Information integration and expanded access were common themes among exhibitors displaying healthcare information technology (IT) products at the 2006 Annual Healthcare Information and Management Systems Society Conference & Exhibition (HIMSS06), held February 12 to 16 in San Diego, CA. Picture archiving and communication system (PACS) vendors were particularly focused on breaking down barriers of access and bringing more capabilities to more users, regardless of location. The following are highlights from a few such exhibitors.

Siemens highlights continuum of care

"Patient care is no longer about one doctor's office or one hospital bed," said Tom Miller, President, Healthcare IT Division, Siemens Medical Solutions (Malvern, PA). "It's about care delivery occurring across multiple settings and among interdisciplinary care teams, each with a network of collaborative support systems that must act in a coordinated and timely manner."

Addressing that issue, Siemens' exhibit featured the company's newest workflow-driven health information solution (HIS), Soarian. According to the company, Soarian marries clinical and administrative cycles with integrated image acquisition, radiology information systems (RIS), PACS, and the postprocessing capability of the syngo Suite in a single system. The longitudinal clinical repository provides clinicians with real-time, browser-based access to all images as well as patient histories, demographics, allergies, and test results.

The system also features embedded analytics designed to continuously monitor and measure key business drivers and identify areas for improvement. Web-based push technology allows the system to notify users when new information relevant to their role becomes available. It also automatically pushes an alert to the appropriate end user when the system determines that a metric is outside the acceptable range of performance. Once corrective actions are taken, the system can monitor progress toward the defined goal.

Cedara focuses on integration

The theme for Cedara Software (Mississauga, Ontario, Canada), a Merge eMed company, was integration of image data and multiple clinical information sources on a single desktop, throughout a single enterprise, or from sources across the globe.

As part of that theme, the company displayed the Cedara I-Reach, a Web-based DICOM server designed to provide access to relevant information in the proper context accompanied by clinically relevant tools. This solution securely provides Internet-based remote access to images, reports, and workflow and administration tools. The scalable, thin-client format allows for integration with HIS and RIS as well as original equipment manufacturer (OEM) archives. It provides basic image manipulation and measurement tools and access to current and prior images using the same user interface as the Cedara I-SoftView system. Images are compressed using DICOM JPEG 2000 techniques to facilitate loading and display of large data sets across low bandwidths.

Advanced functionality is available in a variety of options, including multiplanar reformatting (MPR) with thick slab support, maximum intensity projection (MIP), 3-dimensional (3D) volume rendering, batch reformatting, and curve reformatting. Orthopedic tools and templates are also available and include specialized tools, such as image relation and Cobb angle measurements.

Cedara also showcased its new Clinical Control Center (C4) designed to allow the user to launch independent viewing applications from a single patient worklist through the use of configurable protocols. According to the company, this capability offers the seamless integration of third-party clinical plug-ins from any vendor. At HIMSS06, Cedara demonstrated the system by using a range of the company's own viewing applications, including Cedara PET/CT, IllumiView, OrthoWorks, I-Response, PrimeLung, and CalScore.

"Cedara's toolkit approach to integrating imaging data and clinical information significantly expands the value and availability of patient information," said Cedara President, Brian Pedlar. "Workflow, integration, and information exchange represent an important piece of the solution for electronic medical records, system integrators, and process management companies. Any healthcare IT provider that wants to broaden imaging revenue opportunities within its customer base or is faced with the challenge of providing tight integration between image data and multiple clinical information sources on a single desktop will find these tool-kits of value."

Amicas enhances Vision PACS

At HIMSS06, Amicas, Inc. (Boston, MA) highlighted several enhancements to its Vision Series PACS, including a secure portal for referring physicians to obtain real-time status and results without dedicated hardware or software.

Vision Reach, a new distribution feature, was designed to enhance communication between radiologists and referring physicians (Figure 1). This feature provides a secure connection for the display of key images, including annotations, reports, and relevant histories through a zero-installed, client-free Web-based application. Vision Reach integrates the radiology report from the RIS with key images from the PACS and creates a single multimedia report. Then, using common e-mail and secure messaging, the system alerts the referring physician that the report is available on any e-mail-enabled device, including personal computers and Blackberry-type devices.

"While PACS adoption has been tremendous, technologic barriers such as system downloads, plug-ins, and challenging security issues have hampered the widespread adoption of PACS by referring physicians," said company President, Peter McClennen. "Our research indicates that a PACS is generally used by <10% of a facility's referring physicians. Referring physicians do not sit at desks with high-end computers. They are highly mobile, working at numerous facilities without widespread computer access."

"By eliminating installation and any client-level application requirement, we are able to reach a tremendously wide range of referring physicians with this exciting new product," said Kang Wang, PhD, Vice President of Research and Development.

Amicas also showcased the Vision Watch feature. This Web-based tool provides automated, proactive quality of service, business decision support, and system health monitoring of the Vision Series PACS and can be accessed on any computer throughout the enterprise. It includes study tracking and provides statistics and graphs showing timeliness and consistency of study delivery as well as reports, statistics, and graphs designed to aid in business decision making.

Fuji previews 3D viewing software

FUJIFILM Medical Systems USA, Inc. (Stamford, CT) previewed, as a work-in-progress, the company's new integrated 3-dimensional (3D) software package, Obliquus. Designed as a component of Fuji's Synapse PACS, the software provides MIP and MPR capabilities.

Obliquus was designed to be an integral part of the Synapse PACS, allowing interactive performance and diagnostic image quality to be accessed throughout the system using the standard Synapse user interface.

"This 3D component is a step toward the realization of Fuji's Comprehension Vision, which is our strategy for expanding Synapse to cover all the functions of traditional systems such as RIS, mammography, 3D, and reporting and decision support in one comprehensive system," said Clay Larsen, Fuji's Vice President, Marketing and Network Development. "It allows users to maintain productivity by staying inside the Synapse application while still accessing 3D functions."

"While it provides all the basic diagnostic 3D functions that radiology uses today, this new component is a stepping stone on our path to the complete Volume Exploration component of Fuji Comprehension," added Bob Cooke, Executive Director of Marketing, Network Systems. "Modalities are producing ever-increasing amounts of volumetric data; increasingly, new ways to visualize that information will become critical to the diagnostic process. While this 3D component delivers integrated MIP/MPR, Volume Exploration will offer fully integrated and high-resolution, interactive visualization, providing a complete tool for radiologists."

Obliquus is currently available internationally to customers using Synapse version 3.1.1 or higher. Both Obliquus and Volume Exploration still require U.S. Food and Drug Administration 510(k) approval before becoming available in the United States.