PCORI Punt is More Than a Bit Ironic

January 26, 2012 by Lena Kauffman

Those waiting to see if the Patient-Centered Outcomes Research Institute (PCORI) would make any facet of radiology part of its initial focus were disappointed—or relieved—Monday when the independent research organization issued its first set of research priorities.

The five research “priorities” issued by this Accountable Care Act created organization were so vague in nature and low on specifics that almost any comparative effectiveness research could qualify as something the institute would consider funding. You can click here for a PDF of the full report. Skip to the research agenda part and you’ll find that PCORI will focus on funding research on comparisons of prevention, diagnosis, and treatment options.

Really? After two years and multiple board member meetings at costly hotel conferences across the country is that all the institute’s leaders could...

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Money, the Fairest Incentive of All

January 23, 2012 by Robert Cooke

Having the government provide incentives, or even penalties, is a proven way to force markets—not just in the United States, but globally, whether digital x-ray in France, or digital archiving in Japan. All of these legislative efforts dramatically changed the market landscape and competitive playing field.

Even as far back as the emergence of the first PACS, the incentive to adopt this technology was based on a business imperative. Money makes the world go round, as some might say.

So as a business, the incentive is obvious. Make money. Of course to do so, you must deliver on and keep the promise of differentiated value to your customers, have a mission, etc, etc, etc, but along the way, you better watch your pennies.

Enter business intelligence (BI), a tool used—or should be—to regularly track indicators about business performance, including simulators...

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New Year’s Resolutions for Radiology

January 06, 2012 by Cat Vasko

It’s a new year for radiology. As a recent analysis in JACR reminds us, since the DRA cuts to imaging took effect in 2007—has it really been five years?—the industry has seen a cascade of changes. Provisions of the HITECH Act and health care reform legislation continue to take hold, prompting an array of dramatic responses from hospitals and practices: sales, joint ventures, mergers and consolidation, all motivated by the underlying imperative to do more with less.

With so much to handle on a day-to-day basis—meaningful use! Reimbursement cuts! Coding changes! Managing self-pay patients!—it can be hard to step back and think of the big picture. But as multiple thought leaders underscored at RSNA, big-picture thinking is more important than...

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Head in the Clouds

December 08, 2011 by Robert Cooke

As a vendor at the RSNA, it’s always important to be perceived as being on the leading edge of technology. As the exhibitions get planned, the sales and marketing folks push to trot out the newest, the latest and the greatest. The product development teams somehow always seem to forget that the RSNA happens unfailingly at the same time each year. Despite RSNA being the centerpiece for many organizations’ strategic planning cycles, the bigger you are, the harder it is to coordinate all the timing, delivery, and messaging… and more important the ability to make it work (repeatedly) on command!

As vendors’ Thanksgiving travel plans are made, dreams emerge for the mythical PowerPoint to software converter, and fog begins to get sculpted.  Buyers also dream for a realistic portrayal of what’s available and what is the next solution to the myriad clinical and business...

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Why can’t we all just behave?

December 03, 2011 by Cheryl Proval

I’d rather meet Freddie Krueger than some of the characters described by William Bradley, MD, and Valerie Jackson, MD, department leaders in San Diego and Indiana respectively, in their talk on problem employees. After all, you expect to meet a monster in a horror film, but not in your local radiology department or practice. To prevent one bad actor (or actress) from wreaking havoc in your organization, implement the following matrix for creating a healthy organizational culture that doesn’t allow problems to fester, recommended Paul A. Craig, chief of human resources and risk officer at UC San Diego: “Both clinical and technical staff expect leaders to assure a civil workplace.”

1. Set clear expectations and maintain a zero-tolerance policy for violations. 2. Have HR department train you and your employees to recognize and respond to early signs of dysfunction. 3. Listen carefully and maintain an open-door policy. 4. Role...

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49 flavors of meaningful use

December 03, 2011 by Cheryl Proval

In their meaningful use survey released at the meeting, KLAS and the RSNA found that 60% of the 216 radiologists surveyed plan to either look into or attempt to demonstrate meaningful use of HIT. Only 6% said they understood what it takes. Most PACS vendors with RIS had already picked up this scent and said they were in the process of seeking certification. A few had already achieved it. In the absence of specialty-specific guidelines, vendors and providers will be challenged to make meaningful use meaningful.

FUJIFILM hopes to achieve modular certification of its Synapse RIS in January, with a longer-range plan for complete EHR certification this summer. “I think the outpatient market has decided that the most economic and efficient path to meaningful use is using the RIS platform versus adding a separate EHR,” says Jim Morgan, VP, medical informatics, Fujifilm. “Secondarily, customers are understanding that beyond meaningful use,...

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Its beginning to look a lot like a PPM

December 03, 2011 by Cheryl Proval

If there was a specter haunting the meeting, it was concern about competing with large teleradiology companies on subspecialization and quality. Considering the size and resources of some of these companies, the concern is not idle. According to Mike Boylan, chief commercial officer, Virtual Radiologic, the company’s more than 400 radiologists read 7 million studies a year, and 30,000 involve critical findings. It takes a highly engineered workflow featuring a sophisticated IT workflow platform and a well-oiled operations center with 100 employees to achieve those productivity numbers.

The company has closed a series of practice acquisitions this year, and representatives from those practices typically cite the technology platform as a factor in their decision to be acquired. “When you think about the typical practice, you have a radiologist reading from one platform and then sliding across the room to read from another,” Boylan says. The vRad Enterprise Connect platform is...

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The über platform

December 03, 2011 by Cheryl Proval

Workflow tools for an increasingly distributed radiology are important, but if those workflow tools can be built on a broader health care intelligence platform that has access to all health care enterprise information systems—even better. That is Microsoft’s play with its radiology workspace within its Amalga product.

While it is possible to launch, for instance, Epic’s EHR, from PACS, the key is limiting the data feeds to only that which is needed so that the radiologist does not have to search the entire record, says Sean Sigmon, senior product marketing manager, Microsoft Health. (This is what Paul Chang, MD, referred to in a talk earlier in the day as “data dimension reduction to provide tactical awareness.”)

“We are empowering PACS, not doing PACS,” adds John Strauss.

Amalga achieves this through an elaborate system of pointers (don’t ask me to...

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The worklist on steroids

December 02, 2011 by Cheryl Proval

The lack of distributed reading solutions for practices covering multiple clients has caused a good deal of pain over the past five years and in response, practices have brought forth some interesting solutions, both ugly and elegant. Many vendors, including traditional PACS vendors, showcased new worklist solutions meant to meet this need, but we also saw the emergence of a new category of companies specializing in radiology workflow.

Compressus has been offering and refining it’s virtual worklist, called MedxConnect for at least five (and probably a few more) years, and now McKesson is offering the solution as The Reading Network. The worklist offers the ability to filter studies in a variety of ways, including by subspecialty and urgency. It also can pull prior studies from participating providers based on bandwidth as early as 12 hours before a study is performed, using rules to winnow only the relevant...

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The cloud’s behind

December 02, 2011 by Cheryl Proval

Behind every good cloud lies a reliable data center, so with all of the action in the cloud at this year’s RSNA, it stands to reason that there would be data center announcements. Agfa’s Miriam Ladin reports that Agfa has repurposed its IMPAX Data Center into a solution called the Imaging Clinical Information System based on the following four pillars: capturing the information; storing the information; exchanging the information within the organization; and providing image access to customers outside the organization via ZERO, a zero-download technology platform that provides the cloud solution.

McKesson announced the deployment of its Horizon Medical Imaging PACS across Ireland, featuring the company’s Enterprise Data Repository System, a rules-based enterprise data management solution. “Things are not as simple as on a departmental solution,” notes George Kovacs, McKesson. “It necessitates a single logical layer of integration, a single method of access....

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More speech, more cloud

December 02, 2011 by Cheryl Proval

Speech recognition company Medquist acquired cloud-based speech engine M-Modal last year, and this year added a worklist/workflow component with the Poesis product, homegrown at the University of Chicago. The new component also is cloud- based, with some software resides on a local server. “When we dictate, it’s not just about taking the voice and translating it into words,” says Chris Spring. “There’s contextual meaning. We run it through a series of NLP processors and rule sets to be able to deliver real time alerting.”

Poesis includes a suite of three tools, a worklist that provides a view across multiple PACS, a clinical documentation tool that provides a prompt or alert, and a business analytics tool for performance, quality, and safety monitoring. Handy feature: Every application can be launched from within any other application.

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Speech mobility

December 02, 2011 by Cheryl Proval

Nuance will soon send its Power Scribe 360 Reporting Solution into the cloud, enabling health care providers to voice-enable their mobile EHRs in 20 different languages. There will be two components of the mobile platform, says Jonathan Dreyer, Nuance. One component is the health care development platform, which vendors and other developers can leverage to speech-enable their products, currently available. The other is a delivery mechanism for cloud-based services, beginning with speech. Voice profiles and templates will reside in the cloud, and all of the processing power required will be offset to the Nuance data center.

Janet Dillione, Nuance executive VP and GM, Healthcare, acknowledges health care’s security concerns with the cloud. “We built our cloud with the expectation and assumption that some of the clouds will be private clouds,” she says.

The company’s relatively new 360 solution employs natural language processing that maps to SNOMED,...

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