Radiology in 2013: The Year of Imaging Software

For radiologists and radiology vendors, the past 12 months have centered on health care reform – would the U.S. Supreme Court uphold the law, and if it did, what would it all mean? With the court’s decision, at least part of that question has been answered. Now, the industry has turned its focus to what can be done in the next year to make practice more efficient and improve how its providers interact with other specialties.

One of the biggest strategies for accomplishing this goal will be the implementation and use of new software offerings, experts say. The increasing use of more complex information in radiology practice has necessitated intelligent systems to more effectively capture and analyze data. Whether the new products impact work flow or patient care, new software developments will play an integral role in how you obtain, analyze, and share images in the future.

According to Eliot Siegel, MD, diagnostic radiology and nuclear medicine professor at the University of Maryland, the bulk of new software capabilities will target enhanced communication, taking how providers share information to the next level.

“So much effort has been put in during the last 20 years to actually get us to the point of being digital and having images available anytime, anywhere and being more efficient in image interpretation,” said Siegel, also the associate vice chairman of informatics. “But relatively little has been done about communicating radiology findings and information that’s important about the patient and making sure we receive return communication that our recommendations have been acted on.”

Within the next year, he predicted, radiology software will meet provider needs by not only recording when studies are completed, reported, and shared with referring physicians, but also by providing feedback on whether referring physicians acted on any radiology recommendations.

Main Provider Desires

A common provider complaint is the difficulty frequently associated with transferring images from one facility to another. In many instances, CDs are lost or referring physicians can’t download the images. Sharing studies between health care systems is also a particular challenge, Siegel said.

“It would be good to see hospitals and clinics having more universal use of images,” he said. “We should be able to transfer images directly and digitally, like sending an email. Only it would be in a safe, secure way from one facility to another.”

The Image Share Network, launched by the Radiological Society of North America (RSNA), is already moving the industry in this direction. Tested at five pilot sites nationwide, this initiative gives patients access to their diagnostic images via a patient health account, enabling them to transfer images to their physician much like they would in their email accounts.

Siegel also predicted the rise of software that can produce better analytics for radiology, as well as enhance natural language processing for radiology reports. Ultimately, he said, an effective system would summarize pertinent information and allow providers to either agree or disagree with the computer’s interpretation of the data. Such a system would offer improved text and structure capabilities.

What’s Coming in Communications Software

One of the most active areas in communications software development is work around speech recognition and natural language processing. Several companies are working to make these tools smarter, Siegel said.

For example, M*Modal and Nuance are developing software that will be able to understand and discern meaning from, and potentially act upon, information included in reports. Montage is also creating software that can mine current and previous radiology reports for specific words, such as pneumothorax, and correlate them with pathology reports.

“I’m really excited about this next generation of intelligent systems that generates reports and makes sure they’ve been read and acknowledged,” he said. “Computers can be useful tools to understand and extract information from the report, act on it, and allow for follow-ups.”

Additionally, many vendors are tackling improved image sharing software, using RSNA’s Image Share as a model. The most important advancement here is that these products will likely be standards-based rather than proprietary. Having a universal solution will allow health care facilities of all types - both in the same and different systems - to share all types of diagnostic imaging data associated with individual places.

Although the solution isn’t yet standards-based, information technology software developer mPlexus introduced its latest product - DICOM RadiX - at this year’s RSNA annual meeting. This automated software shares images and retrieves them from imaging archives instantly. When integrated with other mPlexus products, RadiX can transfer images between facilities, even those in separate institutions.

Ongoing work at the University of Texas MD Anderson Cancer Center has also produced software, called ViSion, for creating easy-to-use, multimedia reports. Like Facebook, the software lets radiologists tag specific radiology images with anatomy and pathology terms and dictated narrative descriptions. The product compiles the data into a single graphical representation of the patient, linking key images to anatomical sites. Providers can also use the software to link imaging results to prior exams, creating timelines for disease and tumors.

According to information on the MD Anderson website, ViSion functions in several languages and can interface with any PACS or image display workstation that uses a Microsoft operating system. The software is scheduled for commercialization in 2013.

Modality Advancements

Upcoming software developments won’t only affect workflow and practice management. Many will impact the efficiency and effectiveness of imaging equipment.

Radiology manufacturer Siemens will release a new software platform for its MR systems, called D13A. Cleared by the FDA, D13A will be a common MR platform and will work with four existing Siemens products: MAGNETOM Aera, MAGNETOM Skyra, MAGNETOM Avanto, and MAGNETOM Verio.

“Our goal is to put the patient first. MR is costly equipment, and there has been a lot of discussion of what the benefit will be, having health care systems pay that price,” said Milind Dhamankar, Siemens senior director of product marketing. “We want to have MR correct at the first step so there’s no need to repeat scans or worry about image quality. The biggest benefit will be the assurance through automation and technology that every study will produce good, consistent image quality.”

D13A will make the company’s existing Day Optimizing Throughput (Dot) technology - software that personalizes and speeds up MR exams - available to the four previously-mentioned MR systems. In this upgrade, the MAGNETOM Aera and Skyra will gain three new Dot engines for breast, spine, and large joint for knees, hips, and shoulders. MAGNETOM Avanto and Verio will have access to all seven Dot engines: breast, spine, and large joint, as well as brain, knee, cardio, abdomen, angio, TimCT angio, and TimCT Onco.

These advancements could also improve your referral base, Dhamankar said. Offering various types of imaging studies, such as cardiac or liver imaging, will make your facility more attractive to referring physicians and patients.

According to Angela Reeves, a product manager at Siemens, the company will also unveil the syngo DynaPBV body imaging application in 2013. This software will introduce 3D functional body imaging in the interventional lab, providing color-coded, cross-sectional blood volume maps. With this product, physicians will be better able to create patient-specific treatments for tumors, she said.

In addition, Siemens plans to make its cone beam CT, known as DynaCT, available next year. Images acquired with cone beam CT are sent to 3D independent workstations for reconstitution through the software’s algorithm within 90 seconds, she said. Providers will also be able to visualize fine structures, such as the inner ear, with the DynaCT micro software that uses a 16-bit detector and a 65,000 grey scale range.

Philips Healthcare will focus its software advancements on accessibility over the next 12 months. Through a new development, customers will be able to reach patient data virtually anywhere without compromising safety.

“Zero-foot print software has great benefit for administrators because if they have a problem, they simply turn off the browser, turn it back on, and link up to the software again,” said Michael Valante, Philips’ director of marketing enterprise imaging informatics. “And, by not loading software onto computers, it eliminates an administrative challenge for IT folks.”

Not having software on a computer or device also offers a patient privacy advantage, he said. Patient data does not linger on individual electronics. Philips plans to apply for FDA 510(k) clearance in January.

How to Choose Software

As with any radiology purchase, choosing new software can be a daunting task. However, it is possible to identify which product will best meet your needs. Siegel advised that you only consider products that have already been tested in other health systems.

“You need to find products that are backed up by people who have actually acquired data to demonstrate the software’s impact and effectiveness,” he said. “I think a lot of products make claims about improvements, but it’s important to have the data to determine whether they are indeed resulting in productivity and efficiency improvements.”

In addition, make sure any software product you choose isn’t an island - it must be able to connect to different systems. Avoid products that can’t facilitate intercommunication or allow your electronic health records to take advantage of other third-party products.

Instead, Siegel said, select products that ensure interoperability. These tools will make it easier for you to incorporate other best-of-breed third-party developments as they enter the market.

“Remember, it isn’t about just finding software that works well with your system,” he said. “It’s important to have products that work across vendors and assume the heterogeneity of departments that will have different information systems and modalities.”