PACS Powers the Enterprise

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Robert Berkenblit, MD, Montefiore Medical Center  
2007 marks another banner year for digital image management systems. Vendors are rolling out a host of new features designed to streamline radiology workflow this year in the Windy City.
More vendors are offering ER discrepancy tools to help hospitals identify and manage discrepancies between the initial ER and final radiology interpretations. Other features such as instant report alerts boost communication with referring physicians to expedite care and improve service. Visitors also can view an array of dashboard tools. Some help sites monitor and measure performance, while others enable PACS vendors to monitor the system and proactively identify and manage problems. Look for more tools to simplify multi-site image management. These include roaming user profiles that not only streamline workflow for radiologists who travel among facilities, but also assist physicians viewing studies from home. More vendors are incorporating PET/CT tools to help handle hybrid exams. And the era of enterprise PACS is apparent with more and more vendors touting ‘ology’ assists like digital orthopedic tools.
So make your list and make the rounds. RSNA ’07 promises something for everyone in the PACS market.

Agfa HealthCare (Booth 4106) is highlighting its solutions in radiology imaging and imaging informatics and launching a new set of IMPAX suites and a new line-up of workflow solutions supported by expert services. The company is holding its cards tight to the chest in terms of system details, but the full portfolio will be on display at showtime.
Agfa is emphasizing its leadership in helping hospitals successfully transition from analog to digital solutions. The company’s vision is to accompany hospitals in their transition from analog to digital to IT solutions, with a view to improving the delivery of medical and patient care and supporting a more cost-effective healthcare arena. 

AMICAS (Booth 2583) is highlighting RadStream and debuting both VisionReach 2.0 and Vision Series PACS Version 5.5.
The RadStream workflow solution is proven to improve radiologist productivity, service and quality for referring physicians. The system makes possible the automation and documentation of critical results communication and the prioritization of imaging exams based on a “most likely to interrupt” logic. Researchers at Cincinnati Children's Hospital and the University of Cincinnati College of Business found that RadStream improves radiology report turnaround by more than 50 percent and reduces interruptions to radiologists by nearly 25 percent. AMICAS successfully integrated the technology into RealTime Worklist. RadStream also complements the Vision Reach referring physician portal.
Vision Reach 2.0 extends its functionality to include follow-up order entry, allowing a referring physician to order a follow-up exam–in addition to receiving instantaneous secure notification when a report is available. It provides proactive electronic delivery, notifying the referring physician when exam results are ready. Vision Reach also integrates the radiology report with key images and creates a single "multi-media" report for referring physicians. It uses e-mail and secure messaging to proactively deliver images, reports and information to any e-mail-enabled device. The zero install client web-based application eliminates installation and any client level application requirements. Vision Reach is available as a standalone referring physician product or in combination with Vision Series products.
Vision Series PACS Version 5.5 introduces enhancements to RealTime Worklist, including role-based workflow management. Also included are extended Vision Watch reporting capabilities and new advanced high availability options. Role-based workflow management makes it possible to create custom workflows for everyone involved in the radiology round trip. For the radiologist, it optimizes reading patterns and enhances communication. For the technologist, it facilitates instantaneous awareness of where patients are in the imaging process. For the referring physician, RealTime Worklist delivers quicker results and better service. AMICAS is showing examples of role-based workflow management such as identification and communication of ED discrepancies. Besides the ED wet-read assessment, other exam factors can be captured and stored with the study, such as teaching file status, image quality assessment and study reservation.

Aspyra (Booth 3307) is releasing CyberRAD RIS, AccessRAD RIS/PACS and AccessNET PACS.
CyberRAD RIS, AccessRAD RIS/PACS are designed to meet the needs of acute-care hospitals, enterprise-wide delivery networks and large imaging enterprises. Both products offer end-to-end solutions that automate processes at every point of patient workflow. AccessRAD RIS/PACS version 6.3 includes expanded support for outpatient imaging center applications and real-time management views using a “dashboard,” allowing the user to monitor overall department workload.
AccessNET PACS provides basic PACS functionality and clinical workflow management. Version 6.3 includes improved configuration management tools, support of XDS-I for implementation in regional health information organizations (RHIO), default role-based user profiles, better handling of imported external studies and enhanced disaster recovery connection with partner InSiteOne. Aspyra is demonstrating mammography hanging protocols to enable efficient diagnostic reading of digital mammography studies and other advanced hanging protocols to improve the radiology exam interpretation.

BRIT Systems (Booth 3503) is introducing enhancements to its DICOM routing module.
New routing rules for the Roentgen Router include: auto-routing based on study status changes and the “Doctor Pal” mechanism that intelligently routes studies based on different RVUs, keeping same patient studies linked together to help facilitate reading and diagnosis and differentiation of studies by CPT codes, such as screening mammography versus diagnostic mammography exams.

Candelis (Booth 6926) is displaying its ImageGrid PACS appliance with the addition of an enhanced ImageGrid web viewer, IG Viewer. The web viewer provides a way to view studies from any workstation on a LAN or WAN, or remote workstations via a VPN. IG Viewer’s Import Too makes it possible to import a study to the ImageGrid from any PC or workstation.

Carestream Health (Booth 2513) is unveiling new Kodak Carestream PACS features and showing the Kodak Carestream Digital Dashboard.
The latest features of Kodak Carestream PACS include dynamic streaming capabilities to enhance the rapid delivery of images to clinicians in on-site and remote locations. The PACS platform offers optional integrated applications such as image fusion, orthopedic surgical templating, 3D imaging and advanced cardiac features.
Kodak Carestream Digital Dashboard provides administrators a way to monitor equipment performance, storage utilization and user volumes. PACS administrators can verify the status of any networked device via a color-coded digital display. The digital dashboard also makes it easy to track the number of concurrent users for a device, the number of read and unread imaging studies and the status of other tasks.

Cedara Software (Booth 1316) is sharing with RSNA goers its C4 (Cedara Clinical Control Center), including C4 integrations and C4-enabled applications.
For OEMs, the C4 framework delivers desktop integration of clinical applications to an established RIS/PACS solution. Organizations can integrate once using a C4 interface and any C4-enabled plug-in using this path to deliver a streamlined clinical imaging solution. 
The works in progress Cedara I-Reach, an example of a C4 host, facilitates the viewing of diagnostic images over the internet. High performance and a seamless user interface facilitate image distribution throughout the enterprise or remotely. The latest version of I-Reach includes the C4 integration which enables I-Reach to launch into a variety of C4-enabled plug-ins.
C4-enabled applications include Cedara I-ReadMammo, the works in progress Cedara I-Response, Cedara OrthoWorks Pro Planner, works in progress Cedara PET/CT, Cedara B-CAD and various Biotronics3D solutions. Cedara I-ReadMammo is a multi-modality, vendor neutral mammography viewing application that provides PACS companies with mammography workflow capabilities. The works in progress Cedara I-Response allows users to automatically generate a variety of quantitative calculations, compare tumor activity at multiple time points and visualize therapy response in individual, configurable layouts. Cedara OrthoWorks ProPlanner is a templating and stitching application that brings orthopedic workflow to any imaging desktop. Cedara PET/CT, another works in progress, follows radiology workflow and solves image fusion challenges in a PACS environment. As an example of third-party integration, C4-enabled the works in progress Cedara B-CAD will be shown using this ultrasoud CAD application from Medipattern. Several C4-enabled Biotronics3D applications will also be shown, including virtual colonoscopy, angiography and general diagnostic.

Cerner Corp. (Booth 1365) is demonstrating ProVision Workstation software.    
The Workstation complements Cerner RIS/PACS to create a cohesive suite of radiology solutions. The ProVision Workstation and Cerner RIS/PACS save time for radiologists by reducing the number of steps to view relevant images. Cerner’s radiology solutions create an uninterrupted link between patient images and the electronic medical record (EMR). ProVision PACS offers a complete range of image management products, including image acquisition, storage, display and web distribution services. Cerner’s paperless and filmless PACS solutions optimize workflow and eliminate waste in the radiology department. The ProVision Workstation further streamlines radiology workflow through one-click access of the Cerner Multimedia Foundation, a single repository for all types of images across multiple care venues.

CoActiv (Booth 5741) is showing EXAM-RIS and EXAM-PACS and announcing the validation of its EXAM-VAULT Quad-Redundant Archiving system for use with the Philips Xcelera echocardiography system.
The fully web-based EXAM-RIS is integrated with EXAM-PACS and includes single and multi-site scheduling, multi-site billing, information and charting (EMR), document scanning, web-based dictation, transcription, exam report templating, auto report distribution, billing, custom management reports, voice recognition integration, modality worklist and
HL7 integration with HIS, billing and other applications
CoActiv EXAM-PACS incorporates paperless features and scans and attaches paperworks to digital exams for instant review in both the CoActiv EXAM-CONSOLE and EXAM-VIEWER windows. Built-in EXAM-PACS software supports scanning with any TWAIN compliant single- or multi-sheet scanner. 
EXAM-VAULT Quad-Redundant Archiving supports all-inclusive medical image acquisition, viewing, distribution and archiving and is validated for use with the Xcelera system. 

DR Systems (Booth 2165) on the RSNA floor is featuring Release 8 of the Unity RIS/PACS.  Highlights of the Unity RIS/PACS Release 8 include: patient link to merge or link unintended duplicate patient records; patient registration to allow for pre-registration preparations; smart forms to associate appropriate exam and insurance form templates with patient; patient tracking; film tracking; mammography tracking; mammography image; mammography CAD; mammography reporting; exam workflow notes to initiate tasks to facilitate tracking workflow and setting priorities and sentinel to monitor overall facility including exam and report statistics, workstation configuration and application status. System-wide enhancements support National Provider ID (NPI); anonymization of patient exams so that they can be used for training, education, publications and presentations and an interface to allow query and creation of an EMPI (enterprise master patient index).

Dynamic Imaging (Booth 4765)–which on Oct. 11 was acquired by GE Healthcare–is demonstrating IntegradWeb PACS and RIS/PACS with additional features.

The latest version of IntegradWeb PACS delivers scalability to more than 1 million exams per year, a significant reduction in the time to view the first image and support of the latest version of Microsoft SQL Server 2005.Two IntegradWeb PACS advancements, both pending FDA 510K clearance, include the IntegradWeb PACS native PET/CT solution and enhanced comparison mode. PET/CT provides a complete package of advanced tools native to IntegradWeb PACS for PET/CT interpretation to make integrated PET/CT functionality available anywhere with an internet connection. Enhanced comparison mode includes innovative study layouts to compare two studies to the current study, improved study layout flexibility and synchronization of priors for projection studies (e.g. CR/DR). Additional new features include enhanced enterprise master patient index support with intelligent MRN linking, exclusive worklist, custom templated result email messages for referring physicians and support of DICOM overlays.
Dynamic Imaging is highlighting new approaches to its graphical user interface and viewer design as a work-in-progress. These designs focus on the next generation Study List, Patient Folder and Cardiology viewer. Each tool provides the user with flexibility when navigating and visualizing the superset of information required for interpretation workflow and image analysis.
Dynamic Imaging is showing two clinical applications to be integrated with IntegradWeb PACS: including peerVue qiVue and CAD Sciences ProStream. peerVue qiVue integration includes intelligent tools to manage continuous quality improvement in imaging: ER discrepancy alerts, peer review and critical finding notification. IntegradWeb PACS is integrated with CAD Sciences ProStream for prostate imaging. Included with integration to ProStream is CAD Sciences fTP (Full-Time-Point) visualization algorithm for MR prostate imaging. Additional clinical applications integrated to IntegradWeb PACS include Orthocrat TraumaCad, MedImage MedView, TeraRecon AquariusNet, Vital Images Vitrea, Barco Voxar 3D, Barco Voxar 3D VesselMetrix and Dynamic Imaging IntegradWeb Mammo.
IntegradWeb RIS/PACS, an all-inclusive, unified solution for ambulatory environments, is an integrated solution that includes single login, intelligent bi-directional information sharing via web services and RIS-driven workflow for facility staff and PACS-driven workflow for radiologists. Highlighting the suite of new features is the Payor Contract Management module, which now performs DRA (Deficit Reduction Act) calculations. IntegradWeb RIS/PACS recognizes the impact of same date of service (DOS) procedures and calculates expected reimbursement, so facilities can accurately project expected net revenue. The enhanced module also helps ensure that expected reimbursement is received and alerts users if the maximum reimbursement is not posted. Module logic considers the impact of both DRA and HOPPS fee schedules and applies the appropriate same DOS modifiers to facilitate appropriate payment.

Eclipsys (Booth 6959) is showcasing Sunrise Radiology and Sunrise PACS. 
Sunrise Radiology and Sunrise PACS are fully scalable and can be integrated with Sunrise Clinical Manager for a robust, enterprise-class imaging solution. The latest release of Sunrise Radiology features support for multiple secondary MRNs, enhancements to online scheduling by physicians, speech recognition module enhancements, support for PACS-driven workflow with third-party PACS, additional flexibility and granularity in managing users’ rights and permissions and improved performance and scalability.
The latest additions to the Sunrise PACS workstation family, powered by Sectra, provide speed in displaying and managing extremely large datasets, full RIS/PACS integration and a modern, scalable architecture.

Emageon (Booth 8508) is sharing with RSNA goers its RadSuite Express.
The turn-key solution helps facilities producing less than 80,000 radiology studies a year install and start using PACS in days. RadSuite gives specialists and referring physicians in smaller facilities access to multi-disciplinary 3D imaging tools. The simplified web-enabled, single-server solution is based on Dell technology. The RadSuite Express product features the imaging best practices, optimized hanging protocols and workflow capability experience.

eRAD Inc. (Booth 8538) is introducing a scheduling module for its eRAD PACS.
The module enables multi-site imaging centers to centrally manage patient information, procedure schedules, insurance verification and room allocation. The PACS Scheduling Module is available as a standalone application and as an add-on to its PACS. The scheduling module is integrated with the PACS at multiple levels. The products share the same patient information and provide access to a patient’s history of images and reports from a single user interface. The interface is browser-based, making access to information available from numerous locations without imposing a heavy burden on the customer for managing individual applications and settings on multiple stations. User profiles, GUI preferences and other individual settings are centrally managed and applied to the local machine each time the user logs on. User and system level security and data encryption features provide compliance to HIPAA access and tracking rules.

Fujifilm Medical Systems USA (Booth 1129) is highlighting Synapse version 3.2, integration with ProSolv CardioVascular’s CVIIS, future extensions to distributed 3D software and an expanded data model for Synapse PACS.
Synapse Version 3.2 addresses recent trends in digital mammography and includes the ability to display and manage CAD results, MQSA compliant image overlays and diagnostic/screening reading protocols. It also further enhances the ability to serve the needs of digital mammography. Fujifilm is introducing Synapse Version 3.2.1, too.
With the acquisition of ProSolv CardioVascular, Fujifilm is extending its PACS platform and demonstrating integration with ProSolv CardioVascular’s cardiovascular image and information system (CVIIS) for any modality, including cath. The company is highlighting integrated Corridor4DM (previously known as 4DM-SPECT) capabilities. Nuclear cardiology physicians and technologists can benefit from access to 4DM review, analysis and quantification tools from any ProSolv CardioVascular workstation for reporting and image management.
Future extensions to Fuji 3D software cover PET/CT fusion and digital mammography. The company is showing works in progress advancements to existing diagnostic MIP/MPR capabilities for Synapse. All 3D applications are designed to be available anywhere on the network that Synapse PACS is available. 
The expanded data model for Synapse PACS includes tight integration of Empiric Systems Encompass.NET RIS functionality that provides hospitals and imaging centers with a customizable solution capable of meeting all imaging and information needs.  Also, as a work-in-progress, Fujifilm is demonstrating expanded information content, which includes an advanced information model that covers the radiology department.

GE Healthcare Integrated IT Solutions (Booth 1729) is showcasing Centricity Imaging-PACS version 3.0 that delivers several powerful new benefits to hospitals and imaging centers that help improve efficiency. For example, new IHE profiles within Centricity PACS version 3.0 automate exam acquisition, reporting, and communication for referring physicians. New customers also will benefit from an updated LINUX architecture, while current Centricity customers also can implement version 3.0 within their existing infrastructure. Other additional features include:
  • New  decision-support tools such as the Business Intelligence Portal, which helps  administrators maximize valuable resources
  • Enhanced  security features to protect patient information, providing access only to  those who truly need it.
  • With  new voice-driven commands and highly configurable worklists to manage exams  with greater efficiency, GE Centricity PACS manages exams with greater  efficiency.
GE also is showcasing its Centricity AW Suite 2 (Advantage Workstation) that combines advanced visualization tools from AW software within Centricity Imaging-PACS (Picture Archiving and Communication System). Centricity AW Suite 2 offers five optional modules such as CardIQ (cardiology), Advanced Lung Analysis (oncology), Advanced Vessel Analysis (aardiovascular), Autobone and CT colonography. The addition of these modules over the base volume share has completely digitized the diagnostic process to better manage large data sets. Radiologists no longer have to move between workstations to view and manipulate interactive volumetric data sets. Specific tools for CT, MR, PET/CT, and x-ray are now fully enabled on any networked PACS PC, with the benefits of 3D imaging.

GE’s Centricity Radiology solution—which brings together Centricity PACS with the Centricity RIS-IC (formerly known as IDX Imagecast)—allows radiologists and other care providers to manage workflow and leverage a common radiology information system across geographically dispersed locations. Additionally, clinicians have immediate access to significant clinical findings and associated images as well as tools for reducing errors inherent with manual data entry.

Further, GE is featuring its Centricity Imaging ASP, a scalable DICOM archive solution that enhances, protects, and optimizes radiology and cardiology workflow by providing the same rich software functionality but with a pay-per-procedure cost structure. As the primary imaging archive solution deployed in more than 50 sites nationally and five countries globally, Centricity Imaging ASP helps facilities keep storage costs predictable and improve cash flow management by shifting the burden of managing and maintaining the information system to a dedicated GE team. By hosting data at two separate data centers (2,000 miles apart), GE offers a robust disaster recovery plan.

Infinitt (Booth 8520) is introducing Infinitt Cardiac PACS and Infinitt Smart-NET.
Infinitt Cardiac PACS is a complete image management solution for the cardiology enterprise. The integrated solution analyzes, achieves and retrieves 2D and 3D cardiac images via an ECG viewer. It provides image management tools, including image acquisition, storage, displays and web distribution devices. The system is designed for all diagnostic procedures and provides access to complete image data, analysis and manipulation tools. Infinitt-supported modalities include x-ray angiography (XA), ultrasound/echocardiography, MRI, CT and CR/DR. In the case of XA and ultrasound, Infinitt Cardiac PACS offers numerous cardio-specific 2D analysis tools. For XML-based ECG, the application can display, measure and print the ECG signals. In addition, an intuitive user interface and system architecture offer configurable work list management and customizable display protocols. Enhanced 3D processing and customizable report improve diagnostic quality and productivity.
The Infinitt Smart-NET ASP-based program hosts and delivers medical information and images from a secure data centers using wide area network (WAN) connections. Through web-based access, users can access images from any location at any time of day. This web-based, high-speed engine is built on a 64-bit platform. Features include roaming user profiles; support for DICOM  printing, paper scanning and digital dictation supported; CD burning capabilities; support for multiple combinations of high resolution grayscale and color monitors; DICOM modality worklist and priority loading, which makes images available to the radiologist or physician based on an image push set-up rule. 

Intelerad (Booth 4759) is highlighting InteleViewer 3-5-1 and IntelePACS at RSNA 2007.
InteleViewer, the dual-mode viewing application included with IntelePACS, offers rapid performance and an intuitive user interface. New features include freehand and volume region of interest (ROI) measurements, orthogonal measurement, digital subtraction angiography (DSA), thumbnail tabs for easy access to comparison studies, ability to save a study using DICOM Presentation State and real-time cine support for cardiac applications. To bolster performance across WAN, InteleRad has added speed enhancements to its streaming capabilities to help manage the ever-increasing size of imaging studies.
New IntelePACS’ features include a Report Generation and Distribution module. For teleradiology practices that do not use RIS, IntelePACS now handles the entire radiologist and transcriptionist workflow, including reporting worklist, digital dictation, integration with voice recognition, report generation with templates, report sign-off, distribution of reports using HL7 messages, postscript printing, fax sending and email alerts. The Roaming User profiles modules allow an organization to offer multiple ‘user profiles’ tailored to different working situations that roam with them across different sites or between different IntelePACS installations. Users can create customized profiles that fit their preferences and requirements, including number of monitors, display preferences and layout protocols. IntelePACS 3-5-1 also features an optimized RIS gateway functionality. Using a redundant RIS strategy that functions across WANs, IntelePACS RIS gateways use automatic failover mechanisms to improve fault tolerance and load balancing. Finally, IntelePACS now handles DICOM Structured Reports so ultrasound tech notes and other clinical applications data such as vascular, colonoscopy, nuclear medicine and cardiology data can be displayed within InteleViewer.

Intuitive Imaging Informatics (Booth 3965) is unveiling enhancements to Rational Imaging PACS and ImageQube web-based PACS. 
New developments for Rational Imaging include the expansion of PET Fusion with the ability to facilitate workflow by doing full-body MIPs and Volume Region of Interest (ROI). Efficient memory management allows simultaneous display of comparison exams for ease of including available priors and saving annotations. Mammography reading has been improved with the development of MG Overlays and Presentation State to better harness data from digital scanners and MG Scoring. MR Angio has been enhanced with the addition of MIP. Additional templates have been developed for orthopedic practices. Flexibility is furthered by new exam assignment and Custom Auto-Load Worklist efficiencies. Ease of logging in to diverse applications is made possible with single sign-on available through Intuitive’s “Unison” application. Newly completed development provides state-of-the-art support for the release of Solaris 10, coinciding with an improved GUI. Archive compression at the Intelli-NAS level provides economies in expanded storage capacity for both online and farline spinning disc storage, joining the existing compression at the Jukebox level. Auto-diagnostics improvements alert Intuitive Imaging’s support staff to potential on-site difficulties, so corrective action can be taken, often before the site is even aware of any problem.
ImageQube provides improved Custom Protocols using “one-click” layouts. Also new is a fully-automated, personal DVD/CD burner capability, providing exams, reports and key image displays of both primary and rendered data (PET Fusion), for Windows users.

McKesson (Booth 2542) is showcasing its enterprise image management and workflow solutions in radiology, cardiology and endoscopy.

Horizon Radiology Manager is the core workflow component of an enterprise-focused RIS-PACS. The latest release offers additional clinical features such as allergy indicator enhancements, simplification of the non-reportable workflow and enhanced integration to the latest Horizon PACS. 

Horizon Medical Imaging is the newest release of McKesson’s PACS software that now offers the ability for remote radiologists to choose to annotate images, bookmark images, flag images, adjust image presentation, report on studies, and use McKesson's unique ER Discrepancy Reporting solution either over the web or from a dedicated workstation.

Horizon Cardiology 11.1 is the only CVIS on the market that supports hemodynamic monitoring, cardiac catheterization, echocardiography, vascular, nuclear reporting and CPACS on a single platform to provide a fully integrated cath lab, according to McKesson. This product also supports 3D reconstruction of CT for angiography and ventricular function. Additionally, McKesson’s soon-to-be released ECG solution features a complete ECG workflow solution and multi-vendor interface capabilities.

McKesson Revenue Management Solutions business intelligence and reporting tool providing access to medical billing and accounts receivable management information with business intelligence and reporting tools. There are no up-front hardware, software or maintenance costs. With only a web-browser and internet connection, it is possible to see high-level dashboard reports that give you a quick pulse on your practice’s financial and productivity data and drill-down to view the underlying details to make more insightful business decisions.

Merge Healthcare (Booth 1122) is showcasing a variety of solutions designed to deliver a positive return on investment in digital imaging including Fusion RIS/PACS MX, Fusion PACS MX, Fusion RIS MX, Merge Ortho and Fusion PACS GL.
Fusion RIS/PACS MX brings a positive return on investment for imaging businesses and an optimized workspace for radiologists. This single business and clinical application features: exam-driven imaging workflow from scheduling through billing; worklist management customized for each user; single-source access to all patient information with integration into standards-based electronic medical records; point-and-click access to workflow tools such as relevant priors, embedded dictation and document management, interrupt sessions, instant messaging and hanging protocols; 
single-solution access to patient data, such as a patient insurance information or referral details and a single patient master jacket that includes information typically stored in RIS and PACS separately. Other features include business performance monitoring and management with a user-friendly practice analysis tools for mining and reporting on key financial, operational and clinical data, as well as the imaging center’s operational performance and advanced visualization tools including spine labeling, MPR, MIP and triangulation. A Referring Practice Portal allows immediate distribution of reports and images to referring physicians. Portal customization helps imaging businesses differentiate themselves and better serve customers.
Fusion PACS MX, a work-in-progress, provides workflow-integrated clinical applications. It uses leading-edge platform technology to automatically launch the right clinical application required for viewing each study to yield efficiencies by allowing specialty reading like mammography, orthopedics and PET/CT to proceed seamlessly within clinical workflow.
Fusion PACS MX 3.0 also brings new viewing protocols that allow the user to step through different views, the ability to save annotations or measurements as part of the image for improved flexibility and expanded keyboard mappings for better workflow optimization. The PACS also offers workflow and communication tools such as multiple interrupt sessions and instant messaging and native 64-bit processing to load tens of thousands of images simultaneously.
Fusion RIS MX 3.30, another work-in-progress, incorporates the top requests from a Merge Healthcare User Group Meeting. It also contains additional capabilities such as improved fax service, external order ID tracking workflow and national provider number. Other features include enterprise-wide licensing and scaleable design; flexible scheduling options; embedded modules for applications such as document management and dictation to facilitate seamless paperless workflow; a local and regional security business module that helps to address HIPAA compliance with minimal business disruption; Practice Analysis and Crystal Reports for comprehensive business intelligence and billing capabilities tied tightly to the RIS workflow. 
Merge Ortho provides automation designed to minimize mouse clicks for standard planning procedures, such as automatic hip templating, automatic image stitching and automatic reporting. Merge Ortho includes a digital orthopedic template library. The system is designed to integrate with an existing PACS and can be used throughout orthopedic workflow.
Fusion PACS GL, another works in progress, is designed for presentation, storage, retrieval and distribution of medical images, with extensive options for customizing the unique configuration needed for each customer’s imaging practice. Options available in Fusion PACS GL allow users to take advantage of visualization tools such as MIP and MPR. The system also accommodates individual customer preferences. Every Fusion PACS GL solution contains archiving capabilities, which are scaleable as image storage needs expand. Configuration choices are available to optimize each customer’s distribution network, disaster recovery needs and budget.

Meta Fusion (Booth 6456) is announcing enhancements to the Helium radiology practice management solution that support multi-country, localized workflow, while maintaining RIS/PACS integration. The company also is demonstrating RIS-driven imaging architecture.
Meta Fusion has new customizations to support local systems of scheduling, reimbursement and administrative record keeping in a full range of countries. Helium also supports a full range of native languages and character sets.
Helium features RIS-driven imaging architecture that uses a RIS interface as a single skin for controlling all RIS and PACS functions. The user need never switch between applications, although the programs are separate. Helium is fine-tuned for the special needs of imaging centers and small hospitals. The application ships pre-configured to a purchaser’s specifications for plug-and-play installation, eliminating IT support. It incorporates an IT backbone similar to Meta Fusion’s enterprise healthcare IT appliances. Helium provides comprehensive RIS workflow; from patient scheduling and exam reporting through report tracking and CPT and ICD coding. Designed to support individualized practice and department procedures, Helium provides multi-site booking, cross-location workflow and load-balancing and a full range of customizations. PACS functionality delivers filmless image interpretation, communications and archiving. A user-friendly interface streamlines learning curves and supports individual user preferences. Remote 24/7 monitoring and upgrades that download automatically over the internet are included in the comprehensive package.

MIMvista (Booth 4174), a Cleveland-based developer of software applications for radiation oncology, radiology, and nuclear medicine, will be introducing its MIMpacs radiation-therapy (RT) system as part of the release of its MIM 4.1 application suite.
MIMpacs leverages existing MIMvista display software to create an image-centric RT-PACS solution handling traditional modalities and DICOM RT formats, the company said.

Neurostar Solutions (Booth 3582) is debuting 3D imaging processing functionality.

Developed in collaboration with Kjaya Medical, 3D functionality is fully integrated into Neurostar’s Virtual Radiology Network (VRN) application as a location-free, pay-as-you-go application service provider (ASP) offering. The option allows radiologists to process multi-slice images anywhere and at any time in a full range of protocols, including multi-planar reformatting (MPR), maximum intensity projections (MIP),volume rendering, thin-slab visualization and more. The 3D service stores raw imaging data from an acquisition site to Neurostar’s off-site servers. From there, using standard computer workstations and internet connections, users can reconstruct the data using Neurostar’s web-based tool while taking advantage of the processing power of Neurostar’s offsite servers and backend software. Finally, processed 3D data are stored back on the servers for access by any authorized VRN user. Fees for the new Neurostar 3D service will be on a per-use or per-study basis, eliminating upfront investment. Neurostar is showing the 3D application as a works in progress.

NovaRad Corporation (Booths 3202, 6537, 7709) is announcing the availability of NovaPACS and NovaRIS in Spanish and highlighting NovaPACS 7.0 and NovaRIS 7.0.
NovaRad’s Spanish RIS and PACS offer the same features and functions of its English-platform products. To support its Spanish line of radiology products, NovaRad has added a Spanish-speaking support team, project manager and installation team to its service and support department. 
Tighter integration between NovaPACS and NovaRIS offer enhanced image access and scheduling/billing/process management for radiologists and administrative staff. Additional enhancements include an improved information NovaCentral support “command center” for real-time remote monitoring and referring physician features in NovaPACS to enhance image reading efficiency. NovaCentral, an improved command center, enables NovaRad’s customer support team to remotely monitor in real time all critical RIS/PACS functions. This remote monitoring serves as a safeguard to ensure uptime and updates for optimal system performance.
NovaPACS is an enterprise level, scalable, complete, fast and effective PACS solution. Designed for budget-conscious hospitals and imaging centers, NovaPACS offers 3D imaging, image retrieval, a full-feature viewer and brokerless integration. Other features include a seven year onsite archive, offsite emergency backup and integrated RIS, orthopedic tools, Cardio Viewer, MPR and dictation. New features on NovaPACS 7.0 include split/merge study options, multiple site codes, better spine labeling, audio alerts, foot peddle for transcription, enhanced integration between the PACS and dictation software and increased menu customization options.
NovaRIS is a web-based, open standards RIS that generates reports, measures profitability and facilities paperless management of patient records. Featuring the ability to filter workflow by modality and launch dictation from workflow, NovaRIS also contains specialized worklists and reports for stalled and cancelled procedures. New features on NovaRIS 7.0 include in-patient scheduling, a “quick order” wizard and increased menu customization options.

OrthoView (Booth 2973) is featuring demonstrations of its latest Client/Server software and a new module for Limb Deformity repair.
The new client/server software includes customized versions for major PACS vendors, including: GE (Centricity Web), McKesson (Horizon Medical Imaging), Philips (iSite), Agfa (Impax) and Carestream (Kodak Carestream PACS).
As part of its Version 5 software, OrthoView is presenting its new module for Limb Deformity planning. The module includes a capability for "plate contouring" or on-screen plate-bending visualization. The Limb Deformity package allows planning of full leg and single bone osteotomies, with the ability to plan deformities in the frontal, sagittal or oblique plane. A reduction tool allows quick-and-easy visualization of the planned correction and the module supports templating of internal and external fixators, including the Taylor Spatial Frame. In addition, many new templates are available with the new version, including an extensive range of peri-articular plates.

Philips Medical Systems (Booth 4048, 4129, 4165) is showcasing iSite PACS 3.6 and 4.1 and Philips iSite Radiology.
iSite Radiology is a complete radiology viewing solution designed to help sites meet throughput goals. Philips iSite Radiology features real-time, enterprise-wide delivery of diagnostic quality images to support multiple locations and offsite users; a customizable, easy-to-use user interface and advanced workflow tools designed by radiologists to improve efficiency and increase throughput; integrated advanced visualization tools for volumetric image visualization, manipulation and interpretation; open platform standards to integrate with enterprise systems, third-party applications and custom solutions to support clinical workflow and a scalable platform and business model to meet future growth demands.

RamSoft (Booth 4303) is highlighting PowerServer PACS 4.5.
PowerServer 4.5 is the third release under the company's Customer Action Initiative (CAI), an internal program aimed at customer centric software improvement and development. New features offered in the new release include: automated report faxing, study bookmarks, enhanced dictation and transcription, scriptable routing rules, new patient explorer to facilitate patient document creation, viewing and editing, voice notes and new integration with TeraRecon AquariusNET, iCAD, EMC Centera and Dictaphone PowerScribe.

ScImage (Booth 2551) is demonstrating a web-based workflow management foundation in PicomEnterprise.
The workflow management foundation fuses DICOM, HL7 and web services into a single codebase. This foundation provides intelligent workflow that can be layered over separate silos of information to create a unified workflow solution. PicomEnterprise joins core image and information communication protocols with intelligent business rules to create a workflow management foundation. This feature uses PicomEnterprise’s core web services architecture to establish a foundation for improving operational efficiencies within the department and across multiple facilities. Leveraging this foundation, the newest version features dynamic workflow allocation that enable users to assign studies to specific readers based on location, time of day, sub-specialty, individual backlogs and current workload indexes. Administrators can track and manage daily workflow, order backlogs and reporting turnaround. Physician collaboration is facilitated by the addition of instant messaging capability and voice over IP communication to currently logged-in reading physicians.

Sectra (Booth 6513) is launching a comprehensive high-end diagnostic workstation and a new version of Sectra Control Tower.
The new workstation incorporates Sectra’s patent pending technology for retrieving and displaying image data of extreme size to eliminate problems encountered in working with large datasets. Optimized for remote reading, Sectra’s next-generation PACS facilitates the distributed reading scenario in which radiologists read images from multiple clinics. Sectra PACS features efficient distribution of datasets regardless of size through advanced streaming technology. It is designed for variations in network quality and also performs efficiently over high-latency networks.
Sectra Control Tower monitors the daily status of the radiology department and reveals long-term production trends in RIS and PACS. It generates comprehensive reports to support daily management decisions and can support for long-term procurement planning. 

Siemens Medical Solutions (Booths 7713, 7713A, 8313, 8320) is showcasing its syngo software platform, syngo Portal and syngo Dynamics V.6.

The syngo platform includes RIS, PACS, post-processing and distribution. Siemens is focusing on role-based, context-sensitive and knowledge-driven solutions with the goal of helping clinical personnel work more efficiently by providing a system that seamlessly provides information from HIS, LAB, RIS and PACS. syngo applications are based on one architecture, known as Service Oriented Architecture or SOA, and common user interfaces. With a high level of integration, the applications are accessible and available from any workstation—anytime, anywhere—to save time and effort, improve productivity and reduce the risk of mistakes.

Because quick and accurate access to information is key for the user, Siemens is strengthening its focus on the portal approach. Portals provide the entry point to information for the radiologist, referring physician as well as C-level management. Through web-based integrated syngo Portal, fast and secure communication is available between departments and partners, task-specific tools and information—with just one click. For example, syngo Portal Radiologist is structured for radiologists performing specific tasks such as medical checks, reading images and signing off of reports. This structure displays the daily scheduled procedures and the relevant information for the user in their main task area. This helps users to work efficiently as they see just the information they need. The role-based, end-to-end workflow—from order placement to image and report distribution—helps users complete their tasks simply and efficiently. Portals allow information to be available anywhere, anytime—and all in one place. syngo Portals are developed in close cooperation with care providers–providing the users, physicians and clinical staff, with the functions they require.

Also being showcased is syngo Dynamics V.6, a new cardiology image management and reporting solution. The platform offers integrated image and data management, post-processing, and reporting – providing one common solution across the Siemens portfolio for cardiology in the U.S.

Thinking Systems Corporation (Booth 4583) is unveiling ThinkingPACS with enhanced support for PET/CT fusion. 

ThinkingPACS offers comprehensive modality support with imaging technologies including essential and advanced features for general radiology (CT, MR, CR and DR), PET/CT and SPECT/CT fusion, nuclear cardiology processing and analysis, general nuclear medicine processing and review, cardiac PET analysis, PET brain analysis, advanced 3D processing and visualization, orthopedic templating, cardiac catheterization and angiography, echocardiography, general ultrasound and digital mammography. ThinkingPACS provides connectivity to modalities and third-party products through DICOM, HL7 or proprietary protocols or formats. Its ModalityBroker and ThinkingAddOn help integrate all imaging modalities into an existing or new enterprise radiology PACS from a thirty-party vendor. The ModalityBroker is responsible for bridging the modalities to enterprise PACS and providing data verification and validation, while ThinkingAddOn provides either integrated or standalone clinical applications for each modality. Enhanced PET/CT features on the PACS workstation and ThinkingWeb web server include optimized radiology centric or nuclear medicine centric views to satisfy the needs of differently trained physicians; simultaneous display of CT, PET and fused images with multiple window/level settings; shortcut keys for window/level preset adjustment; shortcut key to turn fusion on and off; side-by-side comparison between PET/CT and contrasted diagnostic CT. New features on display at RSNA include template driven, structured reporting for nuclear cardiology and echocardiography; MUGA processing; phase analysis for SPECT and MUGA nuclear cardiac studies; simultaneous processing and display of attenuation corrected and uncorrected nuclear cardiac studies; simultaneous processing and display of motion corrected and uncorrected nuclear cardiac studies.

Visage Imaging, a wholly owned subsidiary of Mercury Computer Systems (Booth 2591), is showcasing Visage PACS/CS.
Visage PACS/CS is based on web and thin-client technology with fully integrated clinical applications including a new release of Visage Cardiac Analysis, a CT cardiac application based on thin client technology. Visage PACS/CS enhances clinical workflow, with advanced tools for 2D, 3D and 4D image review and interpretation, post-processing, data management and image distribution. The image data and applications within Visage PACS/CS are not bound to specific workstations and become instantly accessible anywhere, anytime within the PACS workflow. The thin client-enabled PACS provides virtually instant data access and 3D performance anywhere inside and outside the hospital enterprise, on existing workstations, PCs and laptops. The latest version of Visage PACS/CS improves performance in wide area networks and over slow DSL lines, thus enabling efficient remote operation across distributed imaging centers, providing better services to referring physicians and opening new ways for reviewing images efficiently from home. Visage is highlighting new and optimized tools for radiology, cardiology, neurology, oncology, surgery and other subspecialties such as application-specific display and post-processing protocols, saving and sharing of annotations and post-processing results, volume analysis of lesions and structures in 3D and improved automatic bone removal.