Trend Tracker | SCAR at 25

The Society of Computer Applications in Radiology (SCAR) meeting - which takes place in early June this year - is now firmly established as the principal PACS industry meeting, supplanting RSNA and AHRA with a sharp focus on all aspects of radiology IT.  Much like the HIMSS annual conference in February, this meeting continues to expand in size and stature. While attendees may focus on both the educational sessions and exhibits, there is always a collection of interesting topics at the leading edge of computer applications. Visual perception appears to be the most interesting topic this year.

If you are considering a PACS investment or upgrade (isn't everyone??), then a trip to SCAR (and HIMSS in 2006) is an essential part of your work plan. Now that the era of free-standing PACS has passed, the challenge is building interoperable networks for efficient workflow and information exchange. The major issue - unresolved at present - is the patient EHR, where universal standards and protocols are still being wrestled to the ground. Another year or two, though, and this should be done. However, there is no reason to wait, just proceed with caution - remembering that any software version numbered x.0 includes only bugs that have not been found prior to release.

Enterprise PACS

One of the major topics continues to be the relatively strong rate of PACS installations and upgrades. This is directly coupled with the continued extension of PACS into the broader healthcare enterprise of referring physicians and other specialists who perform imaging studies. The move to enterprise level systems has rudely exposed some of the existing weak links in PACS - bandwidth, workstation design, workflow, security, access and reporting. In fact, PACS has caused a revolution in radiology, especially noticeable in productivity and responsiveness. Less time wasted, no lost files, no place to hide when a report is late - this all spells good news for patients and referring physicians alike. OK, so there is a slight wait while you reboot the computer, or kill the occasional virus.  However, the infrastructure challenge of more studies, larger data sets and the need for 3D diagnostic tools is straining most legacy systems and archives - choking is probably a better term here. Thus, there exists a strong need at most facilities to set aside investment dollars on an annual basis to keep your current PACS up to date, so it remains capable of handling the expanding imaging workload.

Exhibitors in brief

As expected, a large number of PACS and healthcare IT vendors will be on hand at SCAR to demonstrate a wide range of products and services, both hardware and software. My unofficial breakdown of exhibitors suggests the following categories:

Traditional PACS vendors - There is a clear move by imaging companies to offer enterprise level software (EHR) and by enterprise IT companies to offer imaging software (PACS for radiology and cardiology).

EHR - An estimated 50 established and startup companies demonstrated electronic health record (or patient record) systems at HIMSS. Only a subset will be at SCAR, as the market appears segmented by the scale of the healthcare provider operation - large hospitals, small hospitals, small private practice and larger group practices.  No single company dominates all of these market segments.

Storage - New magneto optical drives and other storage options are ready to go, as the cost of storage continues to drop. However, there is increasing attention on the design and management of storage archives and the appropriate network infrastructure.

Clinical Content/Knowledge Software - A few exhibitors will demonstrate plug-in and standalone software that offers clinical content information.

Mobile Devices/PDA - Look for tablet PCs and handheld devices (PDAs) for medical applications. One recent survey from HIMSS noted that tablet PC usage was continuing to increase in healthcare applications. When combined with patient charting software, this looks to be an ideal application.

Archive and Networking Systems - Hardware and Software - There won't be much to see at SCAR, but there are ongoing developments at Cisco, ByCast, Kodak and TeraMedica.

Wireless - Wireless security and wireless network products are a must-see for physicians and techs on the go.

Workflow/Document Management - The exhibitors in this category offer a range of products that include printing, CD burning and paper scanners, since the digital networks still need to manage the import and export of data to/from healthcare providers that are not linked into the network.

Security - Check out software and devices that focus primarily on access control and identity management, such as biometric devices.

Consulting - Some large and boutique consulting firms offer to counsel hospitals on navigating their way to acquiring and utilizing both PACS and healthcare IT. Only you know how much expertise to seek out.

Other - Check out the variety of mobile computer carts, language translation software, middleware and transaction software, too.

And don't forget to wish SCAR a happy 25th birthday.

Douglas F. Orr is principal of J&M Group. Send Trend Tracker questions and comments to