Image and Information Management at RSNA 06: Workflow, Integration and Beyond
The message at McCormick Place was loud and clear at RSNA this year. PACS has overcome basic workflow and integration challenges. The latest vendor offerings up the ante and promise improved workflow and deeper integrations. Many new systems incorporate the next level of advanced visualization tools, enabling radiologists to interpret 3D studies and remain at a single workstation, which represents a workflow plus. Advanced visualization applications weren’t the only new offerings. Digital mammography, enterprise solutions and the small hospital/imaging center market also grabbed their fair share of the spotlight. Integrated RIS offerings and advanced workflow management solutions rounded out the show floor.
The DMIST results are out and shown digital mammography’s superior role in diagnosing breast cancer in women with dense breasts, and the first CR mammography system is on the market. Digital mammography has turned the corner, and sales are skyrocketing. A number of PACS vendors aim to simplify the intricate challenges of storing and recalling digital mammography images with new systems geared to the specific needs of the mammography site. Embedded CAD and multi-modality reading features promise to streamline digital mammography interpretation and simplify breast imaging.
Vendors built on last year’s enterprise momentum and unveiled more systems targeted to the enterprise market. In fact, several moved beyond the walls of radiology and cardiology and presented solutions to help manage non-DICOM images generated by other specialties like pathology and dermatology. New communication tools aim to enhance patient safety and warn users of discrepancies specifically between radiology and busy ER departments. Other vendors showed new solutions targeted to the referring physician market, intending to simplify image delivery and PACS utility.
PACS has penetrated the majority of large and mid-sized hospitals, but many smaller sites, imaging centers and specialty practices are eying digital solutions. Vendors displayed a host of systems scaled to the smaller practices. Offerings included quite a few mini-PACS and ASP solutions.
RIS vendors touted tighter PACS integration and improved workflow tools. At the same time vendors unveiled advanced workflow solutions, designed minimize disruptions to radiologists, streamline communication and mine data to facilitate optimization of staff and modality resources.
RSNA 2006 was a great show. PACS proved its strength and maturity, and vendors managed to show something for everyone. For more highlights and an insider’s look behind the trends, check out the January 2007 issue of Health Imaging & IT magazine.

Absolute Medical Software Systems, Inc. introduced a comprehensive RIS solution with enhanced practice management functionality. 
The RIS offers features designed to streamline the workflow and financial efficiency of hospital radiology departments, imaging centers, surgery centers and private practices, from patient eligibility and scheduling though claim submissions and insurance and self-pay collections. The multi-site, fully web-based RIS provides comprehensive electronic management of a facility’s radiology workflow and includes real-time and batch patient insurance eligibility verification, an enhanced claims editor/clearinghouse solution and automated self-pay collection processes to enable precise management of the revenue cycle. Features include a drag-and-drop user-friendly scheduling interface and advanced report generation tools, including voice recognition. Customizable workflow definitions and reporting templates as well as physician-based report routing rules allow the flexibility to support any practice. Other features include real-time marketing reports and a full range of report delivery options to referring physicians such as fax, email and online report access. RIS functionality and advanced practice management features provide efficiency by eliminating duplication of data input and maximizing returns on claims processing. The result is improved radiology workflow and acceleration of the claims and billing processes, leading to enhanced profitability.

Agfa HealthCare launched functional extensions for digital mammography reading and reporting applications IMPAX PACS and its business consulting group and shared IMPAX Data Center. The company also demonstrated IMPAX Clinical Applications. Finally, Agfa shared information about a potential wireless integration of IMPAX with Ascom and discussed a new alliance with Vocada, Inc.

IMPAX 6.2 provides integrated CAD and MRS Reporting. The company also unveiled a work-in-progress of a new software application that addresses the growing need for digital mammography screening. IMPAX continues to support the display of Mammography CAD through integrations with iCAD's Second Look Digital and R2 ImageChecker CAD image markers. It offers added features for improved workflow and messaging on CAD processed images. A wide range of hanging protocols as well as access to other relevant mammography studies - such as Breast MRI and Ultrasound - allow radiologists to perform all reads directly at their IMPAX workplace. Automatic access to prior mammography studies for ease of comparison is essential to the workflow and patient care. Agfa improved this element to include efficient navigation tools for accessing prior mammography studies.

The integration of MRS Mammography Reporting systems and IMPAX RIS/PACS/Reporting solution meets the MQSA (Mammography Quality Standards Act) requirements in the U.S. marketplace.

The company’s work-in-progress dedicated solution for digital screening workflows in local and multi-site organizations, in stationary as well as in mobile units, is designed to enhance high speed screening workflows. It features a fully configurable active workflow support for double blind reading, and it can automatically trigger third reading when needed. Fast navigation, reading and reporting is actively enhanced by a special keyboard, containing keys to which specific tasks have been assigned. This solution is waiting FDA approval for sales in the U.S.  IMPAX solutions of Agfa HealthCare for digital mammography are vendor neutral, allowing facilities to select the Agfa-validated modality of their choice while still reaping the benefits of a fully functional multi-modality PACS workstation. 

Agfa HealthCare Consulting provides a range of consulting services, including development of strategic direction, situation analyses, business intelligence, resource allocation advice and management workflow adaptations. A team of Management Consultants focuses on the business needs of managers operating in healthcare institutions. These dedicated specialists work closely with hospital administrators in order to help define management objectives, performance indicators and means of measurement.

“The challenges regarding the changing patterns of financing and regulating that the U.S. healthcare sector is facing, create a need to focus on the business management aspects of healthcare facilities and institutions. Hospital managers and administrators have to think beyond the choice of technology and their medical workflows. There is a growing demand among hospital managers for expert advice concerning the identification of the right targets and actions for steering their medical business through the current period of change,” said David Chambers, vice president sales and marketing, Americas.

The Agfa HealthCare Management Consulting Group includes a Business Case service, which analyzes the strategic and financial effects of digitization projects on the whole organization (including HR, accounting, etc.) and helps develop a financial plan which addresses topics such as Return on Investment (ROI), Net Present Value and Internal Rate of Return.

Business Intelligence, which mines existing hospital databases for validated management information, is another service which helps hospital management to make more informed strategic decisions. Agfa HealthCare’s Business Consultants use the DMAIC (Define, Measure, Analyze, Improve and Control) methodology. This industry-wide, standard consultancy methodology offers a set of tools for quantifiable and repeatable management improvement projects and analyses.
IMPAX Clinical Applications is a work-in-progress that will be integrated into Agfa HealthCare’s IMPAX. It offers point-of-care access to such applications as 3-D, Fusion, Digital Subtraction Angiography, CAD, X-ray Vascular Analysis, Virtual Colonoscopy and nuclear medicine. IMPAX Clinical Applications will offer a tighter and more reliable integration in Agfa HealthCare’s PACS than what is typically available with third party integrations to allow healthcare providers to focus on the patient instead of on interoperability concerns. IMPAX Clinical Applications bring several advanced clinical applications into the single IMPAX desktop. The advantages include a single log on, a single solution and Agfa HealthCare’s service and support. They allow radiologists and other clinicians to perform complex image processing without having to go to a specialized workstation.

“With IMPAX Clinical Applications, radiologists will only need to learn one new application, namely IMPAX. The Clinical Applications will be tightly integrated into the IMPAX system,” said Guy Klaassen, Global Clinical Applications Product Line Manager. “IMPAX Clinical Applications will conveniently put information into one place for radiologists so they can make better-informed decisions for their patients exactly where they need it: at the point of diagnosis.” Advanced workflow IT solutions, such as IMPAX Clinical Applications, that will integrate seamlessly into healthcare environments, will help healthcare providers deliver higher quality, faster service, better outcomes and increased customer satisfaction, Agfa said.

Ascom, a provider of wireless notification systems, is testing IMPAX  RIS/PACS for a product integration that could potentially improve how radiologists and other healthcare professionals communicate. If testing proves successful, Ascom’s wireless communication solutions could help get information from Agfa HealthCare’s RIS/PACS solutions to radiologists and physicians when they need them. The testing of the two companies’ systems will be conducted in several hospital sites in the U.S. and Europe. The testing will determine the feasibility of Ascom’s wireless solutions combined with Agfa HealthCare’s IMPAX RIS/PACS solution and their ability to instantaneously notify radiologists, regardless of where they are located, of a situation that requires their immediate attention or clinicians of clinical result availability. Such communication could help make physicians more accessible and signal alerts if immediate action is required, thereby improving the delivery of patient care.

Agfa HealthCare and Vocada, Inc., a provider of Critical Test Result Management (CTRM) solutions, have agreed to integrate their systems and offer radiologists an improved methodology for clinical result distribution and notification. Vocada’s Veriphy CTRM solution offers one-step convenience and automates compliance with all legal and professional standards concerning critical communications. It is a hosted system that requires no additional investment in hardware or software. CTRM is a technology-based strategy to improve patient safety and outcomes and boost staff productivity. It verifies the communication of critical test results from a reporting clinician to the responsible ordering clinician – in time to benefit the patient. “This integration will provide radiologists with a user-friendly interface for PACS, Reporting and for communicating critical patient findings,” said Thomas White, co-founder and executive vice president of Vocada. “The combination will enhance patient safety and boost staff productivity at the same time.”

AMICAS, Inc. debuted RadStream, announced Vision Reach and launched Vision Series PACS Version 5.0.

RadStream was initially developed at Cincinnati Children’s Hospital to solve real world problems in a complex radiology environment. Even with comprehensive RIS and PACS deployment, Cincinnati Children’s Hospital saw room for dramatic improvement in their radiology operation. In April 2006, AMICAS acquired the rights to RadStream and in collaboration with Cincinnati Children’s Hospital began building a new RadStream with the core functionality of AMICAS’ Real Time Worklist, AMICAS Vision Link integration engine and RadStream’s patent pending functionality. “RadStream solves issues that were never considered by PACS or RIS technology. It has improved our radiology report turnaround by 40 percent," noted Mark Halsted, MD, associate professor of radiology and chief of the Radiology Informatics Research Core at Cincinnati Children’s Hospital. "Using RadStream, radiologists reading cases have experienced a nearly 25 percent reduction in interruptions."

RadStream is designed to integrate of disparate RIS and PACS environments, boost soft copy reading and automate communication and documentation of positive results. RadStream automates workflow and communication through the entire radiology experience by providing a single enterprise worklist to integrate disparate PACS environments. With the widespread adoption of PACS, many radiologists find themselves reading on multiple PACS systems. RadStream is designed to integrate those disparate environments with a single unified worklist.
RadStream includes a patent pending Acuity Index which utilizes a multi-factorial algorithm that prioritizes imaging exams based on a "most likely to interrupt" method that was fully tested and validated by the Cincinnati School of Business. The fundamental problem with all PACS systems is that they manage cases on a first-come, first-served basis. "There is simply no accounting for the severity of a case other than a simple ‘yes/no’ to ‘STAT’ concept. Optimal patient care is not first-come-first-served. In particular, in busy departments or for decentralized radiology, practices optimizing workflow is mission critical because it affects the quality of patient care," explained Halstead. The RadStream functionality, as part of the AMICAS RealTime Worklist, automatically prioritizes the workload for the radiologist with the most acute cases being read first. "Prioritizing the most acute cases results in a massive reduction in interruptions to the radiologist. This dramatically improves radiologist productivity," added Halstead.

RadStream’s patent pending "operator concept" automates radiologists’ communications with referring physicians to improve productivity for the radiologist and reduce medical legal risk associated with communicating and documenting positive results. RadStream brokers communication of critical results to referring physicians without breaking radiologists’ workflow and provides referring physicians consistent, final results quickly communicated to them every time they request a call report or we find a positive result.
RadStream is fully integrated with the new AMICAS Vision Series PACS 5.0 and the new Vision Reach referring physician tool. RadStream is expected to be available in the second half of 2007.

Vision Reach is designed to help grow imaging businesses. The system facilitates end to end radiology practice automation including PACS, RIS, Billing and document management in a filmless and paperless radiology operation. It delivers another level of radiology service with proactive e-mail messaging of images, reports and radiology information. New and repeat business from referring physicians is the key to maintaining and growing a successful imaging enterprise. "Despite this, we believe that no application has been brought to market that adequately meets the needs of the referring physician. While PACS adoption has been tremendous, technological barriers such as complex system downloads, Web plug-ins and challenging security issues have hampered the widespread adoption of PACS by referring physicians," said Peter McClennen, president of AMICAS, Inc. "Our research indicates that, generally, a PACS is used by fewer than ten percent of a facility's referring physicians."
Designed to cater specifically to the unmet needs of the referring physician, Vision Reach provides proactive electronic delivery notifying the referring physician when exam results are ready. It integrates the radiology report with key images and creates a single "multi-media" report for referring physicians. Vision Reach then uses common 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 requirement. The platform supports:
  • Multi-Platform – Apple, Linux and Microsoft operating system support
  • Multi Microsoft OS Version – Windows 95, 98, 2000, NT, XP and Vista support
  • Multi-Browser – Internet Explorer, Firefox, Netscape and AOL support
  • Wireless support for: Treo, Blackberry, Windows CE & more
Vision Reach is available as a stand alone referring physician product or in combination with the AMICAS Vision Series of products including RIS, PACS and Financials.

Vision Series PACS Version 5.0 provides advancements to the Lightbeam diagnostic workstation including functionality to support digital mammography, 3D rendering and orthopedic templating.
AMICAS has received FDA clearance to perform primary interpretation of digital mammography, which means that the AMICAS PACS platform supports the DICOM overlay functionality as delineated by the Mammography Quality Standards Act, in addition to other mammography-specific workflow enhancements. Embedded MPR/MIP functionality includes the ability to manipulate complex CT and MR images with multiple imaging preset protocols, capture rendered images and distribute them to referring physicians. AMICAS also introduced significant innovation in the capability to quickly review and compare prior exams. Finally, fully embedded orthopedic templating is available on any Web-based workstation.
Version 5.0 also includes significant upgrades to the core infrastructure including the latest operating system from Microsoft and the latest database and archive technology from IBM. The entire system utilizes the latest in Web services from Microsoft and Java. AMICAS also has enhanced the Vision Watch monitoring tool with version 5.0. The remote monitoring tool is fully embedded within the Vision Series PACS platform. Version 5.0 includes enhancements in the ability to set alerts, thresholds and reports based upon user-configurable rules and delivery mechanisms. Version 5.0 is also fully integrated with a single database and computing infrastructure with the new AMICAS Vision Reach product.

BRIT Systems announced the release of 3D imaging tools native to the company’s The Roentgen Files PACS solution and available on any BRIT Vision workstation within a healthcare facility and introduced new administrative and reporting tools that will streamline radiology workflow and enhance patient care. The company also highlighted its Discordance Tool and CARE program and showed a CCOW-enabled workstation. BRIT and Mercury Computer Systems, Inc. announced an integration and distribution partnership. Final highlights include enhancements to the QC Workstation and the Roentgen Router.

The continued prevalence of multi-slice CT (MDCT) and increased use of MRI prompted BRIT to respond to the clinical needs of its customers and introduce a new set of PACS-native 3D tools. Improved and more powerful MPRs, MIPs, volume rendering and basic 3D imaging tools, along with more efficient viewing tools, are now native applications on all properly configured BRIT Vision workstations. Throughout the facility or enterprise, BRIT Vision workstations can provide advanced 3D rendering tools that were previously available only on third-party 3D software.  Workstations must have a color monitor and an Open GL capable graphic card to utilize the 3D tools.  BRIT continues to integrate and support other third-party 3D reconstruction/image analysis tools. 

“As more powerful multi-slice CT systems continue to enter the marketplace, there is a discernable shift in how radiologists and other physicians view this data,” said Michele Fisher, president, BRIT Systems.  “BRIT is committed to supporting this fundamental shift by enabling the use of 3D and MPR throughout the facility, not just on a dedicated 3D workstation.” In addition to making the 3D tools available on BRIT Vision, clinicians can view the 3D reconstructed images on the company’s BRIT Lite and BRIT View workstations.
Brit’s new administrative and reporting tools will streamline radiology workflow and enhance patient care. “Two or three click normal” templates will allow a radiologist to quickly prepare a “normal” diagnosis report with only a few clicks of the mouse.

BRIT Systems also showcased an enhanced version of the Discordance Tool. This administrative tool facilitates the communication of findings between ER doctors and radiologists. Typically occurring during overnight emergency department radiology reading coverage, an ER doctor or resident may report an exam or image to be normal when in fact, it was abnormal. This tool provides a method of communication for the radiologist to alert the ER department that a problem or illness was overlooked and to verify that the ER department sees the alerts. It also provides statistics on the frequency and types of disagreements.

The CARE (Complete Archive & Read Ensemble) Program is tailored to meet the specific needs of smaller, mostly rural facilities classified as Critical Access Hospitals. It provides a bundled PACS and RIS solution and optionally, diagnostic reading services through one of BRIT’s professional services partners. The pay-per-study fee solution allows Critical Access Hospitals to implement PACS with low up-front costs. BRIT provides all the required hardware and software, as well as maintains the facility’s archive at BRIT’s Dallas-based ISP. Training and system management services are included. Sites can use their own preferred radiology group for reading services or contract for the optional service from one of BRIT’s professional services partners.
The CCOW-enabled BRIT Lite utilizes the vendor-independent HL7 CCOW (Clinical Context Object Workgroup) standard to facilitate the viewing of medical images and reports within a patient context set by disparate clinical applications at the point of care. The workstation offers a single interface, single log-on and sharing of patient context information among different applications associated with the electronic medical record. Users do not need to log onto BRIT’s database and search for their patient images; if the user changes patients within BRIT's application, it will change this "patient context" back in the original application or other applications accessed from BRIT Lite.

Clinicians can log into the patient record in one application to access clinical data across the enterprise, helping the clinician to become more efficient and providing access to information that will enable the delivery of better, more effective, patient care.  
The partnership between BRIT and Mercury paves the way for providing integrated high-end PACS systems, enabling a significantly faster radiological workflow and outstanding image quality for 2D, 3D and 4D data. In this way, consistent data are available throughout the entire hospital enterprise. At the click of a mouse, clinicians and radiologists can access medical data directly from the PACS for diagnosis and patient treatment. The partnership provides advanced 3D capabilities into BRIT’s Linux workstation. Through the use of a Linux client, Mercury’s 3D tools will become an integrated part of BRIT’s top-end workstation to provide features such as cardiac scoring and virtual colonoscopy. Under the agreement, BRIT Systems will integrate the Mercury Visage CS Thin Client Server in its PACS and high-end workstations. The agreement enables BRIT to offer its customers an extended product portfolio covering clinical applications in cardiology, PET-CT, surgery and orthopedics and 3D tools. Furthermore, Mercury will also deliver professional services to BRIT to provide fast time-to-market turnkey solutions for implementing the thin client into BRIT's Linux Workstation. 

Also new from BRIT Systems are enhancements to the QC Workstation. Icons that enhance ease-of-use and features that make it easier for technologists to split exams allow technologists to repair any exam from any modality.

Now, the Roentgen Router DICOM routing module can be used with any vendor’s DICOM-compliant PACS or teleradiology system for auto-routing and prefetching of DICOM studies triggered by information in the exam order and/or study. In its original configuration, the Roentgen Router was a module of BRIT’s web and PACS server.
With the Roentgen Router, system managers build routes based on information within the DICOM header of radiographic images, including body region, modality type and referring physician. Routes are scheduled based on time of day and day of the week. They can also be queued or held and sent at a later time.
Prefetching of comparison studies from any DICOM server or archive is further simplified with the Roentgen Router. A maximum number of prefetches can be established and limited by age of the study, modality or body region.
Each route is monitored to facilitate system administration; failure alerts with detailed information can be customized for each site and system manager. Tools within Roentgen Router support the retrying of failed images based upon a pre-determined time frame, which can be customized per site.

Cedara Software, a Merge Healthcare company, introduced new solutions for integrated imaging workflow.
Cedara showcased new technologies for OEM/VARs designed to further unite image and information management in the healthcare industry.  At the forefront of Cedara's approach to integrated image and information management is a new development platform, named C4 (Cedara Clinical Control Center). C4 allows clinical applications and plug-ins to be tightly integrated into a single workstation, sharing system resources. Operating through a single patient study list, each clinical application can be launched manually or automatically based on user preferences. C4 can be used to quickly integrate clinical applications into any information system. At RSNA, Cedara showed C4 integrated with Cedara I-Reach PACS, Cedara aXigate diagnostic information system and in a standalone capacity. Clinical needs addressed via C4 currently include breast imaging, PET/CT imaging, orthopedic planning, virtual colonoscopy, calcium scoring, oncology therapy response and lung nodule analysis. These capabilities are supported by Cedara's clinical applications Cedara I-ReadMammo, Cedara PET/CT Workstation, Cedara OrthoWorks ProPlanner, Cedara OrthoWorks Spine Analyzer, Cedara IlumiView, Cedara CalScore, Cedara I-Response, Cedara PrimeLung and more *. (Some of the capabilities are works-in-progress.) It is anticipated that additional clinical applications will be available through C4 in the future.
“For many vendors, engineering costs and time-to-market have a significant impact on their decision to develop applications that address specialists' needs; using C4, these applications can be quickly added to existing PACS, RIS and EMR solutions to support a more a comprehensive workflow in a fast and cost effective manner,” explained Ken Rardin, President of Cedara Software and CEO of Merge Healthcare
The Cedara OpenEyes development platform insulates clients from the complexities of deep code development by providing a single uniform set of controls and development interfaces. OpenEyes packages connectivity, visualization and printing services in a flexible and transparent architecture that can be deployed across a wide spectrum of application environments -- from small "one-off" projects to complex web solution services. Cedara OpenEyes is available to OEM organizations interested in accelerating their time to market.

Cerner Corporation demonstrated enhancement to its unified RIS/PACS solution.
New features include a critical results documentation and notification solution that helps support JCAHO's National Patient Safety Goal, as well as order review and approval tools that help optimize this traditionally paper-based process.

CoActiv Medical Business Solutions introduced a multi-modality cardiovascular module to its EXAM-PACS web-based enterprise PACS.      
The new cardiovascular functionality combines local and remote viewing, management, distribution and archiving of cardiac studies including nuclear cardiology, echo cardiology, MRI, CT and more. EXAM-PACS now supports fully integrated digital cardiovascular workflow as a complement to existing comprehensive radiology and orthopedic support.

Commissure launched RadWhere Workflow Orchestrator and RadCube Suite.
The new component to RadWhere Suite enables radiology departments to connect together multiple PACS, RIS, 3D, Advanced Visualization and teleradiology information into a central worklist.

Developed with advanced .NET 2.0 framework and web-based communication, RadWhere Workflow Orchestrator is able to incorporate any combination of legacy and web-based systems, while controlling workflow with bi-directional communication. “The interpreting radiologist can read from an unlimited number of systems yet view a single worklist on one PC,” says Commissure CEO Michael Mardini. “Radiologists will no longer be required to continuously switch between systems in order to bring up a worklist, view images and dictate their cases.”
RadCube Suite is designed to empower hospital radiology departments and imaging centers with rich multidimensional data mining tools. RadCube Suite mines years of critical data to reveal any number of trends and tendencies within radiology departments. RadCube Suite's components include: Business Productivity, Quality Assurance, Utilization Management, Customer Relationship Management (CRM), Educational Effects, Clinical Research, Throughput, Critical Communication Management, Financial Analysis, Trending and Forecasting, and Benchmarking. RadCube Suite provides answers to such challenging questions as the productivity of critical resources including; individual radiologists, technologists, modalities, PACS, RIS, Billing and other reporting systems. It offers quality assurance metrics, including positivity and recommendation rates for each and every radiologist and modality. It also reports on trends in referring physician ordering practices.
RadCube Suite can analyze examination utilization by referring physician, modality, location or indication. It can detail the effects of decision support on exam volume. It also provides benchmark analysis of a department compared to industry standards. RadCube Suite is able to evaluate the effects of education on productivity and clinical practices, as well as reveal candidates for clinical trials. The application can explore disease discovery, progression and treatment.

DeJarnette Research Systems announced a new version of its PACSware Migration Toolkit and unveiling xDL Cross-Enterprise Document Librarian.
Version 2.1 of the PACSware Migration Toolkit supports Canon PACS migrations and includes other new features. New features include a separate GUI for scheduling, separate pre-fetch and background migration schedules, wider support for DICOM objects, improved capture of DICOM errors and improved logging, improved automatic retry capability, improved migration verification module, support for running the MDIG Router as an MS Windows service, support for routing based on modality and support for priority manual migration. The PACSware Migration Toolkit is currently in beta testing at a number of customer sites.
xDL addresses the growing demand for inexpensive, robust and reliable off-site storage of PACS data. xDL is a software layer that can be placed on top of any off-site storage vendor’s service offering. xDL uncouples the medical imaging domain specific knowledge from the off-site storage vendor’s service offering. DeJarnette is working with OEM
partners on commercial rollout of the product in 2007.

Digital AMS demonstrated PACS-in-a-BOX solutions including Catella RIS, Catella PACS and Catella CD Burners and Labelers.
Catella RIS is fully integrated with Catella PACS and allows unhindered flow of schedules, reports and images from one application to the other.
Catella CD Burners and Labelers duplicate quickly and efficiently to provide images to referring physicians, patients and for special back-up needs. The company markets a manual-loading single disk unit and a robotic multi-disk “volume” model. Both are fully automated, transferring a patient’s DICOM images onto a CD, as well as printing a label with the patient name and creation date.

DR Systems exhibited its new Unity RIS/PACS platform at RSNA 2006.    
Unity covers the entire medical imaging exam workflow process. Notable features of the Unity RIS/PACS include:
  • New data conversion tools for legacy RIS/PACS replacement
  • Enhanced Web-based scheduling capabilities
  • RIS workflow management including patient pre-authorization, patient flow tracking,  film tracking, and task management
  • New patent-pending image display methods for improved accuracy and efficiency
  • Enhanced integrated mammography reading, tracking, film digitizing and archiving
  • Enhanced automated exam specific reporting capabilities
  • Enhanced transcription capabilities including Web-based transcription
  • Enhanced multi-database and multi-server capabilities
  • Enhanced PACS access from EMRs and HIS Web portals
The Unity RIS/PACS has been designed to provide an advanced medical imaging and information management system infrastructure for regional health information organizations (RHIOs). DR Systems PACS form the primary radiology backbone of the Santa Barbara Care Data Exchange, the nation’s first and best-known RHIO.
Through a dealer agreement with InSiteOne, Inc., DR Systems also offers integrated on-site and off-site secure DICOM storage for disaster recovery as one of its archive product options. The pay-as-you-go outsourced storage enables hospitals and diagnostic centers to avoid a significant capital equipment expense while still enjoying the advantages of digital image management.
The company discussed the role of its 64-bit operating system and Intel processors in managing massive datasets. The Intel processors used in DR Systems’ technology provide increased processing power for reading large image sets and 3-D imaging on PACS. The increased use of 64-slice CT scanners and similar digital imaging modalities require more robust processing power to be read and manipulated efficiently. The combination of the 64-bit Microsoft operating system and Intel processors running the DR application delivers speed and capability to handle large exam workloads that include these modalities.

Dynamic Imaging featured its latest IntegradWeb PACS integrations—digital mammography and Barco Voxar 3D VesselMetrix. The company also demonstrated PET/CT functionality, IntegradWeb Ortho and IntegradWeb RIS/PACS. Dynamic Imaging’s IntegradWeb PACS digital mammography capabilities include complete digital mammography specific workflows such as customizable reading layouts and sequences for any third-party full-field digital mammography system. IntegradWeb’s digital mammography functionality has been developed to support the new IHE mammography profile, including image manager and image display actors. The system features support for digital mammography CAD. CAD markings are applied to the original digital mammography study and can be archived for future reference.
Barco Voxar 3D VesselMetrix functionality is available as an optional software package with IntegradWeb. The advanced visualization solution for stenosis measurement, stent and stent-graft planning and stent-graft surveillance of the aorta, carotid, and renal arteries can be accessed within the cohesive, anywhere accessible, Web-based user interface of IntegradWeb PACS. Implementation of VesselMetrix includes quantitative vessel analysis for CTA and MRA.
Dynamic Imaging’s enhanced PET-CT functionality includes the display of multiple, simultaneous, three-dimensional PET-CT views for the reading radiologist.
IntegradWeb Ortho uses the technology and consistent graphical user interface of IntegradWeb PACS in an easy-to-use version with features used every day in the orthopedic imaging environment. IntegradWeb Ortho offers tight Web-based integration to Orthocrat TraumaCad and requires no preexisting specialty software to be loaded on the local client station prior to viewing.
IntegradWeb RIS/PACS is an integrated, single-desktop RIS/PACS featuring end-to-end Web-based workflow from scheduling through billing, with document management and digital dictation. This end-to-end workflow expands upon the Web-based architecture of IntegradWeb PACS, fulfilling the complete Web-based workflow needs of ambulatory settings. The RIS/PACS provides a single user-interface desktop; complete sets of operational, business, and clinical data to reduce rejected/denied claims for rapid payment and a unified dashboard with access to all patient and business information. IntegradWeb RIS/PACS is anticipated to be commercially available in the first quarter of 2007.

Eastman Kodak Company debuted RIS Mammography Technology as a work in progress and showed CARESTREAM Information Management Solutions and Virtual Access Desktop for KODAK CARESTREAM Radiology Solutions. The company also showed the current version of CARESTREAM PACS and RIS and shared future enhancements to its CARESTREAM Radiology Solutions platform.
The mammography module for the newest KODAK CARESTREAM RIS platform includes tools that help automate and personalize patient communication and simplify preparation of reports required for MQSA certification.
Kodak’s current version of CARESTREAM PACS software offers a virtual desktop environment that allows any application, including 3D processing, to be delivered to any desktop inside or outside the organization. It also provides dynamic streaming capabilities to reduce the need for large bandwidth network connections, even for viewing of 3D, cardiac CT and other extremely large image files. As a result, healthcare facilities can streamline the delivery of radiology reports through the use of off-site radiologists and specialists. It also offers optional digital dictation, speech recognition and reporting functions for facilities that do not have integrated radiology information systems.
Kodak’s newest CARESTREAM RIS platform will include a complete outpatient practice management system that includes patient scheduling, radiologist interpretation, report distribution, management reporting and billing functions. This system equips imaging centers to handle all aspects of patient workflow beginning with verifying insurance eligibility and ending with submission of claims and posting of payments from patients and insurance companies. 
New works-in-progress features to Kodak’s CARESTREAM Radiology Solutions platform include productivity-enhancing tools and tools that serve entry-level users as well as large healthcare systems and regional organizations. Kodak’s newest PACS platform will support workflow grid computing, which facilitates storage and retrieval of information throughout an enterprise with a shared infrastructure that can serve multiple sites throughout a city or region. Workflow grid computing will increase the availability and redundancy of a multi-site system. It also provides efficient management of distributed storage systems and rapid delivery of archived data to any review location. This workflow grid technology can provide synchronized global worklist and reporting to all sites, while allowing each site to operate independently of the network or centralized server when necessary. Business continuity is expedited by supporting access from a secondary data center if the primary data center experiences equipment failure or a natural disaster. Cost efficiencies can be achieved through the sharing of storage resources, with flexible allocation that can be adjusted to match the changing needs of each facility.    
Kodak also announced that it is working to incorporate additional capabilities as part of its CARESTREAM Radiology Solutions platform:
  • A user-friendly dashboard that will allow PACS administrators and users at any location to monitor workload status and modify it to meet current needs; and
  • Ability to view PET/CT and CT volume matching as native applications. Doctors will be able to conduct full processing and diagnosis for PET/CT studies on any PACS workstation, alleviating the need for a dedicated workstation for this purpose. Integration of the CT volume matching (registration) application will significantly speed up the comparison of past and present volumetric CT data during the reading process.

Emageon Inc. demonstrated new features on its Enterprise Visual Medical System.
Technologist QC is a native quality control tool that runs in the EVMS Advanced Visualization environment, providing a streamlined process and enabling users to correct errors before interpretation occurs. From any secure workstation located inside or outside the enterprise, a user can edit demographics, merge patients or studies, split studies, renumber images, match on Modality Worklist (MWL) and correct images. Personal Content Management (PCM) distributes the entire user environment rather than just the images in the teleradiology envrionment. Users can subscribe to folders to initiate streaming of studies from selected folders, avoiding problems associated with "push-model" found in many systems. PCM stores encrypted versions of the retrieved studies locally, improving performance of the remote user's experience. This allows for simpler remote reading and, coupled with the folder based architecture, provides a useful tool for on-call reading, at-home reading and reading at remote/referring clinics. Enhanced Web Administration provides a comprehensive toolset for PACS administrators, radiology IT and radiology directors. It offers data mining capabilities with reports, configuration tools, audit logs and policy-based deletion settings.

Empiric Systems announced a partnership with FUJIFILM Medical Systems.
The arrangement will leverage the companies’ respective expertise, channels and product offerings in web-based PACS and web-based RIS to provide a complete radiology PACS/RIS solution to outpatient imaging centers. The offering will target out-patient imaging facilities and include a streamlined financial package; the companies are working to combine both systems into an integrated application. It combines Empiric’s Encompass.NET web-based RIS and billing solution into a single offering with Fuji Synapse. 

eRAD unveiled its web-based RIS.
The company announced an OEM Agreement with RIS Concepts, providing eRAD with a branded RIS that has been integrated into a RIS/PACS solution. eRAD RIS integrated with eRAD PACS is currently available.

ETIAM debuted showcase CD-In.
CD-In balances the requirements for security and complex processing and the need for a simple and automatic procedure. CD-In automatically integrates radiology examination images recorded on DICOM CDs and DVDs into a PACS.

Evolved Digital showcased Radweb RIS and View2 PACS.

Radweb is the backbone of Evolved’s digital image workflow solution and is capable of managing the image and data flow across patient registration, order entry, image viewing, dictation, transcription and reporting. Additionally, Radweb can integrate with virtually any HIS for order and report data exchange and with View2 PACS solution for image and data exchange and archiving. The objective of Radweb is to expedite the processing of patient exams, by enabling referring physicians, radiologists, and transcriptionist, with tools that can be accessed anytime and anywhere, thus significantly reducing associated time and expenses. Radweb enables tracking of patients throughout the examination process and eliminates repetitive and time-consuming manual entries as well as the opportunity for human error. Health care facilities operate more efficiently and cost effectively, providing more timely results of patient procedures and enhanced patient care. Radweb incorporates a variety of integrated modules in order to provide a seamless transition, or workflow, of patient images and information between all systems and users.
The Reception module allows users to add a new patient or order, review an existing order, edit an order, cancel an order and track patient arrival. Orders are tracked by the patient’s MRN (Medical Record Number) or Name.
The Technologist module allows the user to work directly from the technologist worklist displaying up-to-date exam status information. The technologist can alter the status of exams until the exam has been completed and is ready for dictation.
The Radiologist module runs a locally on the radiologist’s machine and allows remote access the dictation worklist. The radiologist is able to simultaneously view the images with the preferred hanging protocol already configured and record the dictation. Once the transcription is complete on the study the radiologist receives a report for signing.
The Transcription module also runs locally on the transcriptionist’s machine and allows them to remotely access the transcription worklist remotely. Based on priority or dictation time the transcriptionist can access the study to complete the report, reports can be queued without a completed transcription to be accessed at a later time. A transcriptionist can create “Normals”, or canned reports for routine exam findings.
The Administrator module provides access to six different report categories including: filming reports, exam cycle reports, dictation reports, transcription reports, activity reports, and miscellaneous.
Evolved’s View2 PACS stores Radiology and Cardiology images on a centralized web-based platform that provides the entire medical team with a fully integrated enterprise-wide archival and storage solution. By connecting multiple facilities and/or modalities via a centralized database, View2 provides the healthcare network with an enterprise-wide archival and storage solution for managing images, reports, and clinical data. View2 fully integrates with Radweb. The RIS/PACS povides rdiologists with single sign-on access to a comprehensive set of tools to maximize operational efficiency and turnaround times for report generation. This integration also reduces opportunity for human error and maintains more consistent and reliable data. Additionally, the consolidation of diagnostic tools provides a single source for image and data quality control and auditing purposes. View2 includes integrated dictation, personalized hanging protocols, side-by-side comparisons of prior exams, annotation tools, embedded 3D tools, ECG management, PET Fusion, Document Management, and Ortho Templates. View2 automatically populates the dictation worklist for easy access to digital patient images and related data. Prior studies and patient information are automatically pre-fetched to enable side-by-side comparisons to current patient data and images. Designed specifically for multiple and/or remote locations and departments, View2 allows medical personnel to access electronic patient information by worklist or by patient records in the OR, ER, ICU, or from any authorized PC throughout the facility or existing network. Authorized medical personnel can simultaneously view patient information using View2’s secure DICOM image streaming capabilities. View2 is designed to be vendor neutral and operates on most readily available hardware products, such as Dell, HP, IBM and others.

Foresight Imaging released a software-only version of its TIMS DICOM Gateway software and showed new TIMS features. 
This software-only version of the TIMS DICOM Gateway converts JPG, BMP, and AVI files generated by several hospital departments including dermatology, pathology, and ophthalmology to DICOM. The resulting DICOM studies can then be sent to PACS, recorded to CD/DVD/USB or printed. The TIMS DICOM Gateway software includes DICOM Modality Work List; JPG, BMP, and AVI DICOM conversion; DICOM print; Windows print; CD/DVD burning; DICOM query/retrieve; DICOM receive and DICOM send.
New TIMS features improve workflow and functionality of the TIMS DICOM System. For example, the Update Patient Information feature enhances connectivity of DICOM modalities that are unable to communicate with DICOM Modality Work List. TIMS receives the study from the modality and enables the technologist to match the received study with a DMWL query. The updated study can then be sent to PACS. Additionally, this new TIMS feature can help users append patient demographics or correct patient information errors in studies received via CD/DVD or from other sources.

FUJIFILM Medical Systems USA announced plans to deliver a comprehensive and fully scalable PACS/RIS solution for outpatient imaging facilities via an agreement with Empiric. A co-marketing agreement with Prosolv addresses cardiac and radiology needs. Fuji also launched Synapse version 3.2 with additional digital mammography capabilities. 
The fully web-enabled PACS/RIS offers new Synapse licensing models, a number of specially designed product configurations and a RIS from Empiric Systems. Fuji recently selected Web-based healthcare information system provider Empiric Systems as its RIS partner for lower volume radiology departments and imaging centers. The partnership leverage the Windows-based and Web-based architecture of Fuji’s Synapse PACS and Empiric’s Encompass.NET RIS and the expertise of each company to deliver a streamlined, full-featured PACS/RIS solution that is fully scaleable to the needs of smaller departments and imaging centers. 
To help facilitate the PACS/RIS purchase, Fuji has created a number of customizable Synapse configurations, including server and storage offerings. These configurations are based on Fuji’s experience of needs assessment for approximate exam volumes, but yet can still be customized and tailored to the needs of the individual facility. They are designed to provide a structure to help achieve optimum performance and allow for an expedited deployment. Fuji’s pay-per-use licensing and integrated financing program round out Fuji’s offering for this market space. The pay-per-use model allows facilities to relate their total investment on a per-procedure basis to their procedure volume or income.  And Fuji Financial Services provides leasing and financing options to fit the budget and buying preferences of each individual facility.
The Fuji/Empiric PACS/RIS solution is available now and already being rolled out at customer sites.
The agreement with Prosolv is designed to help healthcare facilities to better leverage their IT infrastructure investment. It centers on an integrated distribution and reporting software solution with the Prosolv cardiology PACS and Fuji’s radiology PACS technology that will provide increased continuity of care during the diagnostic process. ProSolv and Fuji deliver a tightly integrated cardiology/PACS solution that will enable cardiologists to launch Synapse from within the cardiac application and radiologists to link directly to ProSolv. The companies are providing an aligned IT infrastructure that will provide healthcare facilities with the ability to build economy of scale and realize cost savings by having a uniform approach to their storage and disaster recovery solutions.
A core component to Fuji's complete acquisition-to-archive diagnostic solution for women's healthcare imaging, Synapse v. 3.2 was introduced on the heels of the FDA approval of Fuji's FCRm FFDM system. The new version addresses the unique workflow, visualization and image processing needs that the interpretation of FFDM studies presents. Digital Mammography has a unique workflow that includes screening and diagnostic workflows, as well as the critical need for comparison models, multi-modality display capabilities and the integration of CAD results. Fuji's Synapse v. 3.2 will extend Fuji's unique Reading Protocol technology to enable reader-specific preferences to be set, providing for efficient and consistent screening workflows, and the flexibility to accommodate the unique challenges presented by diagnostic exams. And because Synapse is a multi-modality tool, not just a mammography tool, FFDM data can be integrated into the existing continuum of women's health care imaging that includes ultrasound and MR, while still using these reader-specific preferences. Synapse 3.2 provides specific features to enhance the presentation of this critical image data, such as support for MQSA compliant overlays, the integration of CAD into the technologist and radiologist workflow, and support for Fuji's high quality AON compression algorithm.
The system incorporates Fuji's Pattern Enhancement for Mammography (PEM), which detects and improves the conspicuity of minute structural information within the breast, such as micro-calcifications, through pattern recognition for easier visualization. Particularly with the amount of digital comparisons that emerge from potentially many different acquisition systems, image processing can play a tremendous role in the breast screening diagnostic process from both a quality and efficiency perspective.

GE Healthcare showcased a broad range of information technology solutions targeted at helping healthcare organizations provide high quality patient care across the enterprise while contributing to the organization’s financial health. Featured solutions include Centricity PACS, Centricity RIS and Centricity CVIS. GE highlighted Centricity RIS-IC and its combined Centricity Imaging- PACS 3.0 and advanced visualization solution. GE also announced that it has expanded its alliance with Intermountain Healthcare to include the development of standardized terminology, clinical knowledge management technology and clinical process content as part of their multi-year project for the development of an ‘enterprise clinical information system’ built on GE’s Centricity Enterprise Solution.

GE’s solutions help address the industry demand for the utilization of imaging procedures by tackling the technological, geographical and departmental barriers to broad IT adoption. As imaging services move to the outpatient and specialty settings and healthcare organizations face increasing staff shortages the need for automation, efficiency and tight integration is increasingly clear. GE’s Centricity PACS, RIS and CVIS solutions work in tandem to provide workflow and image management solutions that can be shared across multiple procedural areas while maximizing data capture from medical devices and automating workflow.

For example, GE’s Centricity PACS combined with Centricity AW Suite 2.0 gives clinicians tools for sifting through most data-intensive procedures – optimizing workflow, image quality, application flexibility and speed without needing to move to a separate workstation. Additionally, GE’s Centricity RIS-IC solution helps clinicians manage the administrative and clinical requirements of a radiology department—from a community hospital to an out-patient imaging center to the complex needs of the integrated delivery network (IDN).

Finally, GE’s CVIS optimizes workflow within standalone cardiology departments or throughout the entire healthcare enterprise by offering both the comprehensive and administrative tools that help clinicians deliver higher-quality, lower cost healthcare at every stage of the patient care process.

“By bringing together these disparate islands of information into a single integrated solution we can better provide our customers with simplified access to significant clinical findings and associated images while still meeting the needs of diverse workflows,” said Joe Darr, global segment manager for GE Healthcare Integrated IT Solutions.
GE’s Centricity Imaging RIS-IC solution offers simplified access to rules-based multi-organizational and multi-time zone scheduling, multiple reporting options, outcome monitoring as well as patient and image tracking to help streamline department workflow and increase overall productivity.
Additionally, the enhanced workflow provided by these features combined with closed-loop reporting, redundant data entry reduction, and embedded voice recognition enables clinicians to dedicate more time to delivering high quality care to a larger population of patients.
The Centricity Imaging RIS-IC solution offers additional features that clinicians can use to support an efficient digital radiology department such as an integrated document management to support paperless workflow and an Assisted Patient Matching Module (APMM) to help reduce medical errors through improved patient identification.

An integrated mammography administration module helps maintain records on different aspects of breast imaging exams, which is especially important in mammography studies because of the need for historical comparisons in treating patients.
The combined Centricity Imaging-PACS 3.0 and advanced visualization solution provides on-demand access to raw data. Centricity Imaging-AW Suite 2.0 combined with the Centricity Imaging- PACS 3.0 solution gives clinicians tools for sifting through most data-intensive procedures – optimizing workflow, image quality, application flexibility and speed without needing to move to a separate workstation.
“The Centricity Imaging-PACS and AW Suite software are so well integrated that you can freely work between the two and it automatically cross-references,” said Laurie Sebastiano, MD, a radiologist at St. Luke's Hospital in Bethlehem, Penn. “For the first time we have 3D software rendering connected real time to the 2D PACS images with reference lines.”

Centricity Imaging- PACS 3.0 with AW Suite conforms to IHE profiles and integrates data seamlessly into a user-based solution for radiologists, clinicians and technologists. Running on high-performance Intel Xeon processor-based workstations and servers, the solution offers scalable and fast powerful diagnostic tools for improving the quality and speed of the diagnostic process. GE selected Red Hat’s Enterprise Linux platform to offer additional scalability to support organizations from outpatient imaging centers to nation-wide information systems. 

Also part of the new product offering is GE’s Centricity Radiology Business Intelligence Portal, a solution aimed at looking at how the business is operating by comparing current equipment and process performance against pre-configured values and industry benchmarks.
GE Healthcare and Intermountain are working to help enhance patient care by accelerating the adoption of electronic health records and the use of evidence-based medicine and other forms of best practice among health systems in the United States.

As part of the new agreement, GE and Intermountain will work together to enhance the Centricity Enterprise Solution by developing and incorporating standardized vocabulary and clinical element models that will help enable the use of clinical data, such as protocols for optimal use of antibiotics, providing clinicians with critical decision support tools at the point of care. 
“It’s about bringing science from the research arena to the bedside quicker,” said Mark Dente, MD and vice president of Healthcare Solutions for GE Healthcare Integrated IT Solutions. “Today the amount of time it takes for the widespread adoption of the latest medical treatments and protocols is entirely too long, but with the use of information technology we can make the latest medical information breakthroughs accessible and easier for physicians, nurses and others to implement.”

According to David Burton, vice president for Health Delivery Research at Intermountain Healthcare, standardized clinical content can improve patient care dramatically. “It is time we made use of breakthrough science, best clinical practices and evidence-based medicine to improve patient care and reduce medical errors by making it available and actionable for physicians and patients during routine visits,” said Burton. “Beginning with standardized terminology, we will lay the foundation of a common language so that physicians, nurses and other bedside caregivers will have the latest guidelines available in the clinic and at the bedside.”

“Our vision is to provide an infrastructure that will transform healthcare from a system that reacts to chronic conditions to one that manages these conditions proactively and prevents or, at least, mitigates their long-term complications,” said Vishal Wanchoo, president and CEO of GE Healthcare Integrated IT Solutions. “Through the expansion of our agreement with Intermountain, we are accelerating this vision by developing technologies that will help enable providers to diagnose conditions at an earlier stage, tailor treatments more specifically to the individual patient’s findings and presentation, and prevent long-term complications, wherever possible.”   
In 2005, GE Healthcare and Intermountain announced a multi-year technology development collaboration to develop an ‘enterprise clinical information system’ that takes advantage of Intermountain’s internationally recognized expertise in clinical informatics and GE Healthcare’s clinical software applications and market depth and breadth. The agreement will include solutions for imaging, perioperative, PACS, pharmacy, lab and ambulatory electronic medical records.

Since GE Healthcare’s acquisition of IDX Systems, the GE-Intermountain alliance has worked to incorporate into the Centricity Enterprise Solution many of the features developed by IDX. The IDX acquisition has accelerated the alliance’s efforts to move Centricity EMR toward an integrated clinical, financial and administrative system that supports the creation of lifetime electronic patient records. The alliance will also include use of the Centricity Radiology Solution, a combined picture archiving communications system PACS/RIS. Intermountain plans to use both systems across its 21 hospitals and its network of ambulatory clinics.

Guardian Healthcare Systems released FlowPoint 6.2
FlowPoint is an integrated, Web-based RIS and PACS that enables healthcare enterprises to combine patient medical data and radiology images into one digital record to facilitate enhanced patient care, reductions in potential medical errors and lower administrative costs. Guardian Healthcare Systems is extending the functionality and the feature set of the FlowPoint RIS by integrating document scanning technology. This functionality digitally captures paper documents and includes them as part of the permanent radiological patient electronic medical record to enable a paperless workflow in the radiology department.  Other updates support cash payments and patient invoicing, single user-logon in Microsoft Windows environments, system integrations with industry billing companies and enhanced charge capture support for HCPCS codes, improved label printing flexibility with Zebra printers. FlowPoint also incorporates enhancements to the Enterprise Appointment Scheduling Module, faster FlowPoint application installation process, improved implementation of PACS compression, enhanced multilingual functionality and capabilities and a continued implementation of Microsoft .Net architecture.

INFINITT of North America announced the commercial release of INFINITT Radiology Suites and the scheduled releases of three other solutions: INFINITT Cardiac PACS and INFINITT CDIS (Clinical Device Information System). The company also announced plans to release a lung CAD solution in 2007.
INFINITT Radiology Suites is a fully web-based RIS/PACS solution with advanced 3D capabilities all operating on a single platform. This all-in-one solution features a fusion of RIS, PACS and 3D functions and enables remote access.

INFINITT Cardiac PACS provides a complete image management solution for the cardiology enterprise and features a full coverage of image management tools, including image acquisition, storage, displays and web distribution devices. INFINITT-supported modalities include XA, Ultrasound/Echo, MRI, CT and CR/DR. INFINITT Cardiac PACS is scheduled for release in early 2007.
INFINITT CDIS (Clinical Device Information System) acquires clinical data from various devices used for medical examinations in hospitals and changes the data into industry standard formats to transmit and to store in HIS. With a release date set for early 2007, INFINITT CDIS will enable hospitals to compile statistical data from existing hospital computing systems. CDIS will be able to provide digitized medical examination data derived from not only radiology modalities interfaced with existing PACS but also with clinical devices, patient monitoring systems in ICU and electrocardiograms.

InStar Systems International, Inc. exhibited its RIS.
InStar’s RIS features include enterprise wide scheduling capabilities; scheduling interface; web portal which includes scheduling and viewing of patient reports; appointment cancellation tracking and simple rescheduling of exams; real-time patient status tracking; workflow management across the enterprise; embedded dictation/ voice recognition; a report editor for transcription; integrated billing and mammography tracking; auto-faxing/email of diagnostic reports; film tracking for outside films (incoming and outgoing) and extensive management and marketing reports. InStar’s RIS is a .NET application that is SQL server-based. 

Intelerad Medical Systems Incorporated shared its Reporting and Transcription and Teaching File modules, a Referring Physician’s Portal and InteleViewer Workstation.
The Reporting and Transcription modules incorporate dictation with voice recognition and transcription into IntelePACS for upload to a RIS or other application.
The Teaching Files module provides a training mode for residents. Integrated into the dictation workflow, Teaching Files studies are searchable and indexed by pathology and anatomy.
The Referring Physician’s Portal includes a web page with login for referring physicians and the capacity to send emails to referring physicians that contain a direct link to their patient’s completed study. The Referring Physician’s Portal also contains tools for PACS administrators, including tools for managing access permissions.
InteleViewer Workstation is a standalone DICOM workstation software product for diagnostic reading. It allows the DICOM user to DICOM query/retrieve from multiple sources: PACS, modalities or any other DICOM device. InteleViewer Workstation also allows images to be imported from CD for viewing, or to be sent to another DICOM device.

Intuitive Imaging Informatics (I3) announced PET Fusion functionality for its Rational Imaging PACS, new Rational Imaging features and ImageQube enhancements.
PET Fusion features user-selectable color maps, real time PET transparency manipulation, automated MPR and MIP.
New PACS developments include MIP Imaging and a new user interface. MIP Imaging allows production of high-resolution, 3D reconstructions of phase-contrast MR images or similar relationally-oriented acquisitions. This functionality includes the ability to segment out anatomic regions, to sub-select segments and to provide reconstructions of only those segments.
The new PACS platform encompasses the Common Desktop Environment and Solaris 10. An enhanced Graphical User Interface (GUI) provides state of the art features and a new look and feel to the application.
ImageQube Web-based PACS enhancements include the ability to support paperless workflow, teleradiography scheduling, Instant Messaging, integrated 3-D capabilities and teaching files.

McKesson Corporation announced a distribution agreement with Toshiba America Medical Systems, Inc. and showcased its portfolio of solutions.
The agreement between McKesson and Toshiba calls for Toshiba to offer McKesson’s Horizon Medical Imaging PACS solution with Toshiba’s diagnostic imaging devices, including the Aquilion line of CT scanners. The agreement is designed to offer imaging centers and hospitals under 200 beds a turnkey solution that’s affordable, easy to implement and easy to support. Horizon Medical Imaging is modality independent, helping hospitals to integrate images from multiple modalities with clinical patient data for more comprehensive electronic health records (EHRs). The system also is designed to streamline radiology department workflow and to promote improved radiologist efficiency.
McKesson’s image-enabled care solutions are designed to optimize performance, provide diagnoses more quickly and accurately and connect with the rest of the care team.
  • The Horizon Medical Imaging ER Discrepancy Tracking tool facilitates communication and concurrence of diagnoses between the ER and Radiology. It provides an easy-to-use, formal process to track discrepancies and also automatically tracks the interpretations of diagnoses and related actions taken.
  • Horizon Radiology is McKesson’s integrated RIS/PACS solution. It combines reporting and scheduling with anytime, anywhere access to the complete patient record. Horizon Radiology eliminates steps and increases the speed of the entire diagnostic process, from ordering a procedure to distributing reports to the referring physician. The integrated medical image and information management solutions enable hospitals to eliminate the use of film-based imaging and improve productivity by automating workflow.
  • Horizon Radiology Manager provides complete functionality for radiologists, technologists, other clinical stakeholders and administrative staff to efficiently and cost-effectively manage the diagnostic process. A web-based, feature-rich solution, Horizon Radiology Manager includes a broad range of modules for acute-care and outpatient radiology departments. Some of these include multi-facility patient ID storage, hold-order logic, a patient reconciliation module, enterprise scheduling integration with Pathways Healthcare Scheduling and advanced film-tracking features that will increase productivity.
  • Horizon Medical Imaging is McKesson’s PACS. It enables hospitals and clinics to acquire, distribute and archive medical images and diagnostic reports across the enterprise. Horizon Medical Imaging integrates images from multiple modalities with clinical patient data, streamlining radiology department workflow and improving radiologist efficiency. The system also provides referring physicians with patient images as part of a complete medical record, improving decision making and helping to ensure patient safety.
  • Horizon Rad Station is the viewing platform for Horizon Medical Imaging. It provides immediate access to any image in a study, even for new CT and MR multi-slice studies that may contain thousands of images. The simple, efficient user interface enables radiologists to focus on their primary responsibility: reading images and providing diagnoses as quickly and efficiently as possible.
  • Horizon Rad Station eJacket solution enables quick access to exam results using a Web browser. eJacket provides referring physicians with portable access to information from the diagnostic imaging service for the studies they ordered for their patients. This information includes reports with embedded flagged images, scanned documents, voice clips, flagged images or the entire image set. The eJacket module is also available as a standalone application on tablet PCs.
  • McKesson’s Horizon Cardiology, cardiovascular image and information management system (CVIS), moves healthcare organizations one step closer to a complete enterprise imaging and information management solution. It provides diagnostic image management, archiving, procedure reporting and workflow management. Featuring Horizon Cardiology Hemo, McKesson’s solution supports hemodynamic reporting and CPACS on a single platform.
  • Horizon Optical Imaging is an image management solution designed to support clinical image management of optical imaging devices. The solution makes optical images available enterprise-wide for reference, consultation, conferencing and teaching. The image capture component turns any endoscope with a video output into a DICOM modality. Viewing, storage and distribution are provided through McKesson’s Horizon Medical Imaging.

Medweb demonstrated its range of PACS and teleradiology solutions including fully hosted RIS/PACS/PM with DICOM Workflow Grid; completely 3D, web-based PACS; disk publisher with touch-screen interface and enterprise-wide monitoring, service gateway and statistics program for managing clinical workflow across multiple PACS/RIS/HIS systems.
Medweb's DICOM Workflow Grid helps streamline efficiency, increase radiologist productivity and reduce costs. By coordinating the workflow of multiple, remote radiologists reading from multiple sites, the DICOM Workflow Grid organizes a virtual worklist that allows physicians live, real-time access to patient cases using a regular PC with web access. Medweb places an inexpensive DICOM Web server at each facility to allow any remote radiologist to use the DICOM Workflow Grid to monitor activity on each server and assemble patient cases waiting to be read into a single worklist on his or her PC. The system also gives radiologists added flexibility in their choice of workstation software. The DICOM Workflow Grid also provides a configuration screen that allows the user to select which sites to monitor and is compatible with Medweb or RadWorks workstations. DICOM Workflow Grid boasts integrated dictation, statistics, STAT functions, reporting and image routing based on contract number, state licensure, modality or body part. Both encrypted instant messaging and video conferencing are available for use from within the DICOM Workflow Grid application. Such advanced features bring added flexibility to remote radiologists who want to communicate with other online radiologists or doctors.
Medweb Advanced 3D PACS offers advanced templating that autosegment bone, vessels and organs using any of the built-in default templates or customized templates. Specific 3D views or movies can be created and added to the study if a user would prefer to view them as static images instead of using the interactive 3D interface.
The Global Teleradiology Support Node, or GTSN, is an enterprise solution that provides a single point of access for monitoring and maintaining a network of Medweb servers. Via the GTSN, support technicians can have direct, secure access to modalities for service, maintenance and upgrades. This secure access can reduce the time required to respond to modality support issues and may even allow some problems to be handled without an on-site visit. Medweb's GTSN allows all Medweb servers in an enterprise to be upgraded to the same level of server software simultaneously.
The DICOM Archive Grid is a new replicating database version of the Medweb server and GTSN. It causes all Medweb servers in a workgroup to update each other on what images and studies are stored on them. This provides a single-user interface that allows users to query for studies across an entire enterprise. As it is a replicated database as opposed to a central repository, the report and demographic data for all servers is resident on the local server, so retrieval is instant.
Medweb has added a touchscreen interface to the BravoPro disc publisher. It automatically burns and prints up to 100 CDs or DVDs at a time.

Merge eMed unveiled a range of technology solutions designed to increase productivity and drive new referrals for imaging businesses. Highlights include Fusion RIS/PACS MX, Fusion PACS MX, Fusion RIS MX and clinical applications.
Fusion RIS/PACS MX moves beyond the integration of RIS and PACS applications, delivering a single system that is relevant to the entire spectrum of imaging business needs. From a single screen, its Radiologist Command Center provides point-and-click access to all patient-related information and images, thus eliminating delays and frustrations from toggling and interfacing between disparate applications. Traditional RIS-based information, such as operating performance, insurance or referral, is readily accessible within the single solution. Fusion RIS/PACS MX also incorporates embedded document management, web-enabled distribution, billing and practice analytics capabilities, as well as workflow tools, such as embedded dictation, interrupt sessions, instant messaging, hanging protocols and more.
Fusion PACS MX provides 64-bit capabilities, which enables extremely fast simultaneous loading of thousands of images. Other new capabilities to be unveiled for its Fusion PACS MX system will include integrated mammography*, which makes digital mammography completely native to the PACS; expanded Practice Analysis features*, which offer new opportunities for data mining, reporting and real-time monitoring of information within the Fusion PACS MX; and an enhanced archive framework* with capabilities to speed processing, reconcile demographic data inconsistencies, store data from outside radiology and provide proactive alerts when problems arise or workflow is impeded.
Fusion RIS provides a workflow solution that accelerates productivity from scheduling through billing. Merge eMed showed the recently-released Call Center Scheduler Module and capabilities for real-time dashboard analytics.
Merge also demonstrated clinical applications, including:
  • MergeMammo (formerly I-Read Mammo) – A multi-modality, vendor-neutral digital mammography workstation, MergeMammo allows organizations to display images simultaneously from different mammography systems and to read all breast imaging studies from a single station, including images from the newly FDA-approved CR for mammography which has been created by medical equipment manufacturers. Works-in-progress being shown for the first time at RSNA include: improved full-resolution viewing, algorithm-driven display capabilities to optimize screen real estate, and improved inverted imaging.
  • MergePET/CT – a vendor-neutral software application designed to optimize digital reading for PET/CT studies using advanced imaging capabilities combined with fast and efficient workflow for PET/CT reporting.
  • MergeOrtho - combining image manipulation and automation within an architecture designed for integration and customization, MergeOrtho offers a comprehensive digital solution for joint arthroplasty, trauma, deformity correction and more. MergeOrtho supports surgical planning, templating, archiving and distribution.

Meta Fusion introduced Meta Fusion Helium.
The RIS/PACS application is fine-tuned for the special needs of imaging centers and small hospitals, helping them transition into the digital age. Helium ships pre-configured to each installation’s specifications for streamlined plug-and-play installation, eliminating IT support.  Helium provides comprehensive RIS workflow from patient scheduling and exam reporting though report tracking and CPT and ICD coding. Designed with the flexibility 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. Remote 24/7 monitoring and upgrades that download automatically over the Internet are included in the comprehensive package.

Misys Healthcare at RSNA displayed Misys Radiology, Misys Vision and Misys CPR.
Misys Radiology 5.0 RIS manages information and images in a single source. Current enhancements to Misys Radiology 5.0 include scheduling, patient tracking and procedure history module improvements. Misys Radiology integrates with all PACS systems.

Misys Vision is a complete practice management solution that can improve productivity, enhance revenue and increase operational efficiencies. The combination of Misys Vision and Misys Radiology enables users to track patients' radiology data with administrative information to improve scheduling, registry and billing.

Misys CPR 5.0 is an enterprise clinical information management system and CPOE solution. It features a web-based platform that gives physicians the ability to access patient data without delay, 24/7, from any Web browser. 

Neurostar Solutions, Inc. introduced online services that expand the Virtual Radiology Network (VRN) clinical image workflow platform, from an expert opinion consulting service to a portal enabling online sign up and configuration of a customized VRN solution. The company also showed its expanded Virtual Radiology Community Website (VRC) and VRN eStore. (REO) provides radiologists with internet-based sub-specialist consults as needed. A joint venture of Neurostar and Templeton Readings, the service allows busy radiologists to obtain expert consults for difficult exams and unfamiliar diagnoses. It is powered by Neurostar’s VRN and Virtual Radiology Community Website (VRC) to enable any-time, anywhere access to Templeton’s network of board-certified radiology subspecialists in a full range of disciplines. The application automatically and securely sends the case to Templeton and delivers the final report to clients. The service will focus on expert and second opinions, flexible per-consult fee structure and global accessibility. Radiologists will transmit studies to REO with any specific questions and partial or complete reports, as desired. Upon receipt, they will be guaranteed a specific turnaround time – typically within 24 hours – for an expert response to their questions or report.
The VRC expansion includes support for medical transcription services and today’s growing number of 3D image processing labs. VRC provides a platform for sharing services, resources and information between professional radiology service providers and imaging facilities – including hospitals, imaging centers and private practices – that wish to utilize their services. Medical transcription services and image processing labs and those in need of such services can connect with one another using the site’s service listings and bulletin boards.
VRN eStore is an online portal where medical professionals can configure a complete, customized VRN solution and sign up for it electronically. The eStore guides new customers through a step-by-step process of assessing their needs and current environment and building a VRN. A Neurostar help desk representative assists customers with this online process. Existing customers also can use the new eStore to add services from the VRN portfolio or purchase accessory equipment.

NovaRad Corporation released NovaPACS 6.5 with enhanced administration console tools and increased tool availability on the referring physician viewer.
NovaPACS 6.5 provides additional administration console tools to enable better sorting, reporting and information gathering and viewing. For the referring physician, the “Referring Physician Specialist Viewer” provides the complete set of tools available on PACS workstations. Version 6.5 also provides NovaRad with the ability to monitor the NovaPACS installation in real time to further enhance its support capabilities. Also offered is an option for a cost-effective CD/DVD publisher/printer. Stat reads and the ability for the PACS to support multiple site codes was also enhanced. To complement NovaPACS 6.5, NovaRad offers NovaRIS 6.5, an HL7 and HIPAA-compliant RIS software developed using the same database as NovaPACS to ensure seamless integration.

Numa demonstrated NumaStore and NumaRead. NumaStore provides a robust, reliable, and user-friendly image management system designed specifically for NM and PET/CT. It offers secure long-term cataloging and storage of patient studies over time.  NumaStore also enables efficient retrieval of these studies and supports a paradigm shift in NM and PET studies from simple diagnostic snapshots to a long-term care patient management tool.
NumaRead streamlines transfer of archived data maintained on media such as CD, MOD and DAT tape to more sophisticated storage including NumaStore online RAID, DVD and other long-term archives including PACS.

ODS Medical announced V2.6 Feature/Function software release for PACScomm.
The new release enhances DICOM import to include the ability to auto-reconcile patient and study information by using a worklist server. An external query selector enhances flexibility in study search capabilities by allowing the user to specify single or multi-archive searches. Enhanced administrative configurability of automated processes provide study search and status information. PACScomm V2.6 also incorporates enhanced structured report configurability and added support for the AGFA/Mitra structured report broker, improved web page customization tools for displaying reports in HTML and additional support for the DICOM specification for CD media creation.


PACSGear introduced MediaSuite and new PacsSCAN features.
MediaSuite features import of external DICOM CDs. The comprehensive connectivity solution for documents, film and multimedia images enables hospital file rooms and diagnostic imaging centers to use one application to access all functionality for a consistent user experience; digitize plain film, including mammograms, for prior comparison; import external DICOM CDs; scan paper and include electronic forms to abolish paper “print/scan” cycle and send multimedia images such as JPEG and AVI/MPEG from files, digital cameras, USB memory sticks and flash memory for access to clinical images. PACSGEAR MediaSuite also includes small-footprint CD/DVD burner with label writing as it spins.
New PacsSCAN document and multimedia connectivity features include product-wide JPEG2000 compression to decrease storage and increase interoperability; AVI/MPEG import to send video to PACS; LDAP/Active Directory support for single sign-on convenience; native application support in seven languages and CD/DVD import/export for enterprise distribution.

Philips Medical Systems showcased iSite solutions, ViewForum workstation and EasyAccess PACS.
iSite image and information management system delivers on-demand diagnostic-quality images over existing hospital networks, with advanced radiology reading stations and “always online” long-term storage. iSite PACS comprises iSite Enterprise, iSite Radiology and iVault. iSite Enterprise is based on iSyntax technology, which provides clinicians and referring physicians with access to just-in-time diagnostic-quality images anytime, any place throughout the healthcare environment. iSite Radiology is an advanced reading station that provides full-fidelity diagnostic presentation of current and prior studies and associated clinical information using a single application. iSite is designed to improve workflow and efficiency across the entire enterprise. It provides all the tools needed to deliver the best possible care to patients.
ViewForum multi-modality workstation is centered on the patient. It provides (authorized) users with instant access to all of the patient’s studies for review and a wide range of clinical applications in the area of Cardiology, Vascular, Oncology and Orthopedics on a single workspot.
Philips EasyAccess Radiology PACS, which is built in partnership with Sectra, consists of image and workflow management systems and viewing packages with innovations. EasyAccess’ flexible and scaleable architecture can be scaled to fit the clinical needs of any radiology department.

RADinfo SYSTEMS launched Micro PowerPACS Mammography.
The Micro PowerPACS Mammography solution allows a facility to efficiently view, manage, distribute and store digital mammography images from computed radiography (CR), full-field digital mammography (FFDM), and other modalities offered by a broad range of manufacturers. Micro PowerPACS Mammography is scalable and configurable, and has the functionality to upgrade to RADinfo SYSTEMS’ full PowerPACS or as standalone solution that can be integrated with a PACS vendor of choice.

Ramsoft debuted RamSoft One, a fully integrated practice and image management solution, and showed PowerServer PACS 4.2.
RamSoft One is designed to be easy to use for radiologists, referring physicians and facility staff. RamSoft One’s integrated RIS and PACS system is reliable and efficient, improving the quality of patient care. It increases overall productivity by reducing paper, film and labor and by making patient records accessible to the staff from anywhere.  It eliminates RIS and PACS integrations and multi-vendor complications. RamSoft One’s Referring Physician portal allows referring physician offices to place electronic requisition orders, view and print reports and view images.
PowerServer PACS 4.2 provides continuous software to take advantage of the latest in security, imaging and network technologies.  New tools include:
  • Spine Labeling to label all vertebrae and disks with just a few simple clicks
  • Dynamic Zoom for access to the commonly used pan, zoom, cine, window and level tools at the touch of a button
  • Professional Dictation Module, a web-based dictation module that is quicker, easier to us, and conforms to the way a transcriptionist works It supports Philips Speech Mic, Philips Transcription Kit, RamSoft XKeys and RamSoft Foot pedals
  • New Measurement Tools; the Plumb Line and the Cobb Angle measurement tools increase diagnostic accuracy and help reduce exam turnaround times
  • Improved Sharpness tools to provide better performance and increase reading accuracy
  • Improved Workflow Engine  
  • Imaging Pipeline that incorporates the latest graphics technology design principles to increase image manipulation performance and response with respect to all tools
  • Advanced plane linking to automatically link studies based on a large set of criteria
  • Native Orex CR and extended Radlink digitizer support
  • Adaptive Transfer to increase the performance of loading and saving images from clients to the server 
  • Distributed Caching to increase performance and stability when used on high volume networks
  • Security Improvements
  • Refined user roles to improve accessibility and allow for more flexible control of the system
  • Extended audit trails

RIS Concepts, Inc. demonstrated RAD-RIS.

RAD-RIS is a web-based radiology group workflow application fine-tuned for the unique needs of radiology groups reading studies for multiple client facilities. RAD-RIS creates an integrated worklist combining studies across multiple enterprises and locations, while simultaneously interfacing PACS solutions in use at different hospital and clinics. It also features a component for billing clients on a “per-exam” basis, providing radiology groups with a complete business solution.
Features include:
  • Client Facility portal enabling a radiology group’s contracted facilities to manage their own exam workflow using the radiology group’s RIS.
  • Advanced Radiology Group Routing Rules enabling assignment of exams to individual radiologists and radiology sub-specialists by facility, referring physician and modality.
  • Client Contract Management feature designed for radiology groups that bill client facilities for services. This feature includes management and tracking of reading activities by client and provides invoicing reports for contracted imaging facilities. Invoices detail per-exam reading transactions based on contracted amounts for each modality or procedure type. 
  • Radiologist Activity Reports that track the ongoing reading activities of radiologists for use in workload balancing and radiologist payout calculations.
  • Report Distribution through fax and email to both the ordering imaging facility and referring physician. Reports can be printed directly from the system by all users.
  • Referring Physician Portal, enabling group clients to manage their own referring clinicians and allow access to the radiology group system itself as an imaging center referral user. 
  • Exam Report Fax-on-the-Fly allowing client facilities to fax reports from the RAD-RIS when needed.

  • RIS Concepts also announced an OEM agreement with eRad to distribute the RCI product line.  eRad will offer the RCI products as part of an integrated privately branded RIS-PACS solution.

Rogan-Delft showcased its Rogan View Pro-X v3.0 with Mammography, Orthopedic and Rendering packages and Rogan Online XS Archive v6.1 RAIS.

With the new Rogan View Pro-X v3.0 you can Query/Retrieve images through Microsoft Internet Explorer. The same viewing software is available for both radiological as clinical users. The worklist includes image/series thumbnails. Authentication protocols and authorization levels are available for security reasons. Rogan View Pro-X v3.0 also provides an interactive adaptation process especially directed to the radiologist. The Unique Hanging Protocol (UHP) can recognize the radiologist and in consequence presents the UHP in the way that is required by the user.

Rogan-Delft’s next generation View Pro-X v3.0 is available with mammography functionality for the radiologists who desire to use a single application which handles multiple dedicated processes.

At the RSNA Rogan-Delft launched its new View Pro-X v3.0 Ortho with dedicated orthopaedic functionality. Rogan is well renowned for being the oldest independent PACS developing company in the world with dedicated PACS orthopaedic (since 1999).

Rogan-Delft View Pro-X v3.0 brings advanced 3D medical imaging to a wide array of medical specialists and their (multiple) locations. The system can be available for instance, not only in the radiology department but also at home (when you are on call), or at the desktops of medical specialists such as neurosurgeons, cardiologists or orthopaedists. This results in a truly optimized workflow and advanced medical imaging capabilities.

Also, Rogan OnLine XS Archiver 6.1 is a medical image archive and image manager based on next generation requirements. Rogan OnLine XS Archiver 6.1 can deliver any DICOM image uncompressed within a second.

Sage Software, formerly Emdeon Practice Services, showcased the expanded functionality of Intergy RIS 3.5 by Sage and Intergy PACS by Sage.
Intergy RIS 3.5 includes new referring provider marketing fields and diagnosis validation. Intergy RIS 3.5 by Sage offers new alert functions, such as insurance plan alert; referring provider alert and document delivery system status alert; additional productivity reports; appointment limits feature, report approval enhancements; a supervising provider function and more. The RIS incorporates features and dynamic management tools to help users analyze and assess the state of the business.
Intergy PACS by Sage offers improved workflow-based productivity combined with flexible access and innovative tools in an intuitive, advanced Web-based architecture. Intergy PACS harnesses the power of the Web to deliver access to images, reports and patient information from any location—local or remote—at any time, from any Web-accessible PC. Intergy PACS by Sage provides a comprehensive archiving solution within an advanced, on-demand architecture that provides optional clustering for high availability, along with cost effective disaster recovery solutions.

ScImage introduced Version 3.0 of PicomEnterprise and highlighted an agreement for the distribution of Orthocrat's TraumaCad digital orthopedic surgical planning and templating solution.
The new version transitions from enterprise PACS to a complete multi-department workflow system. The unified solution enables exams from multiple departments to be scheduled, tracked, reported, archived and distributed via a single web-based logon by employing a single database to organize varied data from each of these departments. ScImage’s PicomEnterprise is a single web-based system that accomplishes efficient resource and data organization by providing tools for exam scheduling and tracking, web-based conflict resolution, primary interpretation and reporting tools, and results reporting to the designated recipient. PicomEnterprise boasts one database and a shared infrastructure that simplifies workflow for multiple departments. The solution features several time saving and clinical applications for radiology, cardiology, nuclear medicine and orthopedics. 
The agreement with Orthocrat enables ScImage to offer a comprehensive surgical planning application with standards-based, open architecture to streamline integration with its enterprise-wide image management software.

Sectra showed Sectra Control Tower, Breast Imaging PACS, Sectra PACS and Sectra Orthopedic Package.

The Sectra Control Tower management tool provides department managers full control and overview of current production statistics as well as historical data used for trend analysis. New features include live reports, capable of revealing and analyzing bottlenecks in real time. The live reports provide the department manager with instant overview of such selected performance statistics as current queue lengths, patient waiting times and resource usage. The new version of Sectra Control Tower features a full set of predefined reports and a standardized interface that allows customized predefined reports for specific needs. And the new version runs in a web browser and can be deployed and used anywhere at anytime.
The latest improvements to Sectra Breast Imaging PACS facilitate smooth and accurate workflow at breast-imaging centers. The company showed workflow optimization, with blind double reading, CAD capabilities and tight integration with information systems at RSNA.
Sectra PACS is optimized for handling extremely large datasets and provides speed for the user in displaying and managing large stacks. Sectra’s new workstation family presents a solution that enables physicians to perform their work efficiently in a distributed reading scenario independent of network capacity.
The latest version of the Sectra Orthopedic Package adds automatic calibration and new improved semi-automatic hip planning tools to the desktop of the orthopedic surgeon.

Siemens Medical Solutions emphasized workflow optimization within the imaging department, the healthcare facility and across the healthcare continuum. The company unveiled the most current release of its RIS software, syngo Workflow Version 28.0 SLR*.
syngo Workflow Version 28.0 SLR was designed as an easy-to-learn system that focuses on helping customers optimize and streamline their resource and patient care workflows, while assisting them in controlling costs and meeting business objectives.
Specialty Networks LLC of Chattanooga, Tenn., a beta customer for syngo Workflow Version 28.0 SLR, has improved its reporting process dramatically, enabling a 27 percent improvement in radiologist productivity, says Siemens. “With syngo, we’ve replaced 98 percent of paper-based documents for the radiologist, interfaces to third party dictation and third party voice recognition, and all but one transcriptionist,” said Jim Busch, MD, CEO of Specialty Networks. “The efficiencies gained by having a single vendor solution for RIS-driven workflow, voice recognition-based reporting, image call-up and advanced visualization are the primary reasons for the gain in productivity.” Busch added that Specialty Networks has also experienced fewer phone calls for “stat” cases and other status requests secondary to the rapid report turnaround.

Enhancements that have been added in syngo Workflow Version 28.0 SLR and their benefits include:
  • syngo Portal Radiologist, a new Web-based solution that serves as an information and planning center where radiologists are presented with a user interface that is configured according to their role. A radiologist has easy access to patient-relevant information, such as previous reports, lab values and allergies, as well as scanned documents, all in one application window. syngo Portal Radiologist enables users quicker access and improved decision making, such as confirming whether or not the request is appropriate.
  • Increased user-friendliness of paperless radiology workflow with improvements in document capturing and the ability to establish purge criteria for various scanned document types.
  • Improved drop down menus in interactive documents, the primary paperless workflow tool. This increases the number of options viewable in the initial display and reduces mouse clicks, ultimately resulting in time savings for the user.
  • Enhanced ability to store, display and report on allergies, which helps to improve quality of patient care by offering security in decision making.
  • The ability to display notes and related severity levels captured from Clinical Alert processing, which enables users to promptly and appropriately act on the information presented.
syngo Workflow Version 28.0 SLR supports both UNIX and LINUX operating systems; Microsoft Windows-based PCs as workstations; and enhanced Graphical User Interface (GUI) functionality. Through the use of its extensive communication features, document scanning, sophisticated clinical alerts, embedded voice recognition and advanced workflow management, it can help maximize radiological department productivity and resource efficiency.

SourceMedical launched an enhanced version of SourceRad, an integrated application service provider (ASP)-delivered RIS/PACS/Billing system.
SourceRad enables customers to run their imaging businesses with a single solution, improving efficiency with workflow automation yet eliminating traditional capital investments associated with servers, operating systems and IT maintenance. SourceRad has been upgraded to a Microsoft.NET smart client, creating rich application functionality for the user such as drag and drop scheduling and multiple tabs running simultaneous workflows. The improvements enable auto-updating and require minimal network bandwidth. Application functionality enhancements to the product include billing workflow optimization, document scanning capabilities and integrated PACS. SourceRad is fully scalable to the client facility, enabling each radiology facility to pay only for what it uses.

Swearingen Software, Inc. announced Web Schedule Requestor and RISynergy and highlighted a partnership with JulySoft.
The new web scheduling system allows patients and/or referring physicians to request an appointment online at their convenience. The facility's scheduler may then review the requests in real-time and contact the patient to set up the actual appointment. This fully automated system provides more efficiency and convenience for both hospital or clinic staff and their patients.  
RISynergy combines the power and flexibility of RMS RIS with new features including a fully integrated Billing component, streamlined connectivity features, a DICOM Worklist Manager, daily worklist screens, and ongoing Customer Service. The RISynergy Billing module is a fully integrated, robust and flexible component that allows organizations to perform all billing tasks onsite, quickly and effectively. This new feature eliminates double-keying and the need for an outside billing agency. RISynergy offers multiple connectivity options that seamlessly integrates the software with any HIS, PACS, voice recognition software or additional systems. The DICOM Worklist Manager allows communication between the RIS and facility modalities, such as CT, MRI or X-ray machines. The DICOM Worklist Manager closes the gap between the modalities and the RIS, enhancing the system’s ability to manage the daily workflow. The Front Desk, Technologist, and Radiologist Worklists, contained within RISynergy, allow the appropriate staff to view real-time activity and complete tasks by priority in their department and area.
Swearingen’s partnership with JulySoft incorporates the ReminderPro Patient Messaging System into Swearingen’s newly released RISeptionist module. RISeptionist handles routine patient communications, helps prevent appointment no-shows, provides consistent communication, reports patient contact, eases staff overload and maintains a library of prerecorded names and automatically combines multiple calls to the same household.

TeraMedica launched Evercore - VisLite Information Manager.
The system is designed to help solve interoperability challenges in the Visible Light arena. Vislite integrates and manages all (VL) Visible Light Modalities including endoscopy, pathology and surgery, into a single cohesive infrastructure. The information manager then serves this vital visible light dataset to the resident enterprise electronic medical record (EMR) or to the greater Enterprise RHIO/Electronic Health Record (EHR). The integrated clinical focus includes connectivity of visible light data sets with traditional medical images and MPEG2, JPEG, BMP files, in a patient centric context.

Thinking Systems Corporation announced the company’s release of its new plug-in for Philips/Stentor’s iSite PACS. The company also highlighted the new version of ThinkingPACS with supports for the new DICOM 3.0 2006 hanging protocol standard and enhanced support for PET-CT fusion. 
The iSite plug-in was independently developed utilizing iSite’s open API (Application Interface). The new offering provides comprehensive third party PACS solutions to iSite users for all modalities, including PET/SPECT-CT fusion, nuclear cardiology processing and quantification analysis, general nuclear medicine processing and review, PET cardiac analysis, PET brain analysis, 3D/MPR, calcium scoring, cardiac CTA, orthopedic templating, echocardiography, general ultrasound, cardiac catheterization and angiography. The integrated platform enables enterprise-wide access to these modalities.
The new DICOM 3.0 2006 standards establishes the official guidelines for hanging protocol implementation. By supporting the new hanging protocol standards, Thinking Systems will provide interoperability with other systems that support the same standards. In addition, the enhanced PET-CT features include synchronized side-by-side current-prior study comparison; multiple screen layout options; effective use of the large 30” LCD display; real-time SUV, Hounsfield Unit and size measurements; real-time scrolling, alpha-blending, windowing and leveling; and image zoom and pan. The advanced features are available on Thinking Systems PACS workstation and on ThinkingWeb web server to provide real-time PET-CT fusion over the Web.

Toshiba America Medical Systems, Inc. and McKesson Corporation introduced the Horizon Medical ImagingStore 100.
The new mini-PACS solution is exclusively available for Toshiba products, and will enable smaller hospitals and imaging centers that don’t need an enterprise PACS system to store data in a manageable and cost-effective way. Horizon Medical Imaging Store 100 offers the ability to store cases online safely and efficiently, without requiring an enterprise PACS system.  However, should additional storage or a PACS system be necessary as the clinical practice expands, Horizon Medical Imaging Store 100 becomes the building block for full enterprise PACS capability of McKesson’s Horizon Medical Imaging solution. Horizon Medical Imaging Store 100 is compatible with Toshiba’s CT and Ultrasound products, including the Aquilion CT product line and the Aplio XG, Nemio XG, and Xario ultrasound products. 

Viztek, Inc. launched Opal-Rad.
Opal-Rad is a fully web-based, thin-client PACS with advanced image streaming that delivers studies in real time utilizing any available bandwidth Internet connection. The system offers comprehensive image viewing, management and communications features.   
Opal-RAD provides advanced image viewing and manipulation tools, hanging protocols for user customizations and full Modality Worklist functionality. It integrates radiology images, reports, RIS data and other software applications through industry standards such as DICOM, HL7 and IHE.  It provides scaleable architecture to allow sites to add new modalities, users and locations as a practice grows. The Opal-Rad application downloads from a central server and turns any ordinary PC into a diagnostic workstation.