This year's top innovators in healthcare have advanced the industry in many ways. From inventing new tools to reaching the underserved to improving military members' access to care, the men and women on the following pages are blazing a new trail. They are driving interoperability, connectivity and improved patient safety and care. These innovators are virtual catalysts whose efforts are advancing the clinical-IT link, serving as new business models and helping provide less invasive testing and treatment. By proactively addressing clinical and technological needs now, their work betters healthcare for all of us. For that, we salute them.

Nominations for "Innovators," who are all employed by healthcare providers or nonprofit organizations serving the healthcare industry, were solicited via online ballots and visitors to HealthImaging.com and from subscribers of Health Imaging News and Health Imaging & IT.

Ballots were accepted from January 19th through February 9th, 2007.

Sandra Bennett Bruce President and CEO, Saint Alphonsus Regional Medical Center, Boise, Idaho

Under Bruce's leadership, 365-bed regional referral and trauma center Saint Alphonsus has implemented a thorough telemedicine program for cardiology, radiology, pediatrics, neonatology and home care; and both physician and patient portals. The facility also is about to launch an e-ICU program, robotics for interactive surgery services, CPOE, EMR, and the opening of the Center for Advanced Healing, featuring the most sophisticated technologies and evidence-based design principles. Bruce has overseen a focus on involving patients in their healthcare through an expanded website and offering free access to wireless high speed internet in patient rooms.

Premindra Chandraratna, MD, FRCP, FACC, FACPChief of Cardiology, Long Beach VA Medical Center, Long Beach, Calif.

Chandraratna invented a low-profile, spherical transducer device that can be attached to the chest wall for continuous imaging of heart wall motion. The device eliminates the inconvenience and cost of serial echocardiograms for patients whose status requires them. Imaging is performed for one to eight hours and images are stored on videotape or magnetooptical disk. The ultrasound system records for five seconds every minute to reduce the amount of data recorded. The transducer permits rapid diagnosis and triage and the ability to monitor heart failure treatment and procedures in the cardiac cath lab.

John Cheatham, MD, FAAP, FACC, FSCAI Director of Cardiac Catheterization and Interventional Therapy, The Heart Center, Columbus Children's Hospital, Columbus, Ohio

Cheatham treats patients with complex congenital heart disease and played an integral role in the development of a five-axis FPD positioner released by Toshiba. This creative, unique C-arm design allows unparalleled access to the patient. One of the most significant contributions of the equipment is its impact on infants born with hypoplastic left heart syndrome which is fatal if left untreated. Rather than the conventional treatment of three open-heart surgeries, a less invasive procedure is now available with promising early and mid-term results. The Heart Center Hybrid team has successfully performed this procedure on babies weighing as little as two pounds. Cheatham also has helped design new devices and catheters used to treat congenital heart disease.

Michael Day Director of IT, Daughters of Charity Health System, Los Altos Hills, Calif.

DCHS operates six facilities between San Francisco and Los Angeles with a need for efficient emergency departments. Day implemented an ED information system to address increasing ED volume, staff decreases and the need to absorb some of the 40,000 annual ED visits from a neighboring hospital that recently closed. He developed a forum for simultaneous IT and physician input. The results have been an increase between $36 million to $42 million in gross revenues, elimination of lost charts and transcription errors, reduced length of stay despite volume increase and increasing ED level of service charges due to better documentation. Day also is working on ongoing process evaluation to continual improvement.

Geoffrey DeTolve, MD Director of Medical Informatics, Bronson Healthcare Group, Kalamazoo, Mich.

As a member of IT management, DeTolve leads initiatives directly impacting physicians and other caregivers, and serves as the chairman of the Physician Computer Utilization Committee and the Clinical IT Roundtable. He has led several IT-related innovations at Bronson, including the installation and web-enablement of EMR, PACS and CPOE, internal development of software to help physicians avoid neonatal hyperbilirubinemia and tools to speed up inpatient discharges while avoiding patient safety errors, and the creation of a full-time team to provide support for physicians, nurses, and other caregivers through 24/7 rounding. Bronson earned the 2005 Malcolm Baldrige National Quality Award.

James P. Ethier, Lieutenant-Commander, CD, MRT Radiology Technical Officer, Canadian Forces, Health Services Group, Ottawa, Ontario

Ethier is responsible for managing and recommending the procurement of all the Canadian Force's (CF) diagnostic imaging equipment as well as planning for the future. He began with digitizing x-rays, installing PACS at 16 bases across Canada, on board two ships, and overseas. Before deployed medical services had digital capabilities, films were chemically developed on site, and shipped to Halifax where radiologists would interpret the images. Depending on the location of the deployed medical facilities, the reports might take six weeks to arrive. Ethier is now assembling a secure wide area network to enable the CF to link into a global network of medical facility systems.

Richard T. George, MD Post-doctoral Fellow, Johns Hopkins University Department of Medicine, Baltimore, Md.

In 2006, George acted as lead investigator in a study that demonstrated that 64-slice CT scanning could quickly and accurately track blood that has been slowed down by narrowing of the coronary arteries. The new technique could provide a non-invasive method of diagnosing coronary disease, reducing the number of unnecessary catheterizations done to locate blockages. The new procedure takes just 15 minutes to perform and does not require patients to be stabilized ahead of scanning. Researchers felt it could replace other more time-consuming tests that help find blockages. George received the Melvin Judkins Young Clinical Investigator Award from the American Heart Association.

Michael Knopp, MD Professor & Chairman of Radiology, Ohio State University Medical Center, Columbus, Ohio

Knopp received a grant in 2003 to create the Wright Center of Innovation in Biomedical Imaging, which opened in 2005. Goals of the funding include creating an ultra-high-field 7 Tesla MRI scanner to reduce the need for exploratory surgery and permit doctors to closely monitor the effects of medications, and a more powerful PET scanner to help physicians better understand disease processes and treatment. The Center also will explore mobile imaging facilities and remote access systems for advanced diagnostic and imaging capabilities in the field during disasters, and organize an extensive imaging and bioinformatics infrastructure that will integrate the state's scientific community into a virtual think tank for research and development.

Matthew Kuhn, MD Medical Director of Radiology, St. John's Hospital, Springfield, Ill.; Chief of Neuroradiology and Clinical Professor of Radiology, Neurology and Neurosurgery at Southern Illinois University School of Medicine

By merging techniques from astronomy, cartography and forensics, Kuhn is working to aid radiologists in detecting new lesions and changes in lesion size. "BlinkRadiology," used by astronomers in 1930 to discover Pluto, presents images from new and old studies in a rapidly alternating superimposed technique rather than relying upon side-by-side comparison. Kuhn's clinical studies have shown that the technique can increase lesion detection by up to 20 percent. Kuhn continues to perform clinical research to improve radiologists' ability to interpret images more accurately.

Gary Levine, MD Medical Director, Hoag Breast Care Center, Newport Beach, Calif.

Levine helped implement digital mammography at Hoag, as well as a dedicated breast MRI and CAD. The center was the first to interface the reading workstation and mammography information system. Patients use wireless tablet PCs for registration and history. Levine also was the principal investigator in a study on cryoablation of benign breast fibroadenomas, and recently began a joint study to use cryoablation to freeze early stage breast cancers. He is working with industry to improve detection algorithms. He has been investigating the feasibility of a relational map technique for visualizing similar malignant and normal mammograms.

Colonel Gregory Andre Marinkovich, MD Chief Clinical Data Management, Clinical Information Technology Program Office, Military Health Systems, Falls Church, Va.

Marinkovich has developed IT solutions to help efficiently manage outpatient encounters for 9 million military beneficiaries. He is leading the MHS effort to integrate digital and unformatted data from more than 400 military medical treatment facilities into a single EHR. Current testing of his "data link/bridge" between the computable repository and the non-computable PACS data at multiple locations will facilitate electronic access to a complete set of patient data. Marinkovich also has worked to complete an information sharing project almost two years earlier than scheduled, and captured and imported notes from Theater of War environments.

Kevin McEnery, MD Professor of Radiology, Associate Division Head for Informatics, M.D. Anderson Cancer Center, Houston, Texas

McEnery facilitated his organization's digital clinical transformation by seamlessly integrating the PACS and EMR that he co-developed. McEnery's group also implemented interpretation prioritization based on patient appointment time. Before this change, only 80 percent of CT exams were interpreted before appointment despite the efforts of seven employees. The CT service now enjoys 97 percent success and the seven FTEs have been reassigned. The informatics group installed electronic white boards in patient waiting rooms to give patients a real-time view of their preparation for imaging studies.

J. Kevin McGraw, MD, FSIR Interventional Radiologist, Riverside Interventional Consultants, Columbus, Ohio

McGraw conducted one of the largest studies on the clinical benefits of percutaneous vertebroplasty and recently spoke before the Medicare Coverage Advisory Committee to promote the health benefits of the procedure. He works as a consultant to Cardinal Health and helped develop a new vertebroplasty cement delivery system. He also developed a percutaneous spinal stabilization system — V-PIN — that can save patients from open spinal surgery. McGraw has a new patent-pending dialysis catheter that has unlimited blood flow rates. He recently published a textbook about interventional radiology of the spine.

George Mulopulos, MD Chairman & President, American Radiology Associates, Las Vegas, Nev.

Mulopulos has advanced research in musculoskeletal MRI and promoted interoperability of disparate imaging centers and RHIOs. Autonomous routing allows for rule-based forwarding of images to specialists, enabling such guidelines as reassignment based on wait times and degree of specialty required. A virtual work list system gathers pertinent information from disparate systems for the diagnostician. He has applied for patents for the advance routing, distribution of radiological studies, and the creation of a virtual worklist in cooperation with a vendor. His work on image compression is advancing file transmission capabilities. He also is a clinical professor of Diagnostic Radiology at the University of Nevada, Las Vegas School of Medicine.

Julia Napper, RN Director of Performance Improvement and Clinical Safety, Parkland Health & Hospital System, Dallas, Texas

Napper spearheaded the effort at Parkland to implement technology-based critical test result management (CTRM) as a strategy to improve patient safety and boost staff productivity. In a study of 3,000 sentinel events, the Joint Commission found that two-thirds were the result of ineffective communication. Three-quarters of medical malpractice claims against radiologists are due to communication problems. With CTRM, Parkland's radiologists have gone from spending 45 to 60 minutes a day on critical test results down to just 2 to 3 minutes with much better results. Napper and her husband, Terry, who is Parkland's director of radiology, have written about and presented on the topic.

Steven Renard President and COO, Liberty Pacific Medical Imaging/Liberty Pacific Medical Management, Encino, Calif.

Renard founded Liberty Pacific Medical Imaging (LPMI) in 2003, which has grown into a five-center, $30 million company. Because LPMI assumes the risk on behalf of the radiologist, allowing them to establish ownership in the centers they serve without a heavy financial burden or any personal risk, the company is able to attract high-caliber doctors and groups to their centers. Renard also has facilitated better working relationships between cardiologists and radiologists by establishing mutually collaborative reading contract relationships. Renard has integrated the latest technology and led LPMI to become the industry benchmark for expanding new applications in 3D and cardiac imaging.

Katherine Richman, MD Vice Chairman of Education, Director of Thornton Radiology, Associate Clinical Professor of Radiology, University of California, San Diego Medical Center

Richman has championed the use of PACS image management technology to reduce errors and improve patient safety. She has worked to integrate PACS and RIS with speech recognition and scheduling components to help hospitals match the right exams, histories and physicians to patients. With a special interest in women's imaging, she performs hysterosalpingograms and sonohysterograms to assess women for infertility and gynecological issues and is studying the use of 3D ultrasound for these issues. She also does research in breast ultrasound to better distinguish benign from malignant lesions.

Stephen E. Rosenthal, MD Associate Director, Emergency Department, Sir Mortimer B. Davis – Jewish General Hospital, Montreal, Quebec

Rosenthal has initiated, developed and implemented medical informatics projects including decision support systems design requirements and clinical practice guidelines development and implementation. He has implemented electronic records, mobile speech recognition and digital dictation at his facility. He also has worked on developing databases and statistical tools for analyzing emergency department flow and performance. Rosenthal envisioned enabling emergency physicians to access real-time patient data from any point in the ED long before speech recognition was widely adopted, beginning pilot projects in 2004.

Thomas Schultz Medical Imaging Chief Technology Officer, Massachusetts General Hospital, Boston, Mass.

Schultz has established radiology order entry (ROE) at Mass General to make ordering exams easier, ensure appropriate criteria selection, and reduce delays. ROE's success led to tying data into a decision support model. Schultz also has created monitoring systems that connect disparate components of PACS and web-based image distribution. Users can customize automatic notifications — helping reduce system downtime from 6 to 15 percent down to an average of under 1 percent. The facility manages systems accepting and distributing more than 600,000 exams per year with less staff than comparable sites. Schulz also played a role in creating the industry's first image-enabled EMR and web-based PACS.

Wayne Sensor CEO, Alegent Health, Omaha, Neb.

Sensor proactively implemented consumer-driven healthcare at Alegent. He launched the plan in 2005 and today more than 88 percent of employees are participating. Alegent's quality reporting system collects and publishes data for patients to evaluate. Sensor developed a patent-pending "My Cost" tool for patients to access estimated test and procedure costs. Sensor also helped Alegent launch Quick Care, minor medical care provided by physician assistants and nurse practitioners in local grocery stores. Sensor frequently presents at healthcare industry events and was invited by the National Governors Association to serve as an advisory, non-voting member of the State Alliance for e-Health.

Janet Sung, MD President, Windsong Radiology Group, Williamsville, N.Y.

Sung has been devoted to being the first to market with leading-edge technology. That includes bringing PET-CT to the Buffalo area before it was reimbursable. She also was the first in the area to do stereotactic breast biopsies as an outpatient exam, to introduce MRI-guided breast biopsy, and to offer 64-slice CT and cardiac CTA. Sung has established a lease-only capital investment program for equipment purchases so that her organization is always offering patients the latest technology to improve their imaging and diagnostic capabilities. She participates in breast cancer research projects, speaks on women's imaging and, with her husband, established a scholarship at the University of Buffalo.

Glenn Taylor, MD Head, Division of Pathology, Hospital for Sick Children, Toronto, Ontario

Taylor led a multidisciplinary team at his facility to implement the first pathology PACS. He recognized that pathology departments have the same key issues of imaging, security, workflow, patient safety and efficiency and no implemented standard. Acceptance by all pathologists required a streamlined imaging workflow that maintained productivity and provided enhanced visualization tools specific for pathology's high-resolution color images. Taylor's team defined a system that provides security to an image level with comprehensive audit trails on who views or exports each image. The hospital can stream live video from pathology imaging devices over the IT network for real-time audio/video consults.

Tanya Townsend IT Director, St. Clare's Hospital, Weston, Wis.

Townsend directed the successful opening and implementation of an all-digital environment at a brand new facility. In just over a year, she and her team have accomplished a vision for an EHR, wireless handheld computers, CPOE, point-of-care nursing documentation, and medication reconciliation. An all-digital operating room system allows surgeons and anesthesiologists to see on-line documentation, patient radiology images and video. The turnaround time on delivering stat antibiotics at Saint Clare's is 10 minutes, on average. The ability to enter orders and have them verified and administered in near real-time provides an environment focused on improving patient outcomes. Saint Clare's has 99.6 percent compliance with formulary medications and zero transcription errors.

Claude Vézina, MD Director, NORrad PACS project, Timmins and District Hospital, Timmins, Ontario

More than 750,000 people live in northern Ontario, an area the size of France. Due to clinician shortages, remote communities and extremely cold weather, access to healthcare is a challenge. Vézina brought together resources to create one of North America's largest regional multi-site radiology consortiums, which has transformed the quality of healthcare for Ontario residents. The project brings together 10 independent healthcare organizations and uses digital radiology technology and high-speed networks to move diagnostic images and interpretations between community and regional hospitals. Today, 24 hospital sites covering thousands of square miles are connected through a high-speed wide area network.

Richard Warren, Vice President and CIO, Foote Health System, Jackson, Mich.

Warren has led an information infrastructure implementation that includes laboratory, pharmacy, radiology, surgery, clinical documentation, medication management, physician portal, and computerized physician order management systems with the electronic medical record. Warren and FHS teamed with the Jackson Physician Alliance to champion a community electronic medical record and formed Jackson Community Medical Record, LLC. The shared database lets clinicians leverage each other's work and maximize interfaces. The result has been increased accuracy, timeliness, patient satisfaction, efficiency, and reimbursement. The business model provides low entry costs and economies of scale for participating providers.