Radiologists Seek Meaning, Offer Expert Opinions in Online Professional Networking Site
Ambient Experience CT: Radiologists, Administrators, and Patients Weigh In
The Power of the Internet: Booting Up with Greensboro Imaging
RSNA Named One of Nine Most Visionary Societies Nationwide

Radiologists Seek Meaning, Offer Expert Opinions in Online Professional Networking Site

Powered by Web 2.0 technology, the revamped is more functional, user friendly, and fast.

Social butterflies have MySpace. Video lovers have YouTube. And radiologists now have Like its consumer counterparts, is much more than just a case-sharing platform. Physicians visit the site to hone their radiology reading skills, confirm diagnoses, upload interesting case files, and share knowledge with third-world peers seeking expert assistance.

“Our physicians use and myPACS Enterprise to assist with publishing papers or collecting interesting cases to train students or develop conferences,” says Laura Ruhrwein, director of information systems at the Mallinckrodt Institute of Radiology at the Washington University School of Medicine, St Louis.

Also like its counterparts, users supply the content at, with no review boards or structured approval process. “myPACS is more Wild West, but that results in a much higher volume of cases. Sometimes, people just want to see a bunch of cases,” says Rex Jakobovits, PhD, president of Vivalog Technologies, Seattle, the developer of myPACS.

With nearly 13,000 cases and more than 50,000 images online, physicians have a wide selection to browse. According to Jakobovits, the site is the largest repository of teaching case files on the Web. “ has many interesting or unusual cases that don’t exist in our files because they are extremely rare,” says Brian Bartholmai, MD, assistant professor of radiology in the division of thoracic radiology, and chair of the Mayo Foundation Electronic Teaching File Group at the Mayo Clinic, Rochester, Minn.

Founded in 2001, in part with a Small Business Innovation Research grant from the National Institutes of Health, Vivalog developed two teaching file solutions for the radiology community: the free, Web-based and the revenue-generating myPACS Enterprise. The two have a symbiotic relationship. serves as a marketing tool for the paid Enterprise version, which supports the company’s endeavors in both arenas. was launched at the 2002 Annual Meeting of the Radiological Society of North America (RSNA), and was received with much excitement. “The idea was to create a Web site similar to photo-sharing models where physicians could upload images and case files instead. There wasn’t anything like it at the time,” Jakobovits recalls.

Since then, the site has expanded its features in response to user feedback. In 2001, the site added the ability to create folders to organize cases according to user criteria. In 2002, cases became discussion boards with the capability to contribute content. In 2003, an interactive training mode was added, allowing users to maximize the site as a training tool.

The program allows users to view a case as unknown, seeing just the image and patient history. Clicking on different buttons reveals the case findings and diagnosis, which users can then check against their own determinations. Visitors to the site also can search for images that match a particular diagnosis to help confirm their own decision-making. And finally, users can ask the community for help, uploading images to gather others’ opinions. The originator of a case is notified when new posts are made.

This use has been particularly beneficial for physicians in third-world countries. “Radiologists from the United States and Canada provide informal, free consults to physicians from third-world countries who do not have imaging expertise,” Jakobovits says, adding that physicians from 48 countries have uploaded images onto the site.


This year, again at RSNA, launched a revamped site that incorporates a new interactive and display interface. Vivalog has patents pending on the use of AJAX [Asynchronous Java script and XML], the Web 2.0 technology that powers the new platform, in medical-imaging applications. The technology is characterized by rich user interfaces, which increase functionality and ease of use. The experience becomes much more intuitive as well as faster.

Speed is also a goal in uploading files. Vivalog has partnered with Agfa Corp, Ridgefield Park, NJ; GE Healthcare, Waukesha, Wis; and McKesson Corp, San Francisco, to streamline the process of creating teaching files.

Jakobovits notes that previously, files were saved to the desktop using a PACS-created mechanism or as screen captures; these would then be uploaded to the teaching file. “We built a DICOM interface to myPACS so that with one click, a file can be created and sent directly to the site,” he says. Users of myPACS Enterprise have this capability already.

For those without one-click connectivity, the ability to upload a file is still easy. seeks to minimize any barriers to sharing cases. Users decide whether to make a file public or keep it private. Features in the premium Enterprise version allow institutions to keep their entire library completely private and organize the images into customized categories. “These repositories can be used as recruiting tools,” Jakobovits says.

But mainly, they are teaching tools, which institutions or individuals can leverage according to their needs. Roughly 3,500 hospitals and imaging centers are registered with, and 70,000 to 100,000 physicians visit the site every month. It’s not quite the volume generated by counterparts MySpace or YouTube, but it’s just as cool.

Renee DiIulio is a contributing writer for Axis Imaging News. For more information, contact .

Ambient Experience CT: Radiologists, Administrators, and Patients Weigh In

The patient-selected themes in the Ambient Experience CT suite at Laughlin Memorial Hospital incorporate video graphics on the wall and ceiling with coordinated dynamic lighting and sound. The theme is triggered by an RFID card as the patient enters the examination room.

The new outpatient imaging center at Laughlin Memorial Hospital, Greeneville, Tenn, boasts some very advanced technology: a 64-slice CT as well as the state’s only 4T combination, which incorporates a 3T whole-body MR scanner with a high-field 1T open system. But eastern Tennessee is buzzing about the center’s beautiful beach and its breathtaking mountain views—not to mention its arid desert, or any of the other virtual experiences offered by the Ambient Experience CT suite from Philips Medical Systems, Andover, Mass.

“I was lying there watching coconuts fall off a palm tree,” says Lori Ensign, RN, a recent CT patient at Laughlin. “It made me get a smile on my face.”

The Ambient Experience CT suite offers patients a choice of themes, such as Ensign’s beach, a mountain scene, and four others for adults; children have a choice between a meadow and a submarine descending through the ocean. Patients select the theme that makes them most comfortable, then swipe a credit card–sized “theme card” upon entering the CT suite. Images are projected on the ceiling and walls during the scan, accompanied by soothing sounds.

“As a health care professional, I was nervous about my CT scan, because where I’d been [before], the CT scanners were in small rooms, very confined,” says Ensign, who is not professionally affiliated with Laughlin. “This room was large and airy, and the staff were just wonderful with their explanations. It felt really nice and relaxing.”

Jesse Taylor, administrative director of radiology at Laughlin, says the suite’s design contributes to the soothing effect. “The walls are rounded; there are doors that blend into the wall, so when we’re not using the power injector or the ECG machine, they’re not seen,” he explains. “You don’t see typical items, like needle boxes. Even the trash cans and glove boxes are either hidden behind very well-designed cabinetry or recessed within that cabinetry.”

Each theme is different from minute to minute throughout the CT, Taylor explains. “At least one of them will even take you into nighttime if you lie there long enough,” he says. “There’s always something to watch, always something going on in the themes.”

The children’s themes are just as diverting, he says. “In one of them, the child is in a submarine that is going down in the ocean,” Taylor explains. “It’s very bright and vivid. There’s a little meter that is integrated into the picture, and he sees how deep he is, and he finally winds up on the bottom.”

Clinical Benefits

Interactive elements incorporated into the themes help patients, young and old, comply with technologists’ commands. “In the submarine theme, a fish comes out, faces the child on the screen, puffs up like it’s holding its breath, and holds it for whatever time frame we’ve set,” Taylor says. “On the adult themes, it’s an eclipse; when you see a full eclipse, you hold your breath. With that added patient relaxation and cooperation, you have less patient movement, which reduces repeat scans, and, of course, reduces radiation exposure to the patient.”

Chief of Radiology Philip Marino, MD, PhD, expects to reap clinical benefits for patients undergoing cardiac examinations. “Part of patient preparation for cardiac CT is to lower the patient’s heart rate for the scan. What’s been found is that a patient comes into the CT suite, and many times, the anticipation bumps up their heart rate again. The Ambient system is going to be helpful in reducing that anxiety.”

Taylor and Marino anticipate both patient satisfaction and improved throughput to be contributing factors as they await return on investment. “I think if the patients are less anxious, there’s less stopping of the study, a lot fewer questions related to their anxiety,” Marino says. “Once they feel comfortable on the table, the scan will go quicker. We have another high-speed CT in the next building, and I’ve noticed that scans just seem to be quicker with the Ambient.”

Ensign adds, “It’s very scary for people, because they don’t know what to expect. When you’re in health care, you kind of know, but you still get nervous. To be able to relax when you don’t know what they’re going to find, I would highly recommend it to anyone.” In fact, Ensign had asked to be referred to Laughlin.

Return on Investment

The Ambient Experience suite can be a costly endeavor, explains Janet Ensign, director of strategic business program development at Philips Medical, because the participation of the Philips Medical design team is crucial. “If there’s one key thing in terms of the optimal return on investment, it’s getting our designers involved, ideally before any detailed architectural drawings are done,” she says. “And that gives the customer the flexibility to take suggestions or not take them at their discretion, and it really holds down [construction] costs.”

However, it is important to know what is included. “The cost of the Ambient Experience implementation is basically separate from the equipment cost,” Janet Ensign notes. Construction costs also are separate, and with design as much of an imperative as technology, these have the potential to be steep. “We’re not just looking at the technology; we’re looking at the workflow and how we can make it a nicer environment for the staff,” Janet Ensign explains. “We really are looking to combine both design and technology.”

Taylor believes the cost is worth it. “You see a lot of outpatient facilities putting a huge amount of money into the aesthetics of their entrances and lobbies,” he notes. “We took a different approach. Although we think we have a nice lobby, we took the bulk of that money and put it into the patient exam areas, because we thought it would have more of an appeal, more of an effect. When the patient leaves, what’s going to be the thing he remembers?”

Cat Vasko is associate editor of  Axis Imaging News. For more information, contact .

The Power of the Internet: Booting Up with Greensboro Imaging

The Web sites of Greensboro Imaging (top) and its Breast Center (right) feature the same color palette and feel as the facilities themselves.

When Preston Allen, MBA, executive director of Greensboro Imaging, Greensboro, NC, initially envisioned the Web site that would represent his centers, he says, “I was looking at the Web site as a very efficient mechanism to put information out there.” Greensboro Imaging had been restructured, renamed, and redesigned; the business was developing a home page for the first time as part of its aggressive new marketing strategy. “I wanted a boxy, efficient, kind of shake-and-bake Web site,” Allen says. “What we have is something totally different than that.”

What Greensboro Imaging has is an Internet presence effective enough to win the Platinum Quest Award for best marketing through a Web site from the Radiology Business Management Association (RBMA), Irvine, Calif. “It’s not your typical Web site,” Allen explains. “It’s an artist’s design, but it’s also high tech. One of the things that we did at the same time was completely renovate all three of our imaging centers. When patients came in, we wanted them to feel comfortable, and although they could tell we were a cutting-edge high-tech organization, that was not to overshadow the caring, comforting feeling. And we wanted to continue that same thought, that same concept, on our Web site.”

Greensboro Imaging invited the Web designer, an artist, to tour its facilities, and the palette of its site reflects the colors used inside its two regular imaging centers—soothing cream and tan shades as well as warmer orange and red hues. For the same reason, the palette used on the Web site of Greensboro Imaging’s breast center is different, though the basic template remains the same: “It’s a slightly different design concept, with pink colors and flowers and butterflies,” Allen explains. “If you go to the breast center, you feel that as a part of the ambiance. It has a female feel to it, which is appropriate.”

Initially, the site included relatively standard information—directions, contact information, downloadable insurance paperwork. “We also had a professional photographer come to our centers to take pictures of our staff,” Allen says. “So, the people on the site are our doctors and our employees. We wanted them to have some pride in our Web site.” Allen soon realized the marketing potential of the Internet. “It was a learning process for me,” he recalls. “Our Web hosting folks have a system to count the number of hits, and I was flabbergasted. We were getting 12,000 or 15,000 hits a day. I was astounded at how many hits we were getting.”

Now the site is being expanded to reach out to physicians as well as patients. “We already have updated the Web site, and one of the new tabs is called ‘Physician Information,’ where physicians can read about some of the new procedures that we’re doing,” he explains. “One of the cool things about that feature is that even though it says ‘physician info,’ you and I both know that if we see something that’s for someone else, that’s the first place we’re going to go. Patients are smart. They’ll go to their physician and say, ‘I was looking on the Greensboro Imaging Web site, and I saw something about this procedure. What do you think?’ And then that will inspire the physician to go on and look at it as well.”

Also included on the physician page will be a link to Greensboro Imaging’s PACS. “A doctor can send a patient over for a CT and then he can [log on] to our Web site to look at that patient’s full chronology of imaging studies from the beginning onward. It’s another way for us to get people to come to our Web site.”

New Internet trends also are on deck for “We want to develop a Podcast or Webcast, so that when patients want information about, say, breast MRI, a doctor will be on there giving them a brief summarization of what they can expect,” Allen explains. “Patients want to be educated and have access to resources on their terms. There’s nothing more irritating than to be on someone else’s terms when you’re trying to get information. I think that’s one of the biggest reasons to have a Web site, so that people can find answers to their questions whenever they want—be it 3 in the morning or 2 in the afternoon.”

Cat Vasko is associate editor of  Axis Imaging News. For more information, contact .

RSNA Named One of Nine Most Visionary Societies Nationwide

The American Society of Association Executives (ASAE), Washington, DC, has released a book on what makes a successful nonprofit organization, entitled The 7 Measures of Success: What Remarkable Organizations Do That Others Don’t. Based on a study of 15 years of data, the book establishes standards for nonprofits and names the nine best nonprofit organizations in the country. A familiar name can be found among them.

“It was a considerable honor for RSNA to be selected as one of the most remarkable associations,” says Dave Fellers, CAE, executive director of the Radiological Society of North America (RSNA), Oak Brook, Ill. “The study indicated that one of the major reasons for RSNA’s success and member satisfaction is a result of the organization staying focused on its mission of education and research.”

The book, which was released in August at the ASAE’s annual meeting in Boston, has RSNA keeping company with the American Association of Retired Persons, the American College of Cardiology, the American Dental Association, and the Girl Scouts of the USA, among others. The seven measures alluded to in the title were benchmarks that the nine honored societies shared.

“Although most of our members already appreciate the value of RSNA membership, acknowledgement of RSNA’s superior delivery of services by ASAE, the premier organization representing the nonprofits in the United States, is very gratifying,” Fellers says.

To purchase the book or for more information, visit

—C. Vasko