Inside IT Strategies – Moving Radiology Workflows to the Cloud

May 17, 2012 by Leave a comment

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

Last May I was interviewed by Imaging Economics for a story about healthcare trends driving “The Cloud’s Clout” and its application in diagnostic imaging. A year later and many of the issues challenging providers remain the same – an explosion of big data, system consolidation and performance degradation, and scarce IT resources.  Add in healthcare reform, the emphasis on accountable care and value-based purchasing, and cloud is becoming even more prevalent in CIO conversations.

So it’s no surprise that cloud computing continues to dominate the discussion at health IT conferences like World of Health IT in Copenhagen or the upcoming SIIM event in Orlando. And in social media the cloud conversation is at a fever pitch with more than 125 tweets per hour sent with the #cloud hashtag.

But I am seeing a shift in the discussion. When I talk to healthcare CIOs we are no longer focused on cloud computing as a service that provides cost effective image archiving for diagnostic imaging. The conversation has shifted to virtualization of the complete radiology workflow. Can this infrastructure drive scalable performance? Distribute images to remote radiologists?  Provide access to advanced reading tools? Deliver reports to referring physicians? Act as redundant data storage? All while unlocking better resource utilization and lower operating costs?

These CIOs also want to understand how cloud-service providers are collaborating with the IT vendor ecosystem to protect them from technology obsolescence and ensure new levels of data performance, reliability and security. And they demand proof that the cloud’s early adopters have seen the promise of ehealth become a reality.

Our recent collaboration with Intel speaks to the growth and maturation of the cloud in diagnostic imaging. With 10 data centers worldwide and our study count rising to 80 Million, we regularly need to increase our processing power to account for ever-more-detailed images and the larger file sizes they bring. With the Intel® Xeon® processor E5 family, we can significantly boost the processing output that can be achieved with each server. Compared to the previous generation of Intel Xeon processors, the latest models can process images up to 28 percent faster and can handle 24 percent more users.

Watch the video below to see how three diagnostic image providers across the globe are reaping the benefits of cloud in their IT strategy and the impact the Carestream and Intel partnership has on their performance.

 

Enhanced security and disaster recovery drove Orlean’s Regional Hospital to be the first hospital in France to have chosen an off-site data center for medical image archiving and retrieval.

Cloud-based PACS system improves data availability for Klinik Dr. Hancken in Germany.

Renaissance Imaging Medical Associates in the U.S. coordinates the work of many radiologists in multiple locations through a private cloud solution.

How do you think the cloud buzz has evolved? What IT strategies for moving medical images to the cloud have caught your attention?

Filed under Customer Spotlight, Health IT, Health Reform, Innovation, PACS, Radiology, Teleradiology, Videos Tagged with , , , , , , , , ,

Explosion of Data, Need for Consolidated Archiving Prompts CIOs/CTOs to Consider Cloud

May 15, 2012 by Leave a comment

Bruce Leidal

Bruce Leidal, Chief Information Officer (CIO), Carestream

The largest integrated healthcare system in Illinois is investing $40 million in technology to consolidate its data centers into a private cloud. The system’s CTO discussed the project at the Interop 2012 conference inLas Vegas last week.

The staggering sum of $40 million (which represented only a portion of the total equipment investment) highlights the escalating costs created by the explosion of data in healthcare. Imaging modalities—particularly 3D scans such as MR, CT, cardiology, and fluoroscopy exams—are voracious consumers of storage resources. In addition to expanding storage resources, CIOs also need to consolidate legacy departmental systems into a vendor-neutral architecture that achieves efficient information exchange required by meaningful use regulations.

When faced with investing millions of dollars in a new storage platform, many CIO/CTOs may decide to evaluate cloud-based service providers that offer a full spectrum of capabilities and configurations.

Fully featured cloud based services include:

  • A pay-per-use basis; costs are predictable based on imaging/data volumes and does not require an upfront capital investment
  • A delivery of service model that is always available and keep up to date
  • Protection of infrastructure obsolesce over time
  • High service levels versus having to attract and retain top skilled IT infrastructure talent
  • Vendor-neutral infrastructure ensures patient information and images can be easily shared with all authorized users (collaboration with on-site and off-site doctors) or brand of solution regardless of location, as well as integrated into an EMR/EHR.
  • Provide your business users with zero-footprint viewers to expedite access to clinical results via mobile devices (including Apple iPads) as well as PCs or workstations,
  • Maintains ongoing compliance with ever changing regulatory requirements.
  • Ensures business continuity and disaster recovery

CIO’s need to carefully assess their capabilities of providing necessary services and support to ensure the highest level of service with the lowest operational expense. In addition, they must become comfortable with key data being stored outside of the four walls of the business.

Carestream Cloud Illustration

Have you evaluated cloud infrastructure services for your facility? What do you see as the benefits and drawbacks to cloud storage?

Filed under Health IT Tagged with , , ,

The future of breast imaging is in the making.

May 14, 2012 by 2 Comments

Anne Richards, Carestream

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream

Q: Are you seeing more young radiologists going into mammography services? 

A: At mammography conferences and continuing education courses around the world, I’ve been seeing younger participants than in the past. In fact, I’d say that more than half of the radiologists attending a recent seminar in Brazil were under the age of 40.

This is a great trend for the future of our field!

Historically, breast imaging in general—and mammography in particular—has been viewed as a difficult and unglamorous vocation.

It involved the monotonous task of looking at primarily normal images. It has been characterized by a high rate of recalls and retakes, as well as low reimbursement and higher risk of litigation. Compared to interventional radiology and other specialties, it just didn’t have the “wow” drawing power.

So what is attracting today’s up-and-coming radiologists to this area of specialty?

The multi-modality nature of breast imaging may be part of the answer, with mammography, ultrasound, MRI, and molecular imaging being used in tandem for screening and diagnosis. In addition, advances in digital technology are making this a cutting-edge discipline with appeal for younger medical school graduates.

Beyond just the technology, though, there is the point on which we all can agree: screening mammography saves lives. And saving lives is a strong motivator for anyone in the field of medicine.

If you have an open fellowship in breast imaging, let me know. Together, let’s do all that we can to encourage these future luminaries in the making.

What motivated you to go into the field of breast imaging? Who supported you in your efforts?

Filed under Mammography Tagged with , , , , ,

Place Your Guess in the May X-Ray Image Challenge

May 9, 2012 by 6 Comments

Congrats to Jeremy Enfinger, who was this month’s “Guess The X-Ray” challenge winner! Jeremy correctly identified the image as an ipod.

Place your guess in May’s image challenge in the comments.

may x-ray challenge

This month’s “Guess the X-ray” challenge runs until June 4.  The first person to correctly identify the subject of the x-ray will be the winner.

Happy guessing!

Sorry… Carestream employees and their agencies are prohibited from entering. 

Filed under Image Challenge, Radiology Tagged with , , ,

Dream Job: Lead Radiology Technologist for the Dallas Cowboys

May 7, 2012 by 2 Comments

Norm Burgess is entering his 28th season of imaging professional football players. Today he’s Lead Radiology Technologist for the Dallas Cowboy’s home games–a dream opportunity for many rad tech sport fans. Burgess gives us a quick look into game time imaging of professional football players.

 Q: You’ve been a Radiographer for the Dallas Cowboys for some time- what is the best part about this job? 

Norm Burgess

Norm Burgess, lead technologist, on field with the Dallas Cowboys, 2011

A: I’ve been a radiographer for the Dallas Cowboys since 1984, working on game days. I’ve seen so many different coaching styles and team personalities.  I’ve been with them through 8 coaches, starting with Tom Landry.  Each coach brings different approaches and it is so much fun to be right up with all the action!  I’m located on the 30 yard line, Cowboys sideline,  in neutral NFL clothing, waiting for a page. Each game is fabulous, but participating in the 2010 Super Bowl game with the Green Bay Packers and Pittsburgh Steelers was awesome.  We see a lot of celebrities on the sideline from game to game, and they usually hang out standing by me on the 30 yard line.

Q: Tell us about imaging professional football players and the imaging facilities

A: One of the immediate obvious differences is the size of the patient.  Our table is a heavy-duty table designed to hold 1,000 pounds.  We have to adjust our techniques for the body mass of patients that are much larger and have much more muscle than the average person.

All our patients are STAT.  Myself and another technologist work as a team.  One of us with set up the image parameters, and the other will position the patient.  We have a third person that enters demographic data. The images are used immediately by the team physicians to determine if the player can return to the game and if the player needs additional medical attention.

Q: Working with professional football players has to be interesting, during game days, what is most imaged at the stadium? 

A: We are mainly asked to image extremities, ribs, shoulders, knees, elbows and sometimes cervical spines.  The clinicians are looking for fractures. During some games I’ll be on the sidelines for a full quarter then off to start imaging players, sometime until the entire game is completed.  We usually image 8+ players for each team during a game.  The stadium’s digital x-ray room the same size as an x-ray room in any medical center.  Only this one is only used during games.  The stadium is used for some college games, including the Cotton Bowl, so I’ll participate in those events too.  During the football season we’ll be at all the home Dallas Cowboy games and 4 or so college games.

Q: How imaging changed in the past 27 years? 

A: I became a Registered Technologist with the ARRT in 1967 through a hospital based program in Austin Texas.  When I started with the Cowboys, our imaging was film based.  Now we are all digital.  We image for both teams.  At the end of each game we download images to CD/DVD’s of the visiting team to take back with them. During the game we can transmit the images via our PACS to the visitor locker room for them to review on their workstation.  In my wide variety of radiographer roles throughout my career, the commonality is STAT.  The quicker the image is available, the sooner the player can diagnosed.

What is your dream radiology job? 

Filed under Digital Radiography, Radiology Tagged with , , , ,

Healthcare Reform, Digital X-Ray and Continuing Education Opinion from Chile

May 3, 2012 by 2 Comments

Boris Alvarez

Boris Alvarez, project consultant, Medical Technology School, Universidad San Sebastián

Editor’s Note:  Boris Alvarez, project consultant for Medical Technology School, Universidad San Sebastián , in Santiago Chile, shared his thoughts with us on the difference between public and private healthcare, digital x-ray technology and the importance of continuing education and networking.

Q: Having lived in both the United States and Chile, can you give us a snapshot of the differences you see in planned healthcare reforms?

In my opinion, healthcare reforms in both countries address the need to achieve better access to care, especially for those more vulnerable citizens.

On one hand, the USA has been the most important country in the development of technologies for the whole world. This is increasing healthcare costs by transferring research costs to American patients. The US government expects to use strategies that reduce healthcare prices for the population with fewer alternatives to pay for it.

In contrast, the Chilean government is addressing healthcare access through a framework that allows public and private investment to give access to better technology to the people who can not afford it.

I think the biggest challenges for healthcare institutions are in their capacity to adapt to the new scenario. In the American case, institutions must be able to fit their cost structure in order to be more competitive. In the Chilean case, institutions must follow the technologic vanguard, in spite of the limitations in budget of the Chilean market.

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Filed under Digital Radiography, Health Reform, Radiology Tagged with , , , , ,

Don’t Fear Migrating PACS Data from the Cloud

May 1, 2012 by Leave a comment

Robert Mack

Bob Mack, U.S. Manager of Vue Cloud Services, Carestream

The first of a two-part series on navigating the challenges of bringing healthcare data to the cloud from AuntMinnie.com provides suggestions from attorneys Melissa Markey and Margaret Marchak on benefits and risks of the cloud.

In this article a statement from Markey could fuel concerns that it might be difficult and time consuming to move PACS data from the cloud back to an on-site provider:

“The one kind of [healthcare] data that scares me to death going to the cloud is PACS,” Markey said. “If you’ve got your PACS data up in the cloud, that could take months and many multiples of months to migrate back to another provider. I start thinking about that and I get really scared.”

After working with providers for years on PACS migrations, my experience indicates the real issue is storing PACS data using industry standards – and it applies equally to on-site PACS or cloud PACS services. When transitioning from one vendor to the next, problems arise when a facility’s data is locked in a proprietary format.

Cloud PACS service providers should demonstrate their use of industry standards including HL7, DICOM, non-DICOM, IHE (including XDS, XDS-i) and WADO. And every cloud contract should identify a process and cost for migrating data if the contract is not renewed.

For example, Carestream contracts specify that at the end of a cloud contract, all data stored in the Vue Cloud Archive will be returned at no charge. The customer is required to give 90 days notice and engage Carestream to migrate the data to storage media they provide (from a list of compatible storage technologies supplied by Carestream). The amount of data to be transferred is the only variable that has an impact on the amount of time it will take to complete the transfer and return the data to the customer. Carestream will also certify that it has destroyed the provider’s data once it has been transferred.

In the past, data migration has been a costly and cumbersome process. Modern industry standards should solve these challenges, but it’s always wise to get the data exchange process in writing.

Filed under Health IT, PACS Tagged with , , ,

Nearly Forty Years of Radiology Experience: Three Questions with Gary Allbutt

April 27, 2012 by Leave a comment

Gary Allbutt

Gary Allbutt, visiting relief radiographer in North Dandenong, Victoria, Australia

Editor’s note:  We sat down with Gary Allbutt, who is currently a visiting relief radiographer in Cath Labs, Angiography and General Radiography, in North Dandenong, Victoria, Australia.  We asked him a few questions to get his thoughts on changes in radiology over the past 40 years, observed from his vast experience across commercial and regulatory roles as well as administration, training and other specialties.

Q:  You’ve been involved in radiology for nearly forty years. What was radiology like when you embarked in this profession 38 years ago?

I entered Radiography in  1975 as a student in the Royal Melbourne Institute of Radiography (RMIT) three year course for  “External Studies Students,” who were employed outside of metropolitan hospitals across Australia.

From day one, students undertook an apprenticeship, working side by side with experienced Radiographers, absorbing the culture and work practices.  Logbooks listed required examinations and procedures to be observed and conducted with a progression through general radiography of extremities increasing in complexity to procedures such as Angiography, in the final year.

Modalities such as CT and Ultrasound had just started to appear. Early Angiography was undertaken by “Direct Stick” in Carotids and Trans–Lumbar Aortograms. The Seldinger Technique and selective catheterisation was just emerging overseas and major metropolitan departments here inAustralia.  Manual cassette changers and rapid serial film changers acquired sequential images of the contrast bolus’ passage through the vessels.

Looking back the introduction of new technologies and techniques has been dazzling and un-abated. Take radiographic support in theatre for a hip pinning — radiographs from two mobile machines and manual film processing! The advent of Mobile Image Intensifiers made the guidance of internal fixations more accurate and reduced the patient’s time under anaesthetic.

Compound that now with the advent of hybrid theatres with systems supporting neuro surgeons, as well as vascular, orthopaedic and others. This is just one phenomenal area of growth let alone Ultrasound, 3D and Cone Beam technologies. From my early days in 1975 these developments would have been almost inconceivable.

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Filed under Digital Radiography, Radiology Tagged with , , , , ,

Harnessing diagnostic imaging for preventative medicine

April 25, 2012 by Leave a comment

Greg Freiherr

Greg Freiherr, Medscape and Diagnostic Imaging Europe contributor, and consultant to the medical imaging industry.

Guest Post:  Greg Freiherr, a frequent contributor to Medscape and Diagnostic Imaging Europe, as well as a consultant to the medical imaging industry

The medical community goes through phases, usually sparked by a technological advance or change in sociopolitical thought.  The most recent, preventative medicine, evolved from the age-old idea that a stitch in time saves nine. This might be true…but conventional thinking is not going to make it so.

A case in point is the work of Dr. Robert Grant, a UCSF professor of medicine and researcher at Gladstone Institute of Virology and Immunology. Grant and colleagues proved more than a year ago that gay men who were HIV negative could substantially decrease their risk of contracting the AIDS virus by taking the antiretroviral drugs otherwise used for treatment. The same arguably might be accomplished by heterosexuals. The problem is money.

Antiretroviral drugs are not cheap. If their prophylactic use were applied widely at current drug prices, preventing HIV would be more expensive than treating its victims. Money aside, however, Grant’s research proved that prevention is possible. All it needs is a politico-economic catalyst. This got me thinking.

I was reminded of how great ideas start. From the light bulb to the airplane, early attempts have always produced less than practical results. Who of us would try to read beside a light bulb whose filament burned out in seconds or get on an airplane that crashes less than a minute after takeoff?   The point is that first attempts are just that – starting points from which the underlying idea is refined. In most of these, it’s the technology that advances.  But why not the politico-economics?

Medical imaging cannot play a substantial role in preventative medicine of the future, if applied conventionally.  By definition, medical imaging is diagnostic. And it’s expensive. Efforts are underway to refine the use of PET to use biomarkers of disease that may appear years before clinical symptoms.  But, like the antiretroviral drugs that prevent HIV infection, a new generation of PET agents will be deemed too expensive to use to screen for the earliest signs of disease.

If imaging is to be a tool in preventative medicine, more than just the underlying technology needs to develop. The imaging community has to think unconventionally to find cost effective ways to apply “diagnostic” technologies to prevent disease.  We must define the advantages that the visualization of these biomarkers provide over simple in vitro tests and then come up with a strategy for their use as part of an intelligent approach to reducing the overall cost of medicine.

This is by no means impossible. Diagnostic imaging has already played this role, dramatically reducing the cost of healthcare while increasing patient safety compared  to practices common only a few decades ago, when exploratory surgery was the go-to modality for resolving clinical unknowns. Succeeding at this next challenge could redefine medical imaging for generations to come.

Filed under Innovation, Radiology Tagged with , , ,

Innovative Technology Makes Dose Reduction Affordable

April 23, 2012 by Leave a comment

Houston HealthcareEditor’s Note:  Houston Healthcare in Warner Robins, Ga.  recently installed six CARESTREAM DRX Systems to streamline image delivery. We asked Tim Sisco, Director of Cardiovascular and Imaging Services at Houston Healthcare, to talk about the impact converting from CR to DR systems has had on their dose reduction efforts. 

Our diagnostic imaging team at the 237-bed Houston Medical Center and Houston Healthcare outpatient imaging center knew that when we converted our CR systems to digital radiography with Carestream wireless DRX detectors we’d see a dramatic difference in how quickly we can provide access to images—an important asset for critically ill and injured patients.

But we didn’t anticipate the dose reduction would be equally dramatic: 40% for in-room and portable systems.

We converted two portable imaging systems serving ER and ICU patients and three general radiology rooms, along with the installation of a new automated DR suite in Houston Medical Center’s busiest exam room that handles ER patients.

As we implemented the new wireless detectors, our staff immediately recognized the potential for dose reduction. We recalibrated our X-ray systems to create an accurate automatic exposure control (AEC) for procedures that use the bucky. Our technologists have also reduced exposure techniques for tabletop and portable exams.

This dose reduction supports our efforts to comply with the Joint Commission’s Sentinel Event Alert on Radiation Risks of Diagnostic Imaging. Our radiology managers and technologists have been educated on how to discuss dose reduction with patients and when speaking with representatives from state, Joint Commission, FDA or other regulatory agencies involved in patient care.

Carestream DRX-1 SystemOur staff is pleased that we are able to enhance patient care by implementing technology that reduces dose.

What have you done to reduce patient dose?

Filed under Customer Spotlight, Digital Radiography, Patient Safety, Radiology Tagged with , , , , , ,

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