Technology and Industry: Healthcare information technology: Report from HIMSS 2004

By Kathleen M. Dallessio
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The 2004 Annual Healthcare Information Management Systems Society Conference & Exhibition (HIMSS 2004) was held at the Orange County Convention Center in Orlando, FL, February 23-26, 2004. One of the largest healthcare information technology (IT) conferences, it attracted approximately 20,000 healthcare professionals and included 715 technical exhibitors, many focused on providing solutions designed to deliver combined management and storage of images and patient information.

InSiteOne debuts on-site DICOM storage solution

For large medical facilities, InSiteOne (Wallingford, CT) introduced a new Storage Area Network (SAN) solution, which manages digital image data and enterprise-wide information storage. Built on the HP StorageWorks Enterprise Virtual Array (EVA), the SAN option is an enhancement to the company's InDex Nearline solution.

Designed for facilities with data-intensive needs, this SAN provides rapid-access, on-site storage to complement InSite's offsite DICOM archives for long-term storage. With the new system, images are stored on-site as they are acquired, currently on RAID proxy servers, with the new HP StorageWorks SAN providing another option. A copy of the image is automatically sent to InSiteOne's mirrored data centers in Arizona and Connecticut for permanent storage and disaster recovery.

Jim Champagne, Senior Vice President at InSiteOne, noted that, in addition to accommodating ultra-large radiology or cardiology image files, HP StorageWorks provides ample storage for data from a range of additional healthcare IT applications. "The complex demands of DICOM and the data sizes of diagnostic images typically drive the choice of a storage solution for institutions," he said. "Now this solution offers DICOM storage with the flexibility and capacity to store data for the enterprise."

GE Healthcare highlights radiology/cardiology system

GE Healthcare (Waukesha, WI) showcased its new Centricity Enterprise Image & Information System (EiiS) family of products at HIMSS 2004. This system combines radiology and cardiology image storage and allows users to access patients' images, reports, and waveforms from a common, secure system, which is viewable from any secure personal computer.

"We're seeing high demand for a combined radiology/cardiology approach, as it integrates what had been disparate islands of information into a common system," explained Vishal Wanchoo, Vice President of Imaging & Information Systems for GE Healthcare. "Now there is only one image and information system for the IT department to install, support, maintain, and update. Although it is one system, it has the sophistication to address the unique needs of these different clinical users with dedicated radiology and cardiology workstations."

The customizable radiology workstation was designed to handle large data sets and features a dedicated radiology toolset that includes three-dimen-sional, maximum-intensity projection and multiplanar reconstruction capabilities. The system can be accessed through portal and EMR applications and can be connected directly to the EMR system via a standard URL.

IDX showcases Imagecast

IDX Systems Corp. (Burlington, VT) featured its Imagecast Image Management fully integrated, single-database RIS/PACS solution at the meeting. Imagecast PACS was designed as an enterprise-wide image management system and uses the company's Web-based Enterprise Access. This image management system distributes images to referring providers throughout the enterprise over existing network resources.

Because the Imagecast PACS does not have its own database, all RIS and clinical information displayed in the PACS is taken directly from Imagecast version 10/Imaging Suite database, upon which the system is built. This seamless integration allows the RIS information to be accessible from all aspects of the PACS system, including the reading workstations and Enterprise Access.

With an installed base of more than 730 sites, the system features a Web-based architecture, proactive support, just-in-time viewing technology, and security features. It employs a single, integrated, fully documented standards-based relational database with dozens of workflow-driven trigger points for automated custom report printing, faxing, and e-mailing. The system is also scalable in two ways: scale-out and scale-up. The scale-out approach allows the system to scale multiple users by establishing a load-balanced server farm where application servers can be added as demand requires. It also supports the classic scale-up model, placing all services on a single clustered or stand-alone SMP-based server.

The system's Interface Workflow Manager handles HL7, DICOM, XML-Web-Services, and MSMQ, MQ-Series messages and is able to use any combination of data from the RIS database to route images. Real-time image distribution across in-house networks and the Internet is accomplished using the just-in-time iSyntax technology running in a standard Web-browser client, allowing for instant image display across the enterprise. For security, the product line supports 128-bit SSL encryption, desktop security standards for single sign-on implementations, and Internet encryption for e-mailed reports.

VitalWorks and Amicas highlight combined technology

VitalWorks Inc. (Ridgefield, CT) featured the RadConnect RIS and the Vision Series PACS from Amicas, now a wholly owned subsidiary.

Built on a Web- and Java-based platform, RadConnect RIS is the core component of the company's integrated RIS, PACS, and radiology billing system. It features a browser-based graphical user interface, the ability to integrate with Internet-based products, and platform-independent operation.

According to the company, RadConnect RIS is a "no-client" application that can run on a standard Web browser and requires no client installation. System management and updating can be performed at a single server.

The system also features patient flow monitoring, recommended diagnosis codes, online physician report approval and electronic signatures, report auto faxing and e-mailing to referring physicians, a bar-coding option for film tracking, transcription and physician review, an electronic interface to a mammography tracking system, and voice file storage with patient data.

The company also highlighted the unified solution of the RadConnect RIS and the AMICAS Vision Series PACS. This Web-based system provides a unified, distributed workflow that eliminates double entry and the need to work with separate systems to obtain needed information and images. The RealTime Worklist technology integrates and automatically updates data on all system displays.

Kodak showcases PACS, secure e-mail, and more

Eastman Kodak Co. (Rochester, NY) highlighted its latest information management enhancements for their DirectView PACS System 5 at HIMSS 2004.

The company's new DirectView Versatile Intelligent Patient Archive (VIParchive) was designed to provide enterprise-wide management of DICOM and non-DICOM images and information across multiple storage devices and locations. In addition to addressing PACS and cardiology information needs, the software system can manage the information storage needs of a variety of back-office systems, including purchasing, inventory, and other records systems.

According to Kodak, this scalable, vendor-, media-, and technology-neutral system can be integrated throughout a healthcare system's existing IT infrastructure to provide dynamic and transparent lifecycle management of information. In fact, the company claims, "this platform is so scalable that it can manage almost any amount of information and a virtually unlimited number of storage devices from multiple vendors."

VIParchive is currently available in Europe and is expected to be available in the United States in the second quarter of 2004. At the same time, the company also expects to launch a new content-addressed storage (CAS) system in conjunction with EMC Corp. (Hopkington, MA).

The Centera CAS system was designed to provide rapid, online access to fixed content at a cost comparable to tape library or optical jukebox storage systems. When used together with the VIParchive software, this new system allows information to be readily accessible during the time period when it is most frequently reviewed. The VIParchive software reads the DICOM file headers and applies site-specific storage plans to move or copy information to online, near-line, or offline storage systems, as well as to delete data after the necessary retention period has elapsed.

"Combining Kodak's VIParchive platform with EMC's Centera storage system enables IT staff to trim administrative costs associated with storage management without sacrificing system performance," said L. Jeffrey Markin, General Manager of healthcare information systems and Vice President of Kodak's Health Imaging Group.

Kodak also unveiled a new registered e-mail feature for KODAK Secure E-Mail Service that addresses privacy concerns when sending e-mail messages containing patient information via the Internet. The new feature notifies the sender of the time and date that the recipient opened the e-mail.

"Radiologists need assurance that referring physicians have received a diagnosis or other information about their patients, and referring physicians need confirmation that their patients have reviewed e-mails that contain treatment information or other important instructions," said James M. Keese, Kodak's Health Imaging Group's Chief Privacy Officer.

The system encrypts the messages in <0.1 seconds and is compatible with any SMTP mail system. It also allows security administrators to implement virus scanning, content filtering, and message archiving.

"Our Secure E-Mail Service enables healthcare providers to communicate with payers, patients, and physicians while meeting HIPAA privacy and security rules for protecting patient-identifiable data," noted Patrick Faure, Privacy and Security Program Manager at Kodak. "This service can be managed at the customer site or through a secure remote interface." Faure reports that future service enhancements are expected to include doctor-to-patient communication, drug prescription delivery, and digital signature capabilities.

Finally, a new tool kit was introduced that will allow Kodak engineers to rapidly integrate the PACS System 5 platform with selected vendors' radiology information systems (RIS), electronic healthcare record (EHR), electronic medical record (EMR), dictation systems, and other information management systems. Once this integration is complete, users can access and view information from RIS or EHR/EMR systems from PACS System 5 workstations, without the need for multiple computers and separate sign-in procedures for each system.

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Technology and Industry: Healthcare information technology: Report from HIMSS 2004.  Appl Radiol. 

April 13, 2004

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