Radiology Image & Information Systems

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Picture archiving and communications systems and radiology information systems are flexing their muscles in Dallas with vendors rolling out new systems geared to meet the specific needs of a broader range of clinical users.

EMR/EHR/PACS integration could steal the show with the latest and greatest PACS wedding images and the patient record. The maturity of the PACS market is apparent; new systems target the relatively uninitiated imaging center market, and vendors are peddling solutions to facilitate data migration to second- and third-generation systems. New RIS/PACS products and partnerships are being spotlighted at the show.

The dedicated RIS market is still going strong, too, with vendors showing new products and features to better support the administrative tasks of the radiology department.




Agfa Corp. (booth #734) is highlighting its IMPAX Image and Information Management and Professional Services and demonstrating IMPAX RIS/PACS for Outpatient or Imaging Centers, TalkStation 3.0 and the Enterprise Clinical Dashboard.

IMPAX ES is an enterprise-wide digital imaging and information management system that brings point-of-care technologies to healthcare providers with the goal of image-enabling the EHR. IMPAX ES features 'Connectivity Inside' and a new thin-client Clinical Application Server for results distribution in phase I, which evolves to a web-enabled Clinical and Diagnostic Display Client Server in mid-2005. IMPAX ES is the next phase within a continuum of IMPAX solutions featuring a single view of patient data for radiology, women's care, orthopedics and cardiology. Key features of IMPAX ES include integrated RIS-PACS-speech recognition; effective workflow solutions for viewing large data set image studies; improved security, privacy and auditing; extended enterprise scalability with Microsoft Windows core components and paperless workflow options.

Agfa's Professional Services offerings include implementation services, systems management and reporting services and security services.

IMPAX RIS/PACS for Outpatient or Imaging Centers provide a single point of access to integrated information and image management workflow and results distribution with a cost-effective, single-vendor solution to increase productivity, profitability and referring practice satisfaction.

TalkStation 3.0 is a fully integrated speech recognition dictation and workflow solution for reporting. TalkStation 3.0 offers a number of enhancements, including interfaces and integration with HIS/RIS/LIS/CIS and PACS, Dragon v7 for improved recognition accuracy and enhanced user satisfaction, improved security features including 'lockout after failed attempts' and recording of log-ins and log-outs as well as improved control over who can view a report and new options that will improve workflow and enable enhanced editing, including dictate, edit, sign (real-time speech recognition with self-editing), correctionist workflow (real-time speech recognition with deferred editing), and digital dictation with traditional transcription.

Enterprise Clinical Dashboard unifies patient records and images from existing standalone systems, presenting this information through a single, web interface. This simplifies anywhere/anytime physician access to relevant patient information, allowing them to focus more on patient care. By leveraging existing IT systems, the Clinical Dashboard also extends the life and value of these application investments, Agfa says. Additionally, Agfa's Clinical Dashboard middle-ware application is built on an open, vendor-neutral architecture, supporting rapid deployment in a matter of months. This is a practical starting point for a full-blown EMR. Clinical Dashboard implementation benefits include increased productivity, reduced operations cost and improved patient care.



AMICAS (booth #3904) is highlighting its Vision Series, complete with multi-specialty PACS applications, comprising the AMICAS Clinical Imaging Platform and demonstrating AMICAS Vision Watch.

The company is showing PACS integration with imaging applications and information assets to provide a cohesive image and information management infrastructure. The company also is showcasing  AMICAS RealTime Worklist and AMICAS LightBeam Diagnostic Workstation integrated with Heartlab Encompass Cardiology, OrthoView, Dictaphone PowerScribe, MEDITECH HCIS, AMICAS Vision Series RIS and AMICAS Vision Series Document Imaging.

AMICAS Vision Watch provides centralized PACS application management across any distributed enterprise, from any web-accessible PC.



BRIT Systems, Inc. (booth #6813) is launching BRIT Lite - Medical Image Web Viewer and demonstrating its Roentgen Burner at HIMSS.

BRIT Lite is a medical image and report viewer that runs within a browser and requires no application installation. It serves as a key building block in BRIT's architecture to provide any image, any time, anywhere within the HIPAA guidelines. The initial release of the application supports montages, scrolling, magnification, window/level, measurement, drag and drop selection, key image selection, comparisons, reports, JPEG2000 support and downloading of studies, series and key images. The product is designed for referring physicians who do not need the additional sophistication and complexity of BRIT's Radiology Workbench for Windows DICOM workstation. It will be available in the first quarter and will be included at no additional cost in The Roentgen Files DICOM Server.

The Roentgen Burner is BRIT's Systems automated CD/DVD burner. It is another key building block in BRIT's architecture to provide any image, any time, anywhere within the HIPAA guidelines. Users from any BRIT workstation or any properly configured DICOM device can send studies to The Roentgen Burner for creation of a custom-labeled CD or DVD that includes a viewing application. The CD/DVD can then be transported to any location and placed in most PCs for viewing the images. The Burner reports the creation of the media to BRIT's DICOM server/archive product, The Roentgen Files, for entry into the patient's HIPAA compliant access log.



Cerner Corp. (booth #3924) is debuting its new Multi-Media Foundation and demonstrating Cerner ProVision PACS and ProVision Web.

Multi-Media Foundation provides the framework for integrating medical images and video, audio and signal data with patient information to offer a 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 can improve outcomes and increase efficiencies.

Cerner also is sharing information about its new PACS data migration project that will automate the transition from a legacy PACS to a new PACS solution, while ensuring accurate demographic and image data. For those who do not choose integrated RIS/PACS, Cerner has enhanced its Visual Desktop Integration (VDI) solution for integration of RadNet with a third-party PACS solution. Cerner RadNet Radiology Information System (RIS) and Cerner ProVision PACS are designed to improve efficiency, accuracy and quality, while streamlining clinical and operational processes.

New workflow enhancements to Cerner's unified RIS/PACS provide capabilities for viewing scanned documents, bookmarking of images and the association of voice files and enhanced role-based design, which all contribute to the success of a filmless, paperless environment. Cerner's unified RIS/PACS solution enables true integration with access to both images and vital clinical information. This solution allows the RIS to drive the entire digital workflow from registration to diagnosis, including distribution and archiving, making filmless and paperless environments a reality, the company says.



DR Systems (booth #6611) is demonstrating Release 7 of its Dominator RIS/PACS performance solution. The enterprise solution approach offers Smart Client "best of both worlds" technology that combines the advantages of thick-client computing and thin-client computing, the company says. Thick-client computing enjoys such advantages as robust speed, computing power, and functionality. Thin-client computing is known for its ease of deployment, the convenience of automatically updating applications software on computers in a network and a modest hardware and software footprint. Smart Client technology uses web services to blend the advantages of both computing approaches. Release 7 also includes system monitoring with integrated remote server control and monitoring with e-mail updates, and enabling of SNMP and NIC teaming; support of IHE - Portable Data for Imaging (PDI); web-based automated enterprise-wide, resource-based scheduling of patients, resources, and facilities; interfacing to the enterprise billing system and integration of cardiology PACS and pathology image distribution into DR Systems' RIS/PACS.



Eastman Kodak Co. (booth #5104) is showing its newest KODAK RIS/PACS suite. The new suite supports native applications such as 3D volume rendering so radiologists can interact with studies and their reconstructions on the same diagnostic workstation. In addition, radiologists benefit from faster, more convenient reading with the improved ability to customize and save their display protocols, based upon the current workstation image layout and functionality, so each type of imaging study is displayed according to their preferences. Kodak's RIS/PACS improves communication with referring physicians by enabling them to receive information in the way that is most efficient for their workflow. The radiology report can be emailed or embedded into an electronic medical record and can include key marked images, with the option to view the entire imaging study via secure web-based access if desired. Kodak's suite also enables referring physicians to order and schedule radiology exams, as well as view patient status and history. The KODAK DIRECTVIEW PACS System 5 features Kodak DIRECTVIEW Versatile Intelligent Patient Archive (VIParchive) management software, which can be expanded beyond PACS to intelligently manage all healthcare data. The KODAK RIS/PACS also easily scales from single workstation to multi-site enterprise and supports UNIX or Wintel platforms.



Eclipsys Corp. (booth #4351) is highlighting its Sunrise PACS and the integration with the Sunrise Clinical Manager, which provides the ability to view a patient's images with the reports all as part of one patient record. The demonstration provides a full representation of the tools available for the primary interpretation needs of the radiologist using high resolution display monitors. These tools include digital orthopedic templates, 3D visualization, multi-planar reformatting and bone densitometry.

Eclipsys also is demonstrating its Sunrise RIS diagnostic imaging solution for both hospital and imaging center environments. Workflow-enhancing tools are available for technologists, radiologists and administrators, including capabilities for viewing scanned documents, bookmarking of images and the association of voice files and enhanced scheduling, orders, patient tracking, radiologist and technologist worklists, report generation and distribution and department management statistics.



Emageon (booth #1021) is displaying its new 2004-R6 product release and Intelligent Visual Medical System (IVMS). New 2004-R6 features include an integrated 2D/3D platform for diagnostic and treating physicians; multi-institutional support; UltraVisual Technologist, featuring web-based administrative tools and paperless workflow; OpenGL high performance graphics; a mammography workstation and integration with Dictaphone PowerScribe voice recognition.

Emageon's IVMS is 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. In addition, Emageon's customer success programs ensure rapid implementation and adoption. The enterprise delivery of better tools, software and services improves results and enhances care.



Empiric Systems, LLC (booth #7220) is introducing Encompass.Net, the company's latest, fully integrated, web-based RIS/PACS, and new EMR product, JaggedEMR, and showing its learning management system (LMS).

The Encompass.Net RIS/PACS/billing system is based on Microsoft's latest .NET development platform to facilitate a more efficient development process and offer more robust performance.

JaggedEMR is a web-based EMR that includes both billing and PACS functionality. NstructNow provides a web-based learning management and content delivery system.



Foliage Software Systems (booth #408) is highlighting its Migration Evaluation services. The services consist of software assessment and migration evaluation and typically last only about two or three weeks. Foliage senior technologists work with hospital staff to assess how well software architecture supports business objectives, the overall quality of existing code and the effectiveness of development and testing practices. Foliage uses focused and tuned versions of the Software Engineering Institute's Software Architecture Analysis Method (SAAM) to assess how well legacy software architecture aligns with business drivers and analyzes code and software processes. The company provides fully documented, informed, realistic information and recommendations, allowing customers to determine whether a migration approach can evolve a product into its next generation. Deliverables include written reports and interactive presentations.



Fujifilm Medical Systems (booth #4609) is highlighting its new Comprehension and showing automated bulk document scanning capabilities.

Introduced in November at RSNA, Comprehension is planned as an expansion of Fuji's Synapse PACS that will understand, include and recall all the events that occur within the end-to-end radiology cycle. The goal is to deal with the spectrum of clinical and business processes as one single, complete, intelligent system versus several integrated systems.

Visitors to the Fuji booth also can learn about the company's automated bulk document scanning capabilities.



Guardian Healthcare Systems (booth #3) is demonstrating at HIMSS its FlowPoint RIS/PACS. The web-based RIS/PACS solution lets healthcare enterprises combine all of a patient's medical radiology data and images into one digital record, enabling more accurate diagnoses and circumventing medical errors that often occur due to insufficient patient health data. The FlowPoint PACS, a set of web services seamlessly embedded in the company's RIS solution, can provide radiology patient information, image management and web-based imaging capabilities, and information distribution to healthcare enterprises, including small- and medium-sized hospitals, physician offices, and medical imaging centers. FlowPoint enables enterprise-wide scheduling to optimize radiology equipment and facilities allowing healthcare enterprises to provide higher quality care, streamline workflow and mitigate the costs of communication and information management. They can more easily store and share patient information using secure electronic methods, while complying with integrated healthcare enterprise initiatives and patient record archiving regulations. With a single consolidated digital file, healthcare providers also can more readily comply with HIPAA.

FlowPoint's web-based design uses Virtology web services-based architecture to improve interoperability. The Virtology web services architecture uses the XML, DICOM, and HL7 healthcare IT standards to offer a versatile clinical platform that integrates many disparate healthcare information systems. Guardian's seamlessly integrated technology eliminates the need for a broker between RIS and PACS and helps hospitals move from a film-based environment to a pure digital one.



GE Healthcare (booth #1710) is highlighting new features on Centricity PACS designed to allow healthcare facilites to enhance existing imaging and IT investments, and to be able to manage multiple sites and system requirements. A new communication tool, Exam Notes, can be attached to an exam and becomes part of the patient electronic medical record. Centricity also incorporates a new PET/CT spatial cursor that allows radiologists to quickly identify a specific anatomical location in PET/CT images across the same study and full integration of radiology and cardiology images and results. In addition, HIPAA requirements have resulted in facilities now being subject to higher degrees of data protection and disaster recovery requirements. Centricity PACS has open standards supporting CCOW (which allows EMRs to work better with PACS), three new IHE profiles and enhanced log-in capabilities to facilitate hospitals meeting HIPAA requirements.

The company also is showing Centricity Enterprise and Centricity PACS SE hardware.



IDX Systems Corp. (booth #2334) is showcasing its Imagecast integrated RIS/PACS offering that 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. The company also is highlighting phase one of a new User Interface strategy and an enhanced interpreting provider worklist.



Images-on-Call Teleradiology (booth #5) is debuting at HIMSS the IOC•PACS•APPLIANCE FilmDigitizerStation.

The new system makes scanning radiographs quicker and more convenient and then adds the images to the PACS network, the company says. The IOC•PACS•APPLIANCE offers diagnostic imaging providers a way to scan film and send images to their PACS from multiple remote locations in a hospital. The system automatically scans film with a single button push. The IOC•PACS•APPLIANCE consists of a 12-bit film scanner, CPU, LCD flat-panel monitor, keyboard, mouse, modem and the IOC FrameStore Software that controls the scanner and transfers the images to the PACS network. The system adjusts images automatically and requires no user image manipulation.

IOC•PACS•APPLIANCE utilizes Images-on-Call software drivers that optimize the scanner's output. The IOC•PACS• APPLIANCE has built-in software for extensive configuration, diagnostics and application support via network or phone lines. Data entry is fully configurable to meet the requirements of any DICOM archive or PACS and information such as imaging site, image source and date and time are automatically transmitted with each image. The IOC• PACS•APPLIANCE has built-in HIPAA compliance securing the data from unauthorized use.



McKesson Corp. (booth #3011) is showcasing Horizon Clinical IT and automation solutions and demonstrating how the solutions fit the workflow of nurses, radiologists, physicians, pharmacists and others and featured medication safety, electronic health records, clinical decision support/CPOE, e-prescribing and other ambulatory solutions, PACS, document imaging and supply management.

McKesson's Horizon Clinicals is a modular suite of next-generation, integrated solutions for physicians and other caregivers. Horizon Clinicals unifies the clinical process by linking all patient encounters across care settings and disciplines. With software, automation, packaging, distribution and consulting, McKesson is a single-source provider of bar coding, medication management and integrated information technologies that help healthcare organizations reduce errors at every stage of the medication-use process.



MedCommons Inc. (booth #7370) is launching MedCommons Gateway, a new product and business model for eReferrals built around open source software. It is a free, user-installed open source EHR document viewer and gateway. The company is demonstrating the MedCommons Gateway in the HIMSS Cross-Enterprise IHE Interoperability Showcase. The initial release of the MedCommons Gateway combines the IHE-XDS standards for CCR, CDA and PDF with a new diagnostic image viewer built to the DICOM WADO (Web Access to DICOM Persistant Objects) standard.



MedQuist Inc. (booth #4941) is highlighting Protege, DocQment Enterprise Platform, Speech Q for Radiology and e-Him Workflow.

Protege is a digital dictation device that uses a Palm OS or Pocket PC handheld to enable users to keep track of patient schedules, manage daily workflow and record dictation.

DocQment Enterprise Platform is a fourth-generation, internet-hosted, document workflow management system that handles dictation capture, routing, workflow management tools, transcription, speech recognition and document delivery services through an integrated, internet-hosted model.

SpeechQ for Radiology is a speech recognition application that combines speech recognition technology, on and off-site transcription services and CodeRunner, a computer-aided coding application. The system adapts to the radiologist to enhance accuracy and speed.

e-HIM Workflow provides a blend of dictation and voice capture solutions for the diverse physician staff. MedQuist Dictation options include digital dictation systems/telephone PBX, analog portables and desktops, digital portables and desktops, handheld units and PDAs and toll-free dictation service. Computer-aided transcription speeds processing and increases productivity, and medical editors perform quality assurance verification. Physicians review, edit and sign patient reports, through a web-based interface within seconds of completed transcription, from anywhere, at any time. Web-based electronic signature module ensures seamless transition from transcribed document to authenticated document. Finally, MedQuist NLP (natural language processing) codes the documents in minutes, enabling coders to validate the codes and move the document to billing faster.



Pegasus Imaging Corp. (booth #5156) is debuting ISIS Xpress, Version 2, designed for high-speed scanning of black/white, grayscale and color documents. ISIS Xpress provides a simple method of accessing high-performance scanners. Software developers can use this toolkit as a managed .NET control or COM component. Version 2 includes the most up-to-date ISIS technology available, supports additional compression formats, and the .NET control now includes an improved object-oriented interface over the previous version. It provides access and complete control over high performance ISIS-driven scanners from Canon, Agfa, BancTec, Bell & Howell, Epson, Fujitsu, Hewlett-Packard, Inotec, Kodak, Microtek, Minolta, Panasonic, Ricoh, Sharp, and Umax. This toolkit also offers compression to standard TIFF, JPEG, and DCX file formats. Depending on user requirements, ISIS Xpress can be used in conjunction with a variety of other Pegasus Imaging toolkit options to develop comprehensive document imaging, forms processing, image processing, and barcode software applications.



Philips Medical Systems (booth #4945) is launching the Xtenity Enterprise and featuring Xtenity RIS, an enterprise-ready radiology information system.

The new Xtenity information system is designed to serve the needs of customers seeking an enterprise-wide solution as well as continue to provide departmental solutions which blend seamlessly into any hospital IT infrastructure. Powered by technology from Epic Systems Corp., the Xtenity Enterprise is designed and built around a core data repository. The system covers all clinical and administrative functions necessary to improve quality of care, drive efficiency and ensure patient safety. Xtenity Enterprise promises lower costs, tight integration, an easy user experience through a single consistent interface and web portal technology for enhanced patient and clinician communication.

Xtenity RIS is fully integrated with Philips EasyAccess PACS and connects with any third-party PACS or HIS. The system streamlines department workflow and strengthens relationships with referring physicians.



SCC Soft Computer (booth #1434) is demonstrating how a good software strategy, built on a strong foundation will help keep the CIO and his department in the game. CPOE, EMR, telehealth/telemedicine, web portals and outreach initiatives will require the right IT in place today to support tomorrow's demands and interoperability of hospital systems. SCC Soft Computer is a software solution built on open architecture and incorporating web services.

The company's ancillary clinical software solutions position hospitals to strategically leverage new technology.



ScImage (booth #6341) is demonstrating the new features and benefits of PICOMEnterprise Version 2.0 at HIMSS and PICOM ECG Suite.

PICOMEnterprise is a comprehensive enterprise level PACS 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. Version 2.0 enables an order-driven workflow for radiology departments while simultaneously giving other departments within the hospital enterprise a tool for acquisition, storage and distribution of both images and reports. Version 2.0 also has a new interface engine that provides a seamless single point of entry through any third-party RIS, EMR or practice management system. Hyper-streaming technology provides instant viewing of images over a broadband connection without utilizing any proprietary image formatting technologies. Viewing, advanced visualization and analysis programs for radiology, cardiology and orthopedics can be delivered to the client workstations using a concurrent network licensing design. Comprehensive reporting tools and document management utilities also are embedded in this web-enabled PACS.

The PICOM ECG Suite is a web-enabled ECG management module that augments the company's cardiology image and information management suite.



Siemens Medical Solutions (booth #617) is highlighting new features on SIENET Cosmos RIS/PACS, demonstrating enhancements to Novius Radiology and launching a new generation of Soarian solutions at HIMSS.

SIENET Cosmos integrated RIS/PACS enterprise solution for hospitals and imaging centers enables users across the enterprise to access patient exams and reports from any location in the network with a standard internet browser. The Cosmos workplace features Siemens syngo common user interface and integration with Soarian Clinical Access, providing the basis for achieving a true electronic health record (EHR). Soarian Clinical Access gives clinicians browser-based, real-time access to the complete patient record, including images and data. In addition to centralized server architecture and fast data access, SIENET Cosmos features a fully integrated RIS component. The solution provides a continuous, efficient workflow from exam planning to image distribution, with fast and effective documentation for billing medical services. Complete integration of RIS, PACS and post-processing means all important information may be accessed at a single workplace and post-processing is no longer dedicated to separate advanced post-processing workplaces, Siemens says. With RIS, PACS and post-processing on a single unit, integration is the basis for optimal workflow, as users only need to log in at one workplace. In addition, to address the large image data volumes that are produced by new imaging modalities such as multislice CT, a fast transmission protocol (iMaxcess) enables the SIENET Cosmos workplace to retrieve and send images from/to the central server much faster than via a standard DICOM transfer. With speed that can help drive faster treatment planning, iMaxcess stands for "image access at its maximum." Communication with all DICOM-based modalities takes place at the usual speed, while communication between SIENET Cosmos components, such as server or workstations, is many times faster.

Enhancements to the standalone NOVIUS Radiology information system include paperless workflow within the radiology enterprise, including document management for scanning, managing and distributing critical documents; user defined, online "interactive documents" for the elimination of paper forms; embedded support for electronic signature capture; and access to online policies and procedures. Predefined clinical alerts automatically notify users when clinical conditions have been met and help reduce medical errors. The system also includes radiologist-defined clinical workflow, such as flexible worklists and extensive teaching folder functionality. Application Programming Interface (API) provides access to data from various clinical and non-clinical sources such as HIS, EMR and web pages.

Siemens also is demonstrating Soarian IT solutions with a workflow orientation that can manage transactions and data and the process of healthcare delivery and the interactions between members of the healthcare community. At HIMSS, Siemens is showcasing Soarian's support of interoperable EHRs in the Integrating the Healthcare Enterprise (IHE) exhibit as well as in the Siemens booth.



Stentor Inc. (booth #2511) is unveiling version 3.3 of iSite Enterprise First PACS. Version 3.3 provides improved clinical features and functionality for physicians and radiologists ac