Managing the Flow in Radiology

EMR Storage: Addressing Capacity and Costs
Moving Virtual Colonoscopy Forward
CEO Spotlight

EMR Storage: Addressing Capacity and Costs

With the amount of data that is created and processed throughout an enterprise, many find the need for an integrated electronic medical record (EMR) system to be absolutely necessary in today’s health care climate. However, a radiology-centric solution only goes so far. Nowadays, a solution must address the entire health care operation.

“When the enterprise adds other departments, such as laboratory, pathology, cardiology, or ENT, plus the information from patient records, the volume of data across the network can significantly affect workflow if the site’s PACS does not scale to accept the volume change,” said Michael Simpson, chief technology officer at McKesson Corp, San Francisco.

Michael Simpson

Simpson said his company brings about diagnostic imaging capabilities based on IT strategy that allows organizations to distribute critical patient information and images across the various settings of care. For example, the scalability of McKesson’s Horizon Medical Imaging solution allows it to be easily upgraded when new components—from 256-slice CT scanners to whole cardiology departments—are added to the enterprise.

But what are the financial implications of such a vast EMR system? According to Simpson, the consolidation of isolated, or silo’d, data storage pools must be considered.

“A well-structured and strategic Clinical Information Lifecycle Management (ILM) plan reduces management costs for technology migration and ensures the optimization of storage tiers, not silos, through the health facility,” Simpson said. Also pivotal are the access and utilization of enterprise content-rich data, including images, waveforms, and structured reporting objects, he continued. These factors will drive health care IT spending.

On the other hand, facilities without the means to manage the ILM of large volumes of clinically relevant data will find it more and more challenging to compete in their local markets. These facilities, Simpson said, will find it difficult to take part in future regional health care networks.

With a focus on optimizing the cost efficiency for storage, McKesson provides a comprehensive, clinically driven ILM that employs lower cost storage options. Its SATA NAS solution, for instance, is an offline media, remote-hosted service that can be optimized only “when the ILM is driven by a comprehensive knowledge of the clinical workflow and access patterns.” Striving to minimize the overall total cost of storage ownership for customers, McKesson looks to take advantage of its extensive domain knowledge and ability to leverage clinical workflow parameters, such as patient age, type of study, referring physician, and reading location, Simpson said.

Areas of growth that McKesson foresees for health care IT include tele-pathology and personalized medicine, which Simpson anticipates will play a key role “in improving therapeutic decision-making and reducing variability in care.”

—Elaine Sanchez

Moving Virtual Colonoscopy Forward

Data has shown that for more than three quarters of America’s population, the sheer thought of a colonoscopy—and the discomfort and inconvenience associated with it—was enough to prevent a person from getting screened for colorectal cancer. Yet, this type of cancer is the second leading cause of cancer death in the United States.

Virtual colonoscopy is growing in popularity as an alternative to traditional colonoscopy. The procedure entails inflating the colon with carbon dioxide introduced through a small rectal tube. With this technique, supported by enhancements to its software technology, New York-based Viatronix Inc pledges that the negative image of colonoscopy will be changed forever.

Viatronix recently introduced upgrades to its V3D-Colon 3D imaging software, including the ability to view the dissected colon segment without distortion or flattening.

The company’s V3D-Colon 3D imaging software demonstrated a number of upgrades that were unveiled at the annual Radiological Society of North America meeting last November. Health care providers will have the ability to load any two colon image series for review and comparison, as well as view the dissected colon segment without distortion or flattening. Users can edit new “translucent view” color schemes, and reports that are compliant with C-RADS guidelines can be created. Other features include an intuitive user interface, automatic segmentation and centerline extraction, electronic bowel cleansing, automatic and interactive navigation, and 100% lumen coverage and verification.

The technology is also cost-effective, according to the company, which points out that the new procedure can bring about increased revenue, faster return on investment, and the increased utilization of CT.

“We deliver high-end organ-specific clinical applications developed around a physician’s workflow,” said Zaffar Hayat, president of Viatronix Inc. “In the near future, we expect to deliver additional organ-specific modules to meet the demands of the radiology market.”

CEO Spotlight

Richard Cohan

Richard Cohan, former CEO of a Web-based supply chain services firm, took on the chief executive position at Logical Images in the first quarter of 2007. Axis Imaging News spoke with him about his vision for the Rochester, NY-based image recognition and visual-knowledge software company.

IE: What skills do you bring with you in this new position?

Cohan: I’ve always been around health care start-ups and growth companies. There’s both an art and a science to building a great company, mostly around having talented people in the right places, having great products and a sustainable business model. I guess I’ve learned a little about how to make that work over the course of my career.

IE: Are there any demands of the job that you didn’t expect?

Cohan: The need for information, validated by the Internet explosion, seems intuitive to the nonphysician, but clinical decision support tools still find resistance among physicians. It is more difficult than I thought to change the way a doctor thinks about using tools to help diagnose, slightly alter workflow, and better allocate time to patients.

IE: How are you overcoming these challenges?

Cohan: It’s a combination of persistence on our part, providing proof points from studies we’ve conducted, and trying to connect improved accuracy to better net income for a hospital or provider. We’re assisted in all this by a great group of physician consultants who use and believe in our product and are our evangelists for its adoption.

IE: Since your arrival as CEO, you’ve already closed deals to place your company’s flagship software in state hospitals as well as facilities abroad. What motivates you?

Cohan: Really, it’s the energy and interest shown by our staff at Logical. Our engineering and support crew are second to none. They are very responsive to new requests for enhancements and are constantly measuring our customer satisfaction. Everyone at Logical is energized about our innovative approach to visual medicine, and we all want the company to become a tremendous success.

IE: Have you brought in a new management team?

Cohan: We’ve expanded our management team a bit in the last 6 months by adding a product line director to focus on VisualDxHealth, our consumer health information site ( We’ll continue to refocus our people on where they can add the most value and continue to promote from within or hire the best people from outside the company. It’s all a part of growing up as an organization.

In addition to the VisualDx professional tool, we have a tremendous opportunity to continue to build our patient-oriented site, VisualDxHealth, which was launched in April 2007 and is growing every month. In fact, the National Library of Medicine is linking to the site to provide its users with the rich medical images we have.

IE: How does your company distinguish itself from competitors in the market?

Cohan: The core differentiator of our products is in our image database and the software products we’ve built for image and editorial management. We have culled the best 60,000 images from more than 1,000,000 visible light images, scanned and processed them to develop what is arguably the best digital collection of visibly presenting disease in the world. We continue to build those assets, so it does create a high bar for any competitor to duplicate. We’ve added other graphics, and plan to incorporate video and medical imaging as well to provide as comprehensive information as we can. We want to be the only tool that physicians, nurse practitioners, first responders, or patients use to answer the question, “What am I looking at?”