Integration moves into PACS and IT booths at RSNA 2004

Healthcare grows more complex and unwieldy with each innovation. Faster CTs, hybrid imaging, 4D ultrasound, and digital radiography threaten to overwhelm practitioners with data. Better communications offer some hope.

At this year's RSNA meeting, exhibit-goers will see products and services aimed at integrating the varied and multifaceted technologies that have come to characterize modern medicine. Servers will route data among the medical fiefdoms, desktop workstations will advance processing with a single click, and storage solutions will offer ways to not only keep up with it all but back it all up.

McKesson will unite image and information management with a RIS/PACS that automates workflow and digitizes the patient record. Embedded in this product, called Horizon Radiology, will be answers for radiology, cardiology, endoscopy, and other clinical specialties. The Web-based RIS/PACS integrates billing, claims, data distribution, and reporting functionality in configurations that can be stretched to handle imaging and outpatient centers, as well as small hospitals or large multisite enterprises.

The RIS and PACS components use standards-based interfaces and the Integrating the Healthcare Enterprise framework to work with other systems. The PACS includes a Web-based single-view workstation and enhanced tools for nuclear medicine, orthopedic templating, and 3D imaging.

Merge eFilm will demonstrate a single-desktop solution of its Fusion RIS/PACS that automates and integrates RIS, PACS, dictation, document management, billing, and practice analysis workflow. The system, commercially launched in July, distributes data through image streaming, as well as DICOM-driven routing methods.

Philips will bring together under its Vequion approach to IT far-flung imaging modalities: the Allura Xper cardiovascular x-ray series, Intera Achieva MR, Eleva general radiography, Brilliance CT family, and ViewForum workstations as well as a new RIS for the North American marketplace that will be unveiled at the meeting. Powered by Epic, the RIS meshes with Philips' EasyAccess PACS or any third-party PACS.

Synapse version 3.1 from Fuji will include advances in CT image processing and DICOM query and retrieve functionality when interfaced with non-Fuji PACS. The new software version will be joined at Fuji's RSNA booth by a work-in-progress being designed to visualize volume-based exams such as multislice CT.

Kodak will unveil the latest version of its RIS/PACS suite, which supports native applications, including 3D volume rendering, and allows improved customization and the ability to save display protocols. The RIS/PACS, which will be available in early 2005, will enable referring physicians to receive information the way they want it with radiology reports e-mailed or embedded in an electronic medical record holding key marked images, with the option to view an entire imaging study via secure Web-based access.

Siemens will showcase Sienet Cosmos, a RIS/PACS shown as a work-in-progress at last year's RSNA meeting. The system allows users to view exams and reports from any location in the network with a standard Internet browser. Cosmos features the Siemens syngo user interface and can hook up with Soarian Clinical Access, which provides real-time access to electronic patient records.

Dynamic Imaging's Web-based PACS, called IntegradWeb, will feature a new Fault Tolerant Grid Architecture that assures continuity among multisite PACS deployments if the network crashes, allowing each site to function independently. Once the connection is reestablished, the architecture automatically resynchronizes each site with the central server to ensure integrated image access and workflow across all locations.

TeraRecon is promising distributed user-friendly 3D applications through its AquariusNET 1.5. Enhancements include bone removal, vessel analysis, improved procedural workflow tools, and volumetric support for images acquired from 64-slice CT. Several other vendors are taking advantage of these capabilities, integrating the AquariusNET server with their own PACS to achieve access to real-time 3D, MIP (maximum intensity projection), and MPR (multiplanar reconstruction) tools.

At RSNA 2004, Agfa will demonstrate the integration of the AquariusNET server with its Impax Enterprise Suite PACS, as will Amicas with its Vision Series Web-based PACS. TeraRecon will demonstrate these interconnections at its booth, as well as a new computer-aided detection server designed to host CAD engines offline. The CAD algorithm behind this server was developed in collaboration with iCAD for lung nodule detection. Clinical testing of the integrated system began this year, and a premarketing approval submission is planned for 2005.

Insight Sciences will unveil its MW Series Mobile Workstations in the RSNA Mobile Computing Pavilion. These workstations combine desktop power with notebook portability, providing rapid processing and enhanced 3D graphics. Insight claims its workstations run up to four times faster than most systems currently used in radiology and PET centers. The workstations can be prebundled with FDA-approved software, including 3D-Doctor, an image rendering, modeling, and analysis package by Able Software, and 4D-MSPECT, a premier myocardial perfusion and function analysis package from the University of Michigan.

The explosion of medical data amid federal regulations regarding patient privacy has energized the search for better storage. At the RSNA meeting, Communication Synergy Technologies will show how its new document preservation and archiving technology works with the company's InForm RIS, allowing compliance records to be easily kept, preserved, and retrieved.

InSiteOne, a provider of on- and offsite secure DICOM storage, is expanding its disaster recovery offering to provide data protection beyond DICOM images. The new service, called InDex Recovery Plus, addresses all medical data, including the databases that drive PACS and HIS/RIS systems. Recovery Plus will back up data on a client's storage area network or on individual servers.

Blue lasers create light with a shorter wavelength than the traditionally used red lasers, allowing more data to be stored in a smaller space. Two companies have announced the development of storage technology based on these lasers. Plasmon claims its ultradensity optical technology can store 30 GB on a single cartridge - three times the capacity of DVDs and magneto-optical media. Sony claims it can pack 23 GB on a single-sided disc with a technology that boasts 11-MB/second-read and 9-MB/second-write speeds. Plasmon and Sony will both feature products based on blue laser technology at RSNA 2004 in the context of plans to develop subsequent generations that within several years could store up to 100 GB on double-sided media.