Managing the Flow in Radiology

A Comprehensive, Cost-effective Cardiology Solution
Let’s Chat: ACR Blog Goes Live
CEO Spotlight: Mohan Mysore of Ashva Technologies
New England VHA Goes Digital

A Comprehensive, Cost-effective Cardiology Solution

Medical imaging and health care IT company Carestream Health Inc, of Rochester, NY, and ScImage, an advanced medical imaging technology and workflow solutions provider based in Los Altos, Calif, have signed an agreement that will allow Carestream to provide medical professionals with a comprehensive solution for enterprise-wide management of cardiology data in the United States and Canada markets.

ScImage and Carestream Health have teamed up to offer a new cardiology workflow solution.

The cardiology offering combines ScImage’s PicomEnterprise software, featuring built-in capture and visualization tools, and CARESTREAM Information Management Solutions (IMS), a scalable platform for the management and storage of digital medical images and information.

“We are pleased to establish such a partnership with this internationally recognized leader in medical imaging technologies,” said Sai P. Raya, PhD, founder and CEO of ScImage. “The combination of PicomEnterprise and the IMS platform is a natural fit. The products are complementary and support the enterprise-wide distribution of multidisciplinary clinical content.”

Utilizing a single database to manage, distribute, and safeguard cardiac information gathered at various points of care, PicomEnterprise was created to decrease costs while increasing productivity. Furthermore, it was designed to provide cardiology departments, outpatient cardiology clinics, and private-practice cardiologists with a single point of access to echo, cath, ECG, vascular, nuclear cardiology, and hemodynamic reports. The solution has the capability to attach all images—DICOM or non-DICOM—documents, digital dictations, and Microsoft Windows-based files to a patient’s record. What results is a centralized location for accessing patient history.

As a data management solution, CARESTREAM IMS allows for the on-site or remotely hosted storage of digital medical images and information. The product has the capabilities of being scaled to meet the needs of a variety of health care businesses within the same software framework, from small medical practices to large medical centers and even regional or national information systems.

“Multilab, multimodality cardiology PACS solutions reduce the administrative burden by enabling hospital IT departments to consolidate individual PACS solutions into a cohesive, centralized solution,” said Michael W. Jackman, president of Carestream Health’s Health Information Systems. “The combination of CARESTREAM Information Manage-ment Solutions and PicomEnterprise can lead to lower cost of ownership, while helping deliver improvements in the way cardiac care is delivered and managed.”

The integrated solution also permits users to access cardiology images and reports through the Internet. Distribution of the product has already commenced.

—Elaine Sanchez

Let’s Chat: ACR Blog Goes Live

Should the oral boards be delayed for 2 years after residency? Is CT colonoscopy gaining legitimacy as a viable screening tool for colorectal cancer? Do radiologists show enough involvement beyond their own hospital communities, or are they becoming apathetic?

The American College of Radiology hopes to find answers to these hard-hitting issues and more—or at least generate constructive debates on the topics. With this objective in mind, and jumping on a trend that has emerged in the corporate world, the leadership of the College launched a members-only blog in September.

“I want to open a two-way conversation between members and the ACR simply, easily, and quickly,” wrote Arl Van Moore, Jr, MD, chair of the ACR Board of Chancellors, on the organization’s web site. “I want to build our community, widen the net, and get us talking with each other.”

Once or twice a week, the ACR discusses a variety of subjects affecting its members or topics surfacing in the news, from hot button issues like self-referral to government relations matters like the Deficit Reduction Act. In order to ensure a stimulating and informative dialogue, comments are posted after they have been reviewed.

ACR public relations manager Shawn Farley, who doubles as blog editor, said that while he looks at all comments before publishing them on the site, he does little to no editing. It’s similar to a letter to the editor section of a major newspaper, he said. Primarily, Farley checks to make sure the individual who made the comment is in fact an ACR member. Members can write pretty much what they want to write, he continued, as long as the remark is not liable or profane.

While the ACR encourages opposing opinions, it will neither tolerate personal attacks nor discriminatory or inappropriate postings. To prevent things from getting nasty, members are required to provide their names with any comment they wish to post. Farley explained, “That’s something we felt was important. We are actually looking for legitimate feedback and a good dialogue with members.”

Guidelines are provided directly on the site, and they are straightforward. Members are not to forward any part of the blog to nonmembers. Off-topic or lengthy topics will not be posted. Copyrighted material must be respected.

These few restrictions aside, the young blog has already drawn a number of responses. For example, more than 25 members shared their strong sentiments on the prospect of a delayed oral board—some calling it a disservice to patients, others supporting a more comprehensive fourth-year residency, and several raising new questions, such as whether the exam’s format should be altered.

For those involved with launching the blog, the interest has left them pleasantly surprised. “I think it’s gone better than we’ve planned or hoped for,” Farley said. “The feedback has been great. People are actually using it and writing in.”

Moreover, Farley said members’ thoughtful insights are representative of a new avenue of communication, an interaction for which the ACR had been searching.

“We’re looking to see what members are really thinking because the ACR exists to serve the needs of our members and their patients,” Farley said. “We felt like this was another avenue to start a dialogue, find out what people were thinking, and be able to explain the issues to members firsthand, in a more personal way.”

To post a comment, members must have access to the user ID and password, which were sent to them both via e-mail and in the September 25 issue of the ACR Daily News Scan.

To view the blog, log onto and click on the ACR Blog button under “Hot Topics.”

—E. Sanchez

CEO Spotlight: Mohan Mysore of Ashva Technologies

When Asia-based radiology informatics firm Ashva Technologies, Plymouth, Minn, opened its US headquarters this year, Mohan Mysore began his new role as CEO. Drawing on more than 25 years of experience in the East and West, Mysore began his career as a service engineer with Philips, later ran his own data storage sales business, and took on the chief executive position at a distribution company. Axis Imaging News talked to Mysore about Ashva’s products and his plans to strengthen the company’s presence in the American market.

Mohan Mysore, CEO, Ashva Technologies

Q: What are some of your qualities that you feel will help you in this new position?

A: My exposure to various facets of a business, and my experience in organizations in both the East and the West, are the two main qualities that will be the tipping point for success. I also enjoy business development—building an organization from the ground up and growing the business internationally.

Q: Ashva has a very strong presence in Asia. What is your strategy in achieving that level of success here in the United States?

A: Ashva has over 600 installations in Asia. It has a strong exposure to end users. This experience and constant interaction with the end user help us to understand the main points and their immediate needs. Being a small company, it is very important for us to react fast to these needs and compete effectively with the big boys in the medical industry.

Our strategy here in the United States is to quickly translate that experience in providing feature-rich software at what I call “jaw-dropping prices.” We do not plan to sell to end users or provide hardware in the United States. We want to stick to what we do best—providing high-quality software at very low costs. This would allow our partners to integrate our software with their hardware and services and offer an affordable solution to the entry-level market, which has still not hopped on the digital bandwagon.

Q: What is your ultimate vision?

A: To put Ashva on the international map as a provider of reliable, innovative, and low-cost software for improving medical care.

Q: How are your company’s offerings different from what is already available on the market?

A: Most solution providers today target the high and mid range of the market, where there is a shorter sales cycle and potential for immediate profits. They hesitate to go after the entry-level market because they do not have the right prices and find it expensive to market to that segment. Ashva provides software with a lot of the high-end features, but at prices that make it suddenly attractive for the players to go after the entry-level market. This is the legendary base of the pyramid, which is huge and will open up an entirely new area of business.

Q: What can we expect from Ashva in the future?

A: The audience can always expect innovative software solutions that are very cost-effective. Our short-term goals are finding the right OEM partners who can bundle our existing solutions and take them to town.

We are also going to provide software in other languages to cater to specific markets in South America and Europe.

We are about to launch a very innovative and unique product in the market. I like to call it the “DO IT YOURSELF” suite. With this software, the end user can build his own solutions! They can build their own RIS or an EMR, for example, and there is no hard coding required. Three months down the road, if the end user changes his workflow, he can change his RIS or EMR without going to the manufacturer—actually, he is the manufacturer himself!

This is a multibillion-dollar market waiting to be explored! In essence, our long-term goal is to provide solutions in the Business Process Management area (BPM), tools to improve productivity and reduce costs.

—E. Sanchez

New England VHA Goes Digital

The seven hospitals that make up the Veterans Integrated Service Network (VISN) 1 perform about 330,000 imaging exams a year. Yet only two of the facilities had commercial PACS systems. The remainder were using either a homegrown system or film, and neither permitted the hospitals to achieve their goals of care and efficiency. So the Veterans Health Administration (VHA) turned to Carestream Health Inc, of Rochester, NY.

Seven VHA hospitals recently installed PACS systems to increase efficiency.

Carestream Health will provide solutions to all seven hospitals that include a Kodak Carestream PACS, a regional archive, data migration from existing systems, network integration, and other professional services. Each location will have 3 years of local storage, with older studies available through a system-wide archive managed by Kodak Carestream Information Management Solutions. Optional features, such as integrated voice dictation, orthopedic surgical templates, and native 3D viewing of imaging exams, will also be included.

The main goal of the hospitals, in addition to updating their systems, is to integrate teleradiology service. Not all of the locations have radiologists available locally to read all of the exams performed, and the VHA wanted to leverage its resources. The VISN 1 encompasses facilities in Connect-icut, Massachusetts, New Hampshire, Vermont, Maine, and Rhode Island. “The system needed a global work list across all of the locations,” said Drew Miller, district manager, East Region, health care information solutions, at Carestream. This would permit a radiologist in Connecticut to read a study performed in Vermont.

In addition, the network wanted a vendor with proven ability in the VHA environment. “Theirs is a unique environment, but we had installed a PACS in a West Haven, Conn, facility and so had the necessary experience,” said Miller.

This meant the company was familiar with the VHA’s RIS (radiology information system) as well as its homegrown PACS system, called Vista. “The Vista imaging system was their default PACS and had been built over the years. It is good at storage, but not ideal from a diagnostic perspective,” said Miller. Those using the system realized they needed an upgrade; those still using film wanted PACS.

The new PACS will permit the hospitals’ radiologists to manage all of their tasks from one workstation. “Some systems require the physician to move to a different workstation to access some of the advanced features, which are implemented through a third party.”

The Carestream system integrates these functions, such as 3D, so that they are available at every workstation,” said Miller.

Naturally, those already using PACS, particularly the two facilities using commercial systems, have had easier implementations than those new to electronic picture archiving and communication. “The system has been completely installed in three of the seven hospitals with the remainder in various stages,” said Miller.

Each primary PACS administrator has received training at Carestream’s Dallas site, and Carestream application consultants will remain on site for multiple weeks while the systems go live, in part because so many are new to PACS. “They have to adjust to the change in workflow that accompanies the transition from analog to digital so we are providing more on-site application training than is typical,” said Miller. Once up to speed, the facilities will see the full benefit of stepping into the digital world.

—Renee DiIulio