ATL leaps into PACS through OEM agreement with Kodak

Kodak wins access to ultrasound workstation

There are three secrets to success in medical imaging's emergingera of DICOM 3.0 connectivity: integration, integration, integration.ATL of Bothell, WA, and Eastman Kodak of Rochester, NY, appearto have discovered these secrets. The two companies unveiled anagreement at last year's Radiological Society of North Americameeting to merge their respective image management systems. Themove promises to expand the reach of ultrasound vendor ATL intoPACS and to enhance Kodak's offerings in ultrasound image management.

The primary goal of the deal is to enable Kodak's EktascanImagelink PACS product to present dynamic and color ultrasoundimages on its workstations along with images produced by othermodalities. At present, Kodak's workstations can only view staticand gray-scale ultrasound images, a capability added to the systemonly recently.

"Access lets you go beyond just the printing of information,both from an image management perspective and from a clinicalperspective," said Lance Hood, director of Access operationsat ATL. "We are able to insert this (Access) system intothe Kodak product line, and into their installed base."

Access is a PC-based system of workstations and servers runningon IBM's OS/2 operating system. Access uses the DICOM standardinternally as its native networking protocol, rather than usingproprietary internal architecture with a DICOM gateway. Accessreceived FDA clearance last year (SCAN 8/31/94), and ATL plansto begin shipping units in the first quarter of 1995.

Access can transfer any ultrasound image, including segmentsof dynamic color Doppler images, for viewing on a workstationthrough a feature called CineLoop. Other scanner companies havesimilar dynamic capture features, but Access can transfer thesedynamic loops from a variety of ultrasound machines to workstationson a network. Such universal connectivity is a must for Accessto succeed as an ultrasound image management system, because mostultrasound departments have multiple brands and models of scanners.The interconnectivity was also a key consideration in the decisionby Kodak to integrate Access into Imagelink.

"One of the biggest things you can do from a clinicalperspective is to capture segments of real-time information, insteadof just single-frame images," Hood said. "With Access,we retain the look and feel of the exams by capturing segmentsof color flow or cardiac cycles or 3-D sweeps through organs likethe kidney or gallbladder, and then take that information off-lineand look at it on a workstation."

The merger of Access and Imagelink technology will be orchestratedby ATL subsidiary Nova MicroSonics, which is headquartered inAllendale, NJ, and by Kodak Health Imaging Systems of Dallas.The first step for engineers at these companies is to splice theAccess system into Imagelink. Kodak will add the Access 100 workstation,Access network file server and Access acquisition module to theImagelink system. The acquisition module is the heart of the Accesssystem in that it supports the network transfer of gray-scaleand color images from ultrasound systems across the network. Anoption to the module enables the transfer of dynamic image sequencesfrom the scanner to the reading room or physician's office.

The next step will be to merge the technologies into a hybridsystem. To achieve that goal, ATL must extend the power of Accessto provide review capability for all modalities. Doing so willboost ATL to the status of a full PACS provider, which Hood seesas an essential step for widespread acceptance of Access.

"Although many hospitals are starting with image managementin the ultrasound department, their vision involves a system forall modalities," he said.

DEFF, DICOM and ultrasound. What makes this scenario possibleis the recent industry-wide embrace of DICOM 3.0 and ATL's decisionthree years ago to build the Access system on this standard, Hoodsaid.

At the time, DICOM was still in its formative stages and primarilyaddressed networking rather than removable storage media suchas optical disks. To address DICOM's oversight of removable media,several ultrasound vendors, ATL included, were promoting the dataexchange file format (DEFF) as an interim standard (SCAN 4/7/93).Since ratification of DICOM 3.0 in 1993 the DICOM effort has eclipsedDEFF, although DEFF is still useful due to DICOM's lack of a protocolfor removable media.

Despite being an early proponent of DEFF, ATL also chose tosupport DICOM when it became apparent that DICOM would developinto an industry standard. ATL deemed DICOM compatibility so importantthat it delayed the market introduction of Access in order tobuild the system's architecture around DICOM. In addition, ithas used its subsidiary, Nova MicroSonics, as a go-between amongcompetitors, promoting agreements with ultrasound scanner companiesto adopt DICOM.

"In dealing with other ultrasound companies, Nova is fundamentallydistinct from ATL in terms of confidentiality of information andthe ability to interface with other companies," Hood said.

Most recently these diplomatic efforts paid off in an agreementamong various ultrasound scanner companies to use DICOM 3.0 asthe standard for ultrasound image networking. Acoustic Imaging,Aloka, Diasonics and Hewlett-Packard joined ATL in signing onto this agreement, according to Hood. Diasonics, Aloka and AcousticImaging have taken an extra step, agreeing to "market thecompatibility" of Access with their products. The phraseis carefully chosen. In essence, it means they will offer theircustomers equipment to make the installed base compatible withDICOM.

In a move that is especially sweet for ATL, Diasonics and Alokawent even further, agreeing to offer the Access acquisition moduleas an option to their ultrasound product lines, in effect usingATL equipment to make their scanners in the field DICOM-compatible.