protocols for customization based on user preferences and modalities, as well as patient-centric and modality worklists, enhanced multi-monitor support and zoom beyond 1:1. It also features workflow tools such as CD burning, QC stations and DICOM save. Compliance with industry standards such as DICOM, bi-directional HL7 and IHE ensure streamlined integration with other medical software systems such as RIS and HIS. The web-based iPACS Prism takes advantage of open, standards-based scaleable architecture to integrate easily with any network or the internet and turns an off-the-shelf PC into an advanced radiology workstation.

RealTimeImage also is debuting iPACS Cardio, a full-featured cath lab viewing, archiving and management solution, based on image-streaming for effective communications across the healthcare enterprise. iPACS Cardio turns any PC into a web-based software-only cath lab workstation that provides a stand-alone departmental solution or that can be integrated easily into the hospital network, the company said.



Stentor (Booth #6527) is demonstrating version 3.3 iSite Enterprise First PACS. Version 3.3 of Stentor's iSite PACS provides improved clinical features and functionality for physicians and radiologists across the entire healthcare enterprise. New product features in Version 3.3 include: remote reading/caching of exams on remote client machines for teleradiology; exam memos for improved collaboration and communication between physicians; image processing filters/CLAHE (contrast limited adaptive histogram equalization) that provides sharpness and contrast adjustments to aid physicians in interpreting and analyzing images; a localizer tool for improved diagnosis and navigation through images; updated key images tools for improved collaboration and fast navigation and a CD Manager for easy image distribution and management. iSite 3.3 comprises iSite Enterprise enterprise-wide, web-based image distribution, iSite Radiology Reading which separates diagnostic presentation and navigation contexts and iVault always on-line medical image archive. Stentor also is highlighting FDA clearance of its iSite PACS for use in the diagnostic reading, enterprise distribution and archiving of digital mammography images.  Version 3.3 is due to be released later this year.



NovaRad Corp. (Booth #1143) is introducing NovaPACS 6.0, a  newly released version that is a complete, turnkey PACS/RIS. Installation, hardware, maintenance and training are included in one price, on one contract. Priced at one-third the price of comparable PACS, NovaPACS includes servers, viewers, prep and workstations and NovaPACS is brokerless, open and scalable, the company said.  NovaPACS easily integrates, brokerless, with existing software and hardware systems.

Among the enhancements in the NovaPACS 6.0 upgrade are: improved handing protocol preferences; reverse cross localize to locate a certain point on an image in the slice; region of interest that provides actual numbers; new measurement tools; customizable preferred settings; fast image loading via background  image streaming; flexible finder functions to locate previous and related studies; faster DICOM image processing; flexible routing rules that makes images available by time of day, day of week or DICOM field; secure on-site 7-year RAID archive; and unlimited licenses. The NovaPACS 6.0 upgrade will be available this month.



Intelerad Medical Systems (Booth #1558) is introducing enhancements to its IntelePACS (version 2-6-3) InteleViewer including MIP (Maximum Intensity Projection) and MPR (Multi-Planar Reformatting). The InteleViewer also will support Teaching Files to enable academic users to combine clinical work with teaching duties.

The company also is showcasing the latest version of its Reporting Worklist software, which addresses IHE management issues, and its new IntelePACS monitor system with enhanced features and flexibility.



Sectra AB (Booth #6517) is highlighting at RSNA its Sectra PACS, which features a broad range of FDA approved, totally integrated clinical applications, all running on the same PACS platform to enhance radiologist workflow. An orthopedic imaging module includes an enhanced templating application, adding new measurement functions and a streamlined workflow to support the entire orthopedic surgery process. A totally integrated and enhanced cardiology PACS provides a set of clinically validated tools designed to support the diagnostic process.  Sectra PACS provides a solid platform for high production workflow while enabling quantitative analysis such as QCA and LVA measurements. Sectra PACS optimized for breast imaging offers specialized workflow capabilities for digital mammography in addition to the productivity tools built into every Sectra PACS workstation. The company also is demonstrating an enterprise-wide, multislice visualization tool with a new 3D and MPR/MIP functionality and advanced CT/PET fusion tools totally integrated in both the workflow as well as the IT infrastructure.

In addition, a number of clinical applications from third-party vendors, members of the Sectra Clinical Solutions Network (CSN), will be on display. CSN allows third-party clinical application vendors to tightly integrate their products to the Sectra PACS platform. Customers can have all their clinical tools available on a single workstation, greatly enhancing efficiency and streamlining workflow. Sectra Control Tower provides hospital management with an advanced tool for optimizing resource utilization in departmental as well as enterprise workflow. It helps facilitate the utilization of required equipment and improves work planning by providing relevant information. Sectra Control Tower also supports system administrators by offering real-time monitoring of system performance and usage.

Sectra is further showing a complete RIS/PACS solution that includes integrated speech recognition. This complete solution is only available in some European markets, but it shows the potential of Sectra PACS as a powerful imaging platform and its integration capabilities when acting as an integrated part of an EPR/HIS/RIS.



eMed Technologies (Booth #4100) is demonstrating at RSNA the eMed Matrix, a next-generation PACS workstation that incorporates a new platform based on smart client technology, an enhanced user interface and peer-to-peer communication. eMed Matrix uses .NET smart client architecture to enable the power of the PC with the reach of the web for easier deployment, maintenance and improved local client performance. The smart client application also can determine the hardware configuration to self-configure and optimize. eMed Matrix is designed to help radiologists get through their reading stack efficiently by displaying the images they want to see first, minimizing load on network bandwidth. The adaptive software of eMed Matrix learns a user's viewing protocol preferences and settings, which follow them regardless of where they log in. eMed Matrix integrates with the HIS/RIS to provide the patient's study with their clinical history and includes tools such as instant messaging, voice over IP, study linking, study notes and key images.



DeJarnette Research Systems Inc. (Booth #1729) is highlighting Ledger, a web-based, IHE-conformant HIPAA logging and reporting tool for radiology department management. Ledger can be used with all PACS conforming to the IHE standard. Features include: logging and reporting of laser imager print jobs; logging and reporting of CD and DVD media burning and distribution; logging and reporting of web server-based image and report distribution; logging and reporting of PACS workstation image and report access; automated reporting and analysis of historical printing; media burning, web access and workstation activity using Microsoft Excel; and real-time monitoring and reporting of HIPAA relevant PACS activity.

DeJarnette also is demonstrating version 2.0 of its dyseCT software. The upgraded software offers an improved segmentation algorithm, handling of neurological studies, improved handling of CT auto-send for some makes and models of scanners, automatic destination fail over and storage commit proxy capability.

DeJarnette also has on display its PACSware Migration Gateway 2.0. The Microsoft Windows-based toolkit supports the migration of PACS data, both images and reports, from a legacy PACS to a new PACS. The toolkit supports multiple migration strategies, including study-based migration, platter volume-based migration, priority RAID migration, pre-fetched based migration, ad-hoc migration and double pitch operation. It also supports functionality, which allows for pre-migration worklists, migration scheduling to minimize interference with daily clinical operations, multi-migration engine operation to speed migration, DICOM data clean-up and data verification.



CoActiv Medical Business Solutions (Booth #2478) is showcasing its Exam-PACS, a low-cost solution touted to reduce film purchases to help hospitals save revenue to pay for the PACS installation and, in some cases, CR equipment.



Rogan-Delft (Booth #7540) is presenting at RSNA its new Rogan View Pro-X Diagnostic viewer (VPX) with a new hanging protocol technique. It is based on the ultra-fast OnLine XS PACS from Rogan-Delft, Microsoft Windows GUI and equipped with drag-and-drop technology. The system is geared for small- to medium-sized clinics and hospitals. It is part of the Rogan OnLine XS product suite. The View Pro-X is available this month, following FDA clearance.

Rogan-Delft also is showcasing the new Rogan Ortho Pro-II solution for orthopedic specialists, with a release date scheduled for the first quarter of next year.



Eastman Kodak Co. (Booth #3537) is demonstrating its newest integrated healthcare product suite that includes RIS/PACS and storage management. The newest release of Kodak Directview PACS System 5 provides customers with enhanced support for specialty applications including mammography and orthopedics; powerful 3D interpretation tools (volume rendering, tissue definition, enhanced vessel tracking, automated bone removal algorithms) and other workflow-enhancing features. Kodak also is highlighting its Enterprise Information Management solution that uses powerful Directview VIParchive software to consolidate and manage DICOM and non-DICOM storage systems for radiology, cardiology, laboratory and back-office systems throughout the enterprise.



Cedara Software Corp. (Booth #6513) is launching a new suite of PACS-enabled clinical tools designed to streamline clinical environments. The new tools incorporate the same intuitive interface and powerful web capabilities as Cedara I-Reach and enhance ease of use and depth of functionality. Cedara I-ReadMammo allows easy study comparison between ultrasound, MRI and mammography studies (users can simultaneously apply tools to multi-modality images), as well as providing hot light functionality and integrated CAD for ultrasound. For radiologists burdened with reporting increasingly large multidetector CT (MDCT) datasets, Cedara CT Works optimizes workflow through a dynamic worklist, interactive thick slab MPR, MIP rendering, curved and batch MPR and 3D reviews. For orthopedic surgical practices, Cedara OrthoWorks family of products provides everything from digital templating to semi-automated 3D reconstruction and spinal vertebra anatomy detection, Image Relation functionality (beyond basic stitching) and a Clinical Data Management System geared specifically for orthopedics.



MedPACS Displays, Inc. (Booth #1701) will debut enhancements to its Vista PACS, a scaleable intranet and internet-enabled, fee-per-study PACS designed for small- to medium-sized hospitals, diagnostic imaging centers and multi-specialty clinics. VistaReport provides an integrated reporting capability that allows the radiologist to type or dictate reports while viewing images in the VistaDisplay. The user can create an unlimited number of templates, which are automatically pre-populated with the appropriate patient demographic information, and voice-dictated reports can be easily edited.  The completed report is electronically signed, placed on letterhead and sent to the Vista archive and RIS. VistaConsult allows radiologists using the Vista system to conference and review images with another non-Vista physician. MultiView provides the ability to view a CT image set in multiple planes, including single and double oblique views, aiding in the diagnosis of complex structures and diseases. Improved Hanging Protocols include smart software so that when a user adjusts screen format and image magnification preferences for a particular type of study, Vista "remembers" the settings and then maintains that each time the user accesses that type of study - making image review faster and more efficient. With the exception of VistaReport, which will be a purchasable option, these enhancements will be included at no charge and are part of the Vista per-study fee. The per-study fee covers all server/archive hardware and software, maintenance and upgrades and viewer software required to support the customer's annual study volume.



Dynamic Imaging (Booth #2753) is unveiling at RSNA new clinical applications, fault tolerant architecture and management tools for large 3D data sets enhancements to its IntegradWeb PACS.

The new fault-tolerant grid architecture assures business continuity in multi-site PACS deployments in the event of network failure. If a connection to a central server experiences temporary failure, this architecture enables each site to continue to function independently. Once the connection is re-established, the PACS automatically resynchronizes each site with the central server to ensure integrated image access and workflow across all locations.

OrthoPACS is an advanced orthopedic package featuring a comprehensive template library, from screws and plates to prosthetic devices. In conjunction with IntegradWeb Image Viewer, this solution enables procedure planning and simulation for orthopedic surgery, osteotomy and trauma cases.

A configurable slice-thickness reformatting engine will automate image formatting to minimize storage space requirements following image post-processing and reconstruction and streamline analysis, management and storage of multislice images. A slab scroll tool creates on-the-fly, in-plane reformatting with adjustable slice thickness, allowing ultra-fast navigation through axial images, while the original images remain unchanged and available for thin-slice review.

A configurable data compression utility automates lossy image compression over time to create increasingly smaller file sizes as studies age.

Tools for boosting productivity and enhancing communications with referring physicians include automatic results notification, which automatically emails referring physicians a link to their studies online once diagnostic results are available. Other new features are a key images template and hanging protocols based on scanning techniques and orientation.



Guardian Technologies International Inc. (Booth #4972) is launching the Guardian-Wise Next Generation RIS/PACS. For a full description, see page the Clinical Information Systems section.



AccuImage Diagnostics Corp. (Booth #8563) is bringing its eStation3D, a management and distribution solution that connects imaging modalities directly via broadband (intranet or internet) to establish a web-based gateway and facilitate a cost-effective workflow. EStation3D puts imaging facilities in close proximity to remote physicians and/or patients. The distribution of DICOM images can be catalogued and managed at a reasonable cost.



IMCO Technologies (Booth #5714) is debuting Quick Click, which has 16 programmable function keys, saving keystrokes and time for the most common functions used by an individual user when using IMCO-view software. The company also is highlighting IMCO-view features, including customized hanging protocols, an integrated RIS and orthopedic templates from most major prosthesis manufacturers in the market and a separate monitor for work list display. IMCO-web provides the ability to receive images on a dual-monitor workstation at a physician's clinic or home.



Evolved Digital Solutions (Booth #4773) is highlighting its web-based, fully managed imaging solution with integrated workflow, online dictation/transcription, secure off-site archiving, patient data, scheduling and a seamless interface. View2 is its PACS solution. Process2, formerly "RadWeb," includes a full-featured RIS, plus: Access2 web-distributed patient data; Scribe2 online dictation/transcription and Cycle2 patient scheduling. Link2 connects any existing system. Bank2 provides secure offsite archiving. This managed solution reduces up-front investment by about half and eliminates the need to hire new staff, the company said.



Eclipsys Corp. (Booth #5143) is showcasing Sunrise Knowledge-Based Diagnostic Imaging. This closed-loop diagnostic imaging workflow solution integrates radiology and other specialized diagnostic imaging capabilities into the clinical workflow to expand integrated clinical information, bring the radiologist into the clinical workflow and improve physician productivity and patient care. 



eRAD/Image Medical PACS (Booth #1914) is introducing three new plug-in modules to enhance client workflow solutions: MPR, 3D and an orthopedic templating module (a joint effort between eRAD and OrthoView). These enhancements are available to eRAD's installed base as well as new clients.



ScImage, Inc. (Booth #1956) is showcasing its PICOMEnterprise PACS. Version 2.0 enables an order-driven workflow for radiology departments while simultaneously giving other departments within the hospital a tool for acquisition, storage and distribution of both images and reports. Version 2.0 also has a new interface engine that provides a single point of entry through any third-party RIS, EMR or practice management system. The enterprise-level PACS is built to be deployed as a single server solution that can serve one or more departments and tie together all of the stored data using a common database. Viewing, advanced visualization and analysis programs for radiology, cardiology and orthopedics are delivered to the client workstations using a concurrent network licensing design. Comprehensive reporting tools and document management utilities also are included. ScImage also is introducing PICOM ECG at RSNA 2004. The PICOM ECG Suite is a web-enabled ECG management module that augments the cardiology offering.

The company also is showing its PICOMOnline archiving option. This offsite disaster recovery and OnDemand TelePACS product provides bidirectional communication between a PICOMEnterprise server and PICOMOnline and facilitates a location-independent workflow, while providing back-up, telemedicine and business continuity services.



Emageon (Booth #2958) is debuting its new 2004-R6 product release. New features include integration with Dictaphone PowerScribe voice recognition, UltraVisual Technologist featuring web-based administration tools and paperless workflow, a mammography workstation, OpenGL high performance graphics, multi-specialty tools and multi-institutional support.
Emageon also is highlighting its Intelligent Visual Medical System (IVMS), an enterprise advanced visualization and infrastructure solution that allows physicians and healthcare professionals to manage, access and visualize medical content using relevant multi-specialty tools through a dynamic user interface. Delivered through Emageon's Enterprise Platform, IDNs, hospitals and imaging facilities are able to deploy a functionally rich, standards-based technology that lowers total cost of ownership. The company's customer success programs ensure rapid implementation and adoption.



RamSoft, Inc. (Booth #8320) is displaying its latest software. The web-based Digital Imaging Solution and software components address the needs of hospital, imag