RIS: Streamlining Images and Workflow
Integration was all the rage with vendors showing off new integrated RIS-PACS solutions at RSNA. RIS-PACS fusion is just the tip of the iceberg, however, as vendors touted everything from integrated voice recognition and dictation capabilities to electronic medical record (EMR) connectivity, referring practice portals and financial and management reporting tools. The drive to go filmless and even paperless was apparent this year with a number of vendors showing off new electronic scheduling and document management tools to facilitate the paperless radiology department or imaging center. A few also highlighted expanded features for mammography, orthopedics and cardiology.

Web-based RIS made it big this year; many systems capitalize on .NET architecture for a scalable solution. While hybrid RIS-PACS made a big splash, some vendors continued to amplify the viability and need for best-of-breed solutions.

The need to maximize productivity across the enterprise was apparent, and one of the latest and greatest features for achieving this mantra is the digital dashboard -providing a real-time snapshot view of the department.

(Note: companies appear in alphabetical order.)   

Advanced Data Systems Corp. at RSNA launched the newest version of its ADS RIS.

ADS RIS integrates with the company's practice management capabilities and provides embedded electronic document management to create a more paperless environment while integrating documents directly to the patients' accounts in the ADS system. Other features include modality worklist to help coordinate workflow by modality; mammography, MRI and ultrasound tracking features to oversee and manage these areas; a multi-view, color-coded appointment scheduler for scheduling by patient or exam type; billing, EDI and financial tracking integrated from the ADS practice management system; DICOM and HL7 connectivity; PACS/voice recognition interfaces; bar coding and electronic signature and built-in dictation and transcription capabilities.

Agfa Corp. unveiled Impax RIS/PACS for imaging centers and Impax RIS and also highlighted the European, Australian and South American release of its MediWeb thin-client solution for radiology order communication and results distribution.
Impax RIS/PACS for imaging centers is tailored for the workflow, integration and implementation needs of single and multi-site centers and integrates RIS, PACS, speech, document management, billing and practice analysis. Impax RIS/PACS provides referring physicians with web access to reports and images.
The newly launched Impax RIS includes a full range of reporting and results distribution tools to support the complete radiology workflow. It offers integrated management reporting features, user profiles to minimize training and maximize efficiency and also optimizes use of resources with electronic scheduling, Agfa said. IMPAX RIS increases revenue through automatic billing data transmission and converts historical data from legacy systems as well as integrates with current and future IT infrastructure.

The web-based MediWeb optimizes workflow efficiency beyond radiology. Exams performed in the radiology department can be ordered and followed up from any desktop, and reports and images generated in the radiology department are available to any authorized user inside and outside of the hospital via a web browser. MediWeb has been successfully installed in four hospitals in different European countries where more than 1,000 users connect to the system daily.

AMICAS, the radiology division of VitalWorks Inc., debuted its Vision Series RIS at RSNA.

Vision Series RIS targets imaging centers, ambulatory care facilities and radiology practices. The modular web-based application provides tight desktop integration to AMICAS RealTime Worklist for optimal, personalized enterprise workflow. Patient context sensitive Vision Series RIS screens can be launched from a single click within the action icons of RealTime Worklist. AMICAS demonstrated end-to-end functionality of RIS-PACS-Financials integration, tracing workflow from the moment a patient is scheduled, straight through to the availability of the final report and images via PACS for referring physicians. Tight integration provides all stakeholders full visibility into RIS and PACS, including images and information management, for enhanced workflow. This tight integration to RealTime Worklist is currently in beta testing and will be available for wide release in June 2005. In the interim, AMICAS continues to deliver Vision Series RIS, Vision Series PACS and Vision Series Financials integration through the brokerless interface, but without the capability to launch Vision Series RIS directly from RealTime Worklist.

DR Systems highlighted its DR Systems PACS/RIS Release 7.

DR Systems Release 7 incorporates cardiology tools; "auto pull" of cases and reports; improved RIS interfaces and expanded mammography reading. New features include integrated cardiology PACS, pathology image distribution and smart client technology. The latest release also incorporates smart client technology. This "best of both worlds" technology combines the advantages of thick-client computing-robust application speed, computing power and functionality-and thin-client computing-ease of deployment, automatic updating on all networked computers and a modest software and hardware footprint. Smart-client technology uses web services to enable automatic updating of software applications in the RIS/PACS, enables users to work with web-sourced data with full functionality of the local computer even offline, avoids poor user experiences and network bottlenecks and facilitates data exchange between desktop- and server- based applications.

Eastman Kodak Co. at RSNA debuted its enhanced RIS/PACS suite and showcased a prototype of its RIS 2010 to meet the needs of diagnostic imaging centers.

Kodak RIS/PACS supports native applications such as 3D volume rendering and improves customization of display protocols based on workstation image layout and functionality, so each type study is displayed according to preferences. It enables referring physicians to receive information in emails or embedded in an electronic medical record-with the option to view the entire imaging study via secure, web-based access. Referring physicians also can order and schedule radiology exams and view patient status and history. Other enhancements include an improved graphic user interface, streamlined exam reporting capabilities, an advanced report search engine, improved diagnostic reading and 3D viewing with associated imaging studies on a single workstation. Clinical tools include MPR/MIP tissue definition and vessel tracking functionality. The suite includes KODAK DIRECTVIEW Versatile Intelligent Patient Archive (VIParchive) software for control of PACS-related image and information storage. Kodak RIS/PACS will be available in early 2005.

Looking forward, Kodak showed its work-in-progress RIS 2010 optimized to meet the needs of diagnostic imaging centers. It can be customized to customer needs, including system screens and forms and worklists to support a facility's unique workflow. It will offer the flexibility to integrate referral physicians and individual privileges into workflow via the Web, as well as workflow resulting from the ability to visualize, monitor, and analyze patient status and customized management reports. The system is built on open architecture and will integrate enterprise-wide based on HL-7, XML, DICOM, IHE Technical Framework, EDIFACT, and others.

Eclipsys Corp. previewed its Sunrise RIS at RSNA and shared plans for a new product family-Eclipsys Diagnostic Imaging Solutions.

The full-featured Sunrise RIS is designed to facilitate administration, workflow optimization and best practices in hospitals and imaging centers. It also provides on- and off-site system access for referring physicians, radiologists and transcribers. Sunrise RIS will be available following the acquisition of eSys Medical Systems. Sunrise RIS will be sold by Eclipsys and its distributors as a stand-alone system that can be interfaced with PACS or clinical systems from other vendors.

After the acquisition of eSys is complete, Eclipsys plans to launch a new product family-Eclipsys Diagnostic Imaging Solutions, which will include Sunrise RIS and Sunrise PACS. Sunrise RIS will be integrated with Sunrise Clinical Manager HIS, which will enable clinicians to view patient records, images and reports in real time from anywhere at any time. Sunrise RIS can be interfaced with PACS or other clinical systems.

eSys showcased its J2EE-based version of its web-based RadioLogic RIS with enhanced clustering and caching technologies for scalability. RadioLogic RIS offers new workflow features including QuickSearch and Enterprise Snapshot Subscription Service automated change notification system.

Evolved highlighted its web-based, fully managed RIS/PACS and highlighted its Process2 for radiology and cardiology workflow, Cycle2 and Team2 centralized management solution.

New features on the next-generation Evolved RIS/PACS features include integrated workflow, online dictation/transcription, secure off-site archiving, patient data and scheduling and interfacing. The company also highlighted its implementation support with a managed service approach to RIS-PACS.

Process2  is an integrated workflow engine for radiology and cardiology that automatically tracks an exam from the initial order entry to the signed clinical report. It can link with any HIS to allow ADT, order and report exchange. Modules include reception, technologist, dictation/sign, transcription, patient data and management reports. The dictation module integrates with Scribe2 web-delivered transcription service and View2 PACS.

Cycle2 handles patient registration and scheduling for outpatient clinics and offers customized screening question and medical-related restrictions. Patient tracking monitors the patient's process through the procedure.

Team2 is a centralized managed solution for radiology and cardiology that integrated digital imaging, workflow and information management. It provides full service support and planning, design, integration, installation, testing and training through the digital conversion.

Ferrania Imaging Technologies showcased its LifeWeb RIS 2.1enterprise level web-based RIS and LifeWeb RIS/PACS.

LifeWeb RIS 2.1 offers an intuitive user interface and DICOM structured reporting module, making it possible to access reports and images within the same DICOM hierarchy. LifeWeb supports speech recognition and allows remote access. LifeWeb also is available as part of LifeWeb RIS/PACS, a brokerless solution.

LifeWeb RIS/PACS incorporates a wide range of digital and web-based solutions, including the LifeWeb RIS/PACS. The system facilitates enterprise-wide online availability of images, integrates legacy systems and non-DICOM modalities and incorporates existing archives.

FujiFilm Medical Systems USA at RSNA shared its expanded vision for Synapse PACS to address the blurring of the RIS and PACS market categories.  

Fuji plans to develop a brand-new market category of information systems called "knowledge management" systems. The new development direction, coined Comprehension by Fuji, aims to deal with the spectrum of clinical and business processes as a single, complete, intelligent system that can embrace all evolving requirements of the radiology domain. Fuji demonstrated a "task-oriented" workflow that allows users to quickly navigate to the work that needs to get done, without the need for complex queries. The task-oriented workflow allows users to navigate to and explore through all information, so they can quickly identify and work with information and events pertaining to their role.

GE Healthcare launched its next-generation Centricity RIS/PACS and highlighted contracts to build two all-digital hospitals.

The new system integrates RIS and PACS data into a user-based solution for the radiologist and technologist. According to GE, Centricity RIS/PACS achieves true integration with one workflow engine that incorporates a synchronized RIS/PACS database to unify patient information, a single radiology workflow engine to address the traditional problems of data synchronization and workflow competition between the RIS and PACS and a single user interface that employs wizard protocols and on-line help. Centricity RIS/PACS helps improve radiologist access to information with a digital radiology cockpit. This single, customizable user interface provides comprehensive radiology information. The cockpit eliminates double log-ins and applications, replacing it with a single log-in and look for a complete patient picture. Centricity web-enabled reporting improves turnaround time and provides a secure, high-quality conduit for diagnostic results.

GE also announced that it has leveraged its expertise to create a focused solution to digitize general care community hospitals and recently signed contracts with two new customers to build all-digital community hospitals over the next two to three years. Once the process is completed, the 133-bed Skaggs Community Health Center in Branson, Mo., and another 450+ bed health system, will chart all patient information online. The hospitals will deploy all GE Centricity modules to document nursing and physician care provided to the patient. Patient care records will flow from the emergency department, operating rooms, intensive care units, through discharge and follow up in the physician office. The Centricity modules (results review, CPOE, flowsheets with monitor capture, progress notes, census boards, H&Ps, eMAR) will create a filmless, wireless and predominantly paperless care environment for a faster, more comprehensive information flow.

In addition, the Community Hospitals Network, one of the major care delivery providers in the Indianapolis area, recently announced implementation plans to digitize its Anderson facility. This would make the five hospital IDN (integrated delivery network), a network of providers organized to provide comprehensive services to a community, an all-digital healthcare system by 2007.

GlobalCare Solutions at RSNA launched its Amalga NoCompromise (Hospital2000) RIS/PACS.

Amalga NoCompromise RIS/PACS is an enterprise system that includes an online permanent archive, dictation/transcription, voice recognition, teaching folders, 3D imaging, document scanning and enterprise web delivery. The system is available as standalone RIS or PACS or as integrated components of the company's Hospital 2000 product suite. NoCompromise receives patient demographic, order and appointment information from the registration, appointment and ordering components of the clinic, ward and radiology systems. Integration ensures data integrity, elimination of transcription errors and duplicate data entry and optimizes patient and report turnaround. The system fully supports paperless, integrated workflows. The radiologist workstation provides access to image manipulation tools, and a single database design allows instant access to the entire patient EMR from the reporting workstation, without the need to log on to external systems. Information available includes: all previous laboratory and radiology results, medication profiles and clinical notes. Because all historical studies are stored on line, there is no "long term" archive; all historical films are instantly available for review, improving the quality and efficiency of patient care delivery, the company said. RIS features include integrated ordering and appointment requests, flexible order creation features, bar-coded data entry, customizable order from layout and real-time folder requests, charge posting and inventory deductions. The system also features role-based reporting signout and a critical result flag indicator.

Guardian Healthcare Systems at RSNA rolled out an integrated RIS-PACS called FlowPoint. FlowPoint lets healthcare enterprises combine a patient's medical radiology data and images into one digital record, the company said. The integrated RIS/PACS aligns information technologies with radiology to optimize business and clinical results, employs web services architecture to provides enterprise interoperability and pathways to new enhancements and provides a single application architecture to eliminates integration problems between RIS and PACS. FlowPoint PACS, a set of web services embedded in the RIS, provides radiology patient information, image management and web-based imaging capabilities, and information distribution to healthcare enterprises, including small- and medium-sized hospitals, physician offices and medical imaging centers. It enables enterprise-wide scheduling to optimize radiology equipment and facilities.

IDX Systems Corp. highlighted its acquisition of PointDx, a developer of structured medical reporting technology and introduced the re-engineered ImageCast system.

PointDx technology will be directly integrated into the IDX Imagecast RIS/PACS, IDX said. Structured reporting in RIS/PACS is expected to improve revenue cycle management and efficiency among clinical staff, reduce medical errors and facilitate delivery of a high-quality report to referring providers. ImageCast with structured reporting will enable a structured report with common medical vocabulary and key images, which can be used to electronically launch the full image set. Additionally, the improved report is designed to facilitate improved outcomes monitoring and better position the referring provider to deliver enhanced care. Finally, ImageCast with structured reporting will help automate or remove steps in the coding and billing process to yield shorter turnaround times and improve the revenue cycle. ImageCast with integrated image analysis and reporting capabilities will be available by mid 2005.
The company also showcased the re-architecture of ImageCast. The reengineered product offers specific workflow tools to meet the needs of both radiology and cardiology. ImageCast for cardiology will be launched at ACC 2005.

Imco Technologies introduced a RIS with appointment scheduler, patient tracker and facility management suite.

The comprehensive RIS includes centralized appointment scheduling, patient tracker, billing, electronic medical record (EMR) capabilities and multi-facility database management suite. The RIS functionality is accessible through the IMCO PACS to increase the efficiency of the user. Imco RIS also includes customizable options and reports.

Insight Healthcare Information Systems showcased its OmniRad RIS.

OmniRad software system is a modular RIS with features that can be configured to meet site-specific needs. Modules include practice management, patient care, scheduling, workflow, financial/billing, quality assurance, transcription, marketing, follow-up tracking and results and outcomes. The system offers customizable forms and reports and assists with referring physician and patient communication. OmniRad RIS is designed for small to mid-size hospitals, radiology departments, multi-specialty clinics, free-standing image centers, ambulatory care centers and breast and women's centers.

InStar Systems showcased its best-of-breed RIS for imaging centers, orthopedic practices and small hospitals.

The InStar RIS features .NET with web connectivity, EMR with document management, dictation/voice recognition, mammography tracking, billing/practice management and eHealthcare online services. InStar utilizes business intelligence concepts and a patent-pending Real Time Patient Status Grid to streamline and accelerate patient workflow. The system also includes a Management Report Suite, which provides real-time management and marketing reports. InStar RIS is modular, full featured and scaleable and can be integrated to various PACS, HIS, dictation and billing systems, the company said.

Integrated Modular Systems Inc. highlighted its web-based IMSI Results Generation and Reporting Suite.

The web-based reporting suite allows access to all tools and capabilities of the web-based resulting system with a standard Microsoft PC and internet browser. Radiologists can use voice recognition or wave file generation to generate preliminary or final results. The system can be integrated into the IMSI RADIN PACS and fully interfaced with any HL7 capable HIS, RIS, practice management system or EMR. Daily patient schedules are presented as a worklist. The system provides completely web-based historical data and allows anywhere anytime access.

Merge eFilm highlighted at RSNA its Fusion RIS/PACS integrated single desktop system and several upcoming RIS/PACS product releases.

Fusion RIS/PACS automates, streamlines and integrates RIS/PACS, dictation, document management and practice analysis into a single solution. Images are distributed via the combination of image streaming and RIS and PACS DICOM driven routing methods to allow more flexibility to get images to the radiologist at the appropriate location in less time while optimizing less bandwidth. The results are accelerated productivity, improved profitability and enhanced patient care, the company said.

Merge eFilm also showed a referring practice portal to enable access to reports and images from Fusion RIS/PACS, RIS-driven Fusion eFilm hanging protocols that can be tied to the procedure or radiologist, multi-tiered storage management and new diagnostic workstation features that include key images, thumbnail viewer and integrated CT/PET image fusion.

McKesson Corp showcased its Horizon Radiology integrated RIS/PACS workflow management system at RSNA.

Horizon Radiology, McKesson's web-based integrated RIS/PACS solution, provides seamless management of images and information for gains in workflow productivity from order entry to report distribution. Horizon Medical Imaging (PACS) and Horizon Radiology Manager (RIS) are available as an integrated RIS/PACS, or standalone RIS or PACS using standards-based methods and the IHE framework to interface with other systems. Features include integrated billing, claims optimization, necessity checking, distribution and reporting functionality. Horizon Radiology provides cost-effective scalable solutions for the workflow needs of imaging and outpatient centers, as well as small hospitals or mid to large multi-site, enterprise facilities.

MediTech highlighted its Imaging and Therapeutic Services application.

The Imaging and Therapeutic Services application provides patient exam coordination, financial control features, tracking capabilities, dynamic result reporting, patient retention tools, electronic signatures, management reports and statistics, integration features and image viewer compatibility.  

Misys Healthcare Systems showcased its Misys RIS-PACS and integration between Misys Insight and Misys Radiology.

The Misys RIS-PACS provides comprehensive integration. The solution interfaces Misys Radiology RIS with Misys PACS Integration Module (PIM), Misys Image Management, Misys Insight and Misys Vision. Misys Radiology integrates information, images and voice into a single information source to deliver operational efficiencies. Misys PIM integrates Misys Radiology with any PACS, and Misys Image Management delivers, manages and stores images, reports and associated data throughout the enterprise. The system enables efficient data exchange across the healthcare community; radiologists can turnaround images and reports instantaneously to physicians and other healthcare professional to facilitate diagnosis and treatment.

The company demonstrated its clinical data surveillance systems Misys Insight and Misys Radiology. Used in concert, the two enable timely access to critical clinical information across facilities, which can reduce potential contraindications to reduce medical errors and improve care.

NovaRad Corp. at RSNA debuted its Nova RIS Enterprise. The NovaRIS Enterprise features a patient information system, embedded business rules and complete integration to NovaPACS. It also provides a web-based architecture to support the capability to work either onsite or remotely with no loss of functionality and a web-based scheduler for patient registration and order entry. Other features include patient history, charge capture, billing, reporting, dictation and voice recognition. NovaRIS Enterprise can be configured for single or multiple sites and targets small 20 to 50-bed hospitals to large multi-site hospitals and radiology groups. The system is HL7-based, fully DICOM compatible and HIPAA and IHE compliant.

Philips Medical Systems at RSNA debuted Xtenity RIS. Powered by Epic, Xtenity provides an enterprise-ready RIS that seamlessly integrates with Philips software and medical devices. It features a rules-based scheduling engine, clinical documentation templates and shortcut tools, automated chart capture for referring clinicians and radiologists and integrated speech recognition. Xtenity RIS can be connected with any third-party PACS and HIS, using standards-based interfaces.

During RSNA, Philips showcased integration between the Philips EasyAccess workspots and Philips Xtenity RIS, plus an early look at a work-in-progress to build similar seamless integration between Xtenity, the Philips Brilliance CT Workspace and the Philips Allura Vascular X-ray system. The truly integrated systems including a consistent user interface across the system for enhanced productivity, to improve radiology workflow, enable higher levels of service delivery and ultimately build stronger relationships between radiology departments and referring physicians. Philips Xtenity RIS is aligned with the industry's vision of a total digital healthcare environment; and it is scalable, and customizable, the company said. Xtenity RIS is built from the ground up to enable radiology departments to easily become fully integrated with the entire healthcare enterprise. Philips Xtenity RIS represents the first in a complete line of enterprise and clinical specialty IT solutions, to be launched by Philips at the annual meeting of the Healthcare Information and Management Systems Society (HIMSS) meeting in February in Dallas.

Sectra unveiled its complete Sectra RIS/PACS at RSNA. Sectra RIS/PACS is a complete solution with integrated speech recognition. The company demonstrated the use of Sectra PACS as an imaging platform and used as an integrated part of an EPR/HIS/RIS.

Siemens Medical Solutions showcased the SIENET Cosmos integrated radiology suite and enhancements to its NOVIUS RIS.

SIENET Cosmos integrated RIS/PACS enterprise solution for hospitals and imaging centers enables users across the enterprise to access patient exams and reports from any location in the network with a standard internet browser. The Cosmos workplace features Siemens syngo common user interface and integration with Soarian Clinical Access, providing the basis for an electronic health record (EHR). Soarian Clinical Access gives clinicians browser-based, real-time access to the complete patient record, including images and data. SIENET Cosmos includes a fully integrated RIS component for continuous workflow from exam planning to image distribution and billing documentation.

The company also unveiled enhancements to its NOVIUS RIS. New functionalities include paperless workflow within the radiology enterprise, such as document management for scanning, managing and distributing critical documents; user defined, online "interactive documents" for the elimination of paper forms; embedded support for electronic signature capture; and access to online policies and procedures. Predefined clinical alerts automatically notify users when clinical conditions have been met and help reduce medical errors. And a radiologist-defined clinical workflow includes flexible worklists and extensive teaching folder functionality. A control center measures processes; the 'dashboard' facilitates resource planning through administrative, radiologists, modality and IT monitors. Finally, an Application Programming Interface (API) accesses data from various clinical and non-clinical sources such as HIS, EMR and web pages.

SmartPACS at RSNA launched 3G, a third-generation product that combines PACS, RIS, 3D and orthopedic templating on one platform.

The single database system allows authorized users to access any function. 3G build on the company's Infinitt RIS/PACS, which provides RIS/PACS fusion, a web-based interface, standard compliance, security, customization and statistical report generation tools.

Swearingen Software launched version 4.0 of its RMS for Windows RIS with site and branch code capabilities.
The new capabilities on Swearingen's RMS 4.0 allow multiple branches to use a common RMS program and database. Users can report on a single branch or all branches combined. A hospital system or group of clinics can run RMS from one location, simplifying IT integration and eliminating multiple, independent databases.

WebMD Practice Services highlighted at RSNA Version 3.3 of The Medical Manager RIS, a new agreement with Dynamic Imaging and plans for a new product-Radiology Navigator.

New features on The Medical Manager include email distribution software, technologist productivity