Picture Archiving and Communication Systems (PACS)

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Siemens Medical Solutions rolled out its new Sienet Cosmos PACS and showcased its Sienet integrated radiology suite product lines designed to address radiologists' varying environments and workflow. The five solution components integrated in the Sienet radiology suite are imaging workflow management, intelligent postprocessing of examination, integrated workplace, image data management and image distribution.

Sienet Cosmos features a fully integrated RIS component, Imaging Workflow Management, and is intended for large radiological practices and radiology departments in hospitals with exam needs of up to 100,000 images per year.

GE Healthcare showcased at SCAR 2004 its portfolio of information technology products for both radiology and cardiology.

Among the highlights were GE's Centricity Enterprise RIS/PACS and Centricity Enterprise PACS 2.1 with CA1000 Cardiologist Desktop (WIP). The RIS/PACS is GE's introductory offering in integrated systems and its key functionalities include a web-based reporting module incorporating embedded digital dictation and voice functions, single sign on and a new common user interface. The cardiology workstation, fully integrated with the Centricity PACS, is designed for image review in catheter and echo labs and includes cardiology measurement and analysis tools.

The company also showcased an example of an ergonomically designed radiologist reading station. GE provides consulting services for reading room design in areas such as furniture, lighting, sound and user mobility.

Additional GE IT product highlights included:
  • Centricity Enterprise PACS 2.0 with RA1000 Radiologist Desktop - GE's web-enabled picture archiving and communications system.

  • Centricity Enterprise Web - the PACS "companion" provides clinicians remote access to multi-specialty images and related data, such as radiology reports, cardiology reports and EKG waveforms.

  • Centricity RIS - GE's radiology information system provides order management, scheduling, image management, supply management and management reporting.

  • Centricity AW Suite - the diagnostic imaging tool offers quick access to volumetric review, volume rendering, three-dimensional (3D) endoluminal navigation and high-resolution multimedia export/filming options. This is the first time GE is transferring the advanced image processing capabilities of its clinical modalities to PACS users (provided the facility has GE scanners.)

  • Centricity Enterprise PACS 2.1 with RA1000 Radiologist Desktop (WIP) - Version 2.1 features works in progress advancements on the RA1000 workstation, including additional methods to facilitate communication across departments, common user interface and mammography workflow tools.

  • Centricity PACS RA1000 AW Suite - The tool merges Advantage workstation 3D, post processing and analysis software tools with Centricity PACS.

  • Centricity PACS RA1000 with voice command - The prototype increases user productivity by driving common mouse events  through voice command.

  • Centricity Web (PACS O.R.) workstation (WIP) - the prototype demonstrates how Centricity Web can be integrated in the surgical OR utilizing Microsoft GWindows and voice command technology.

Agfa Healthcare used SCAR as the launching pad for its new IMPAX ES for orthopedics, a pre-operative surgical planning system for PACS.

The system integrates Hectec's orthopedic surgical planning software, mediCAD, into Agfa's IMPAX OT3000 orthopedic workstation.

IMPAX ES for orthopedics is an orthopedic workstation that includes workflow tools for hip replacement, knee replacement, biometry, osteotomy and coxometry. It is an open system with the ability to import, display and archive DICOM images and features an extensive library of 12,000 templates from 42 manufacturers including hip, knee, elbow, hand, shoulder, osteotomy, pediatric, screws and nails templates. The system also offers magnification calibration of 1:1 and a biometry package.

Agfa also presented an educational session outlining the benefits of PACS in orthopedic pre-operative planning. David Pollock, MD, associate professor specializing in Joint Replacement and Adult Reconstruction, Department of Orthopaedic Surgery at Wake Forest University Baptist Medical Center identified the list during field trials of Agfa's new IMPAX ES for Orthopedics. The rewards include:
  • Instant access - Orthopedic surgeons can use one workstation to access images and patient history to receive more information about a patient and provide added measures of confidence.

  • Current and prior comparisons - Surgeons can compare prior surgical outcomes, compare multiple planning and reference older studies prior to new surgical plans.

  • Multi-modality image review - Surgeons can review high definition MR or CT studies for better identification of pathology and  better preparation for planning.

  • Fast calculations - Complex measurements, calculations and drawings are easily completed digitally; comparison to previous   results are quickly recalled and displayed. Measurement values can be compared against normal value databases, enabling instant clinical reference ability.

  • Improved accuracy - Magnification inherent in medical imaging causes inaccurate planning of implants; calibration of the image improves accuracy.

  • Up-to-date information - No lost or damaged templates. Digital templates are updated regularly and are easily accessible through the orthopedic workstation.

  • Reduced costs - Advance planning enables "just in time" stocking of implants, reducing costs to healthcare facilities and implant manufacturers. Users can also realize a decline in operating room preparation time, a reduction in film printing and an overall improvement in productivity.

Fujifilm Medical Systems unveiled its Synapse Version 3.0 modular release 1 (3.0 mr1). The new release builds on Synapse 3.0 and features enhancements to Fuji's Reading Protocols designed to further facilitate high production radiology.

Patent-pending Reading Protocols automate the presentation of all information contained within Synapse, including documents, image processing parameters and results. With a single mouse click, Synapse can apply a preset presentation model, or specified sequence, for a particular study type and comparison choice. 3.0 mr1 gives users the ability to save, manage and share their reading protocols with other Synapse sites, enabling them to evolve their own interpretation models into industry-wide "best practices."

Fuji also announced the availability of CommonView multi-site foundation technology. CommonView technology automatically brings patient results from multiple sites together into a single patient-focused work list, enabling a radiologist reading group to service multiple related sites where patients may have prior exams in disparate databases. CommonView ensures accuracy and complete access to the entire patient imaging record, regardless of where previous imaging exams were performed.

The company outlined new pricing models, including a volume-based site license model that allow customers unlimited use of the Synapse application, regardless of the number of servers, workstations and modalities that may be in use. The Single Step to Digital (SSD) program is geared for facilities conducting fewer than 45,000 radiological studies a year. SSD is designed to enable lower volume facilities to transform to a digital environment. The turnkey solution offers three individual purchase packages combining Synapse, Fuji Computed Radiography and Fuji DryPix imagers. The recently launched IT CAP - Information Technology Control and Predictability, is a shared-risk financial solution that requires no initial capital outlay and offers low financing rates. IT CAP enables a site to purchase PACS functionality that can grow with them at the same cost per study. Facilities ultimately purchase five years of functionality, including system expansions and hardware and software upgrades.

Philips Medical Systems at SCAR highlighted its new EasyAccess release 10 that combines a web-based PACS with the performance of a power client-based PACS required to deal efficiently with the data explosion. Sales begin this summer. Launched in early 2003, ViewForum effectively controls the data explosion in the MR and CT space. Its viewing intelligence brings complex imaging into the clinical routine. ViewForum eliminates the traditional boundaries imposed by modality consoles and PACS viewing by giving users access to images and information at any workspot. The latest release of the ViewForum workstation is enhanced with a number of additional clinical applications and x-ray domain features.

Philips also showcased its first, easy-to-use management reporting tools for PACS (featuring per user, per system, per study type reports as well as patient and image reports and license usage reports), orthopedic templating for PACS and the first installation of MedQuist SpeechQ, the RIS/PACS voice recognition feature debuted at RSNA 2003. Philips owns 72 percent of MedQuist .

Amicas Inc. launched the fourth generation of its web-based PACS, Vision Series Version 4.0 (V4).

The new features include LightBeam, a web-based, on-demand diagnostic workstation for primary interpretation by radiologists and advanced clinicians that integrates Voxar's Voxar 3D and VoiceLink's voice recognition technologies.

RealTime Worklist is an enterprise workflow tool powered by what Amicas describes as "instant messaging" technology for real-time study status. Workflow Accelerator automatically caches unread studies in order of priority to optimize productivity, regardless of bandwidth or location.

Vision Watch is a web-based application that monitors and manages all major components of Vision, providing system health monitoring, quality of service and business decision support.

Quoting a survey from R.L. Johnson that says unified RIS/PACS systems are selling 25 times faster than standalone PACS units, Cerner Corp. promoted his integrated RIS/PACS offering at SCAR. Cerner's integrated RIS/PACS combines the ProVision PACS and the RadNet RIS.

Eastman Kodak Co. demonstrated and announced the availability of a digital image and information management solution that includes its PACS System 5, RIS 2010 and VIParchive software platform.

The company highlighted its Directview PACS System 5 image-and-information management system that allows radiology departments to store, interpret and manage large volumes of medical images and accompanying information from multiple modalities and vendors. The fully web-enabled PACS also makes it possible to distribute information from one destination to another electronically - via the Internet - thus facilitating and expediting communications between radiologists and referring physicians.

Kodak's PACS System 5 and RIS 2010 have been fully integrated into a single solution that can streamline and optimize radiology department functions. This solution automates elements of the diagnostic imaging process, enables efficient diagnostic reporting and clinical review and facilitates storage and retrieval of the entire patient radiology record.

VIParchive is media, technology and storage vendor neutral, so it can be integrated throughout a healthcare system's existing IT infrastructure while simultaneously protecting it against obsolescence. It allows a facility to set up a storage plan based on DICOM headers and fields. It also allows images to be linked across the enterprise and with other objects such as jpegs.

Further, Kodak along with Fischer Imaging Corp. announced a worldwide agreement. Under the agreement, Fischer will offer the Kodak Directview PACS System 5 and DirectView Versatile Intelligent Patient Archive (VIParchive) management software, with Fischer's SenoScan systems for digital mammography.

RealTimeImage introduced iPACS OrthoPlanner, iPACS iLink broker and iPACS standalone DICOM viewer at SCAR 2004.

iPACS OrthoPlanner is a scalable web-based orthopedic digital workflow technology designed to convert a standard network-connected PC into a full-featured workstation with optional archiving. Additional features include web-based orthopedic viewer, pre-operative planning tools for total-joint replacement, multi-vendor template overlay support, and enhanced measurement and navigation tools.

iPACS iLink is a broker that links standard HIS and electronic medical record (EMR) patient demographic data directly to DICOM imaging devices prior to exams. iPACS iLink also links RIS reports to the images for permanent storage.

iPACS standalone DICOM viewer enables access to DICOM images from any source, independent of the network connection to the iPACS server. It can be used for images streamed from remote server locations and any DICOM image stored locally on a PC or accessed from a CD. RealTimeImage will provide and distribute its iPACS DICOM viewer free to any user who registers on the company website.

Dynamic Imaging debuted its IntegraWeb 3.3, an updated version of its second-generation, web-driven PACS.

The upgrade includes enhanced user interface; web-driven 3D capabilities to streamline 3D image manipulation and to append 3D results and processed images directly to a study; extended IHE-compliant integration capabilities, including a new HL7 integration engine; and a new presentation protocol for dynamic studies.

Intelerad Medical Systems Inc. at SCAR introduced new features to its IntelePACS InteleViewer to enhance image manipulation, workflow and communication with referring physicians.

The enhancements include image selection and annotation tools, providing radiologists with the ability to select, annotate and send key images to referring physicians.

The web-based PACS firm also added intelligent auto-window-leveling algorithms; upgrades to its advanced Layout Manager; the ability to drag-and-drop and select thumbnail image series; and new user-specific preferences.

IntelePACS InteleViewer is a web-based DICOM viewer based on the latest JPEG 2000 technology. The application is launched with the InteleBrowser web interface and employs advanced streaming protocol to speed image access from server to user by progressively refining image detail as it is displayed. The first-generation viewer included advanced user preferences, usage logging and encryption.

Cedara Software Corp. traveled to SCAR with several new web imaging solutions. The integrated clinical packages allow radiologists and specialists to launch orthopedic planning, digital mammography screening, 3D and other applications, directly from a single PACS workstation -- eliminating the need to invest in multiple workstations.

The company's latest technologies include:
  • Cedara I-Report CT - multislice CT navigation and reporting workstation for large multislice data sets. Features include reviewing images in stack mode using MPR (Multi-planar Reformat), MIP (Minimum Intensity Projection) and volume rendering modes.

  • Cedara I-ReadMammo - multi-modality digital mammography workstation designed to improve mammography workflow. Features include automating the presentation procedure and review process for current and prior mammography images to save reading time.

  • Cedara OrthoWorks - orthopedic treatment and digital planning solution that provides orthopedists digital tools to plan treatment and surgery and reduce the support costs of adding new implant templates. OrthoWorks integrates with Cedara I-Acquire to support image acquisition from all orthopedic modalities, including CT, MRI, CR, DR and film digitizers, and uses web Server software to enable Internet-based orthopedic planning.

  • Cedara also showed Cedara I-Reach, a fully diagnostic web PACS that allows surgeons, radiologists, specialists and physicians to access patient information and images from anywhere in a hospital, or external health network, over the Internet.

Hx Technologies Inc. highlighted at SCAR its newly available iHistory clinical information network for digital access to radiology images and reports from one healthcare network to another. iHistory is designed for on-demand, patient-authorized access by physicians to digital medical records located beyond their own enterprise, linking different facilities' PACS and RIS in a vendor-neutral configuration.

The cross-border technology will connect the University of Pennsylvania Health System (UPHS) with Children's Hospital of Philadelphia (CHOP) as part of the National Healthcare Information Infrastructure (NHII).

Hx Technologies plans to add Thomas Jefferson University Hospital in Philadelphia to the iHistory network in June.

RamSoft showed off its RamSoft PACS 3.1, featuring the ability to push studies to PowerReader web clients and improve performance of remote workstations. The technology provides up-to-date information to remote PowerReaders configured by PowerServer's automatic routing.

RamSoft 3.1 offers one-click integration with OrthoView 2.0 to expand use for orthopedic surgeons. OrthoView's orthopedic digital imaging solution provides pre-operative planning and templating for knees, hips and other joints. The integrated products allow surgeons to template any RamSoft PACS image in a digital environment and save a comprehensive report into RamSoft PACS.

RamSoft also highlighted integrated 3D viewing technology from Voxar in RamSoft PACS. Voxar's concurrent user licensing combined with PowerServer provides 3D capabilities to local and remote PowerReader workstations. Rendered 3D images can be captured and saved into RamSoft PACS for access by radiologists and referring physicians. Voxar 3D integrates PET visualization functionality with fast image processing and one-click processes such as 2D, MIP, MPR and 3D visualization, simultaneous comparison of PET and CT images and image enhancement and measurement tools.