Governance, Mission, Growth

Diagnosing on the Go
Philips Releases Digital Starter Kit
The Right Fit!
Imaging Center Gets Remote Connectivity and Rapid Delivery

With Vision Reach from AMICAS, physicians can read reports and images from a Web-enabled PDA such as a BlackBerry or iPhone.

Diagnosing on the Go

With today’s MRI and CT scanners creating higher volumes of images, practices and their physicians can encounter challenges in remotely accessing these files. Often, these limitations are due to bandwidth or, to be more accurate, the lack thereof.

Brian P. Bloom, MD, director of PACS/IT for Tristan Associates Inc of Harrisburg, Pa, pointed out that in some cases, the data exceeds 500MB. PDA downloads typically fall in the 100-300 Kbs range. Furthermore, he said, on-board memory can affect the viewing of large volume sets.

However, with the Vision Reach radiology EMR and portal, manufactured by Boston-based radiology information management firm AMICAS, bandwidth issues are resolved by the technology’s ability to send only key images using JPEG compression techniques. Meanwhile, if the full data set is needed, it is readily available. Designed specifically for referring physicians, the solution uses common e-mail and secure messaging to deliver images, reports, and information to any e-mail-enabled device via a secure Web-based portal. As a “zero install” application, IT headaches that are traditionally associated with downloading and installing software can be reduced.

“In today’s high-pressure, high-volume medical practices, any product or device that streamlines our access to medical information helps,” Bloom said. “Vision Reach—with its unobtrusive HTML messaging and real-time status updating linked with a PDA, Web-enabled phone, or laptop computer—keeps my practice and my referring physicians’ offices running at peak performance with instant access to critical results and images.”

Tristan Associates, a progressive, predominantly outpatient private radiology practice, operates seven wholly owned full-service imaging centers, one breast center, one hospital practice, and multiple professional services contracts with a volume of more than 240,000 exams per year. The majority of its 17 radiologists have subspecialty training, and all were searching for a product that would seamlessly integrate into their current workflow to provide results and images to the fewer than 1,000 referring doctors scattered throughout central Pennsylvania.

Bloom has taken advantage of Vision Reach’s ability to send a report and key images to his PDA so that he could offer a second consult. “One of my partners had an interesting vascular case,” he recalled. “He saved several representative key images, and I was able to view them on my Web-enabled phone. Even though I was away from the office, I was able to confirm his impression.”

He also praised the product’s real-time status updating functionality, which enables referrers to follow a patient’s progress through the system until the final report and images are available. “This has significantly reduced phone calls to check patient status and results,” Bloom said.

The system is also helpful when fielding calls from new referrers. “When we have a new referrer call to schedule a study or call for results, we quickly provide a secure user name and password as well as the Web site address, and within minutes he can see his study and results,” Bloom said. “We also use Vision Reach as a way of providing reports back to our professional service contracted office. This allows our physicians to dictate on our own system, which increases productivity.”

Tristan Associates is now in the process of making even more use of the Web functionality. Bloom said the practice is beginning to deploy the Vision Reach scheduling module, which lets its clients order new or follow-up exams online. This, Bloom anticipates, will streamline the entire process and save them time.

Philips Releases Digital Starter Kit

Through the years, Philips Speech Processing, a Royal Philips Electronics company based in Austria, has offered several dictation starter kits, ranging from lighter packages with DSS player software to professional products that include transcription software. Its latest offering, called the Digital Starter Kit 9397, is a versatile product that the company says merges high-quality digital dictation technology with transcription software and useful accessories.

This new starter kit will replace all current Philips starter kits for dictation and transcription, according to the company.

“Now we have created one comprehensive out-of-the-box solution, where recording and transcription go hand-in-hand,” said Thomas Brauner, CEO of Philips Speech Processing. “The new starter kit combines ergonomically designed hardware with ingenious dictation and transcription software and makes the dictation experience better than ever before.”

Included in the kit is the Digital Pocket Memo 9370, which features virtually unlimited recording capacity and clear sound quality, and the SpeechExec Software, designed to streamline the transcription process. Also, the kit is equipped with the recently released USB Foot Control 2330, which sports programmable controls for more convenient operation.

Powered by the latest recording technology, the Digital Pocket Memo 9370 was developed as a user-friendly resource, allowing for easy control with professional push buttons for single-handed use and smart buttons for intuitive operation. A backlit LCD displays the name of the author and file, as well as the length of dictation. Furthermore, an exchangeable SD card provides virtually unlimited recording capacity.

As the international standard for professional speech processing, the .dss file format produces high-quality sound with a high compression rate for less network traffic and storage capacity. Completed files can be automatically downloaded to a PC through a USB cable, where they can be stored or subsequently transcribed or archived.

Using dictation and transcription software SpeechExec, personnel can efficiently manage transcription jobs by displaying pertinent information, like priority settings and individual file transcription status. Through an intuitive user interface, file processing is made simple, having the ability for automatic transfer of files via a network. Addressing ergonomics, Philips designed the USB Foot Control 2330 to allow for blind operation. According to Philips, transcriptionists can begin and end dictations with a slight movement of the heel, thereby reducing physical strain. Furthermore, a fourth pedal for finishing a transcription job is available, as well as individually programmable controls, which increase efficiency.

The kit is compatible with industry standards, such as SD card, mini-USB socket, AAA batteries, 3.5 mm headphone, microphone sockets, and the .dss format. Included in the package is a lightweight, under-the-chin-style stereo headset, an SD memory card, batteries, a USB cable, and a pouch for easy transport and storage of the Digital Pocket Memo.

Battlefield Imaging welcomed the first US installation of Siemens Healthcare’s MAGNETOM ESSENZA.

The Right Fit!

With a backlog in MRI services, Battlefield Imaging, based in Ringgold, Ga, determined it was time to bring in an additional MRI unit. But Battlefield needed the right fit for its facility and its budget.

After factoring in imaging quality, pricing, customer service, and product footprint, the freestanding outpatient digital imaging center decided to go with an all-new 1.5 Tesla system from Siemens Healthcare. In doing so, Battlefield became the first facility in the United States to install the MAGNETOM ESSENZA.

“To continue to be a leader in imaging services in our community, we felt it was important to be able to provide same day or next day service to our customers,” said Barbara Marshall, the facility’s administrative director. “We heard about the ESSENZA, and after much investigation, we decided that this would be a good fit for our organization.”

Siemens is proud to point out that the MAGNETOM ESSENZA offers one of the lowest total costs of ownership in the industry while providing high-quality system performance—something that admittedly surprised Marshall. “It has been a pleasant surprise to obtain such great imaging on a magnet that has a price point that is cohesive to our reimbursement reductions,” she said, adding that the image quality was comparable to, if not better than, other MR units available on the market.

Another quality that impressed Marshall and her colleagues at Battlefield was the size of the unit. It was not necessary to remove any walls or ceilings; rather, the unit was rolled through the door and down the center’s 6-foot hallway. At approximately 3.5 tons, the magnet is lightweight and sports an ultrashort bore length of 145 cm. Furthermore, the system’s advanced magnet design contributes to ensuring maximum product uptime with a state-of-the-art zero helium boil-off magnet.

According to Siemens, though actual results may vary, the system was designed to provide an optimal operating cost that could save facilities as much as 50% on their MR energy bill. Automated workflow is conducive to simple training for less-experienced MR users, the company reported..”

“Siemens developed the MAGNETOM ESSENZA specifically to provide smaller hospitals and imaging centers with the opportunity to offer high-field imaging to their patients,” said Jeffrey Bundy, vice president, Magnetic Resonance, Siemens Medical Solutions USA Inc. “What’s more, the system also addresses the needs of clinicians, by offering imaging strength, clarity, and overall efficiency designed to improve a center’s workflow and revenue stream.”

Agreeing with Bundy, Marshall also noted that more facilities will have the opportunity to benefit from a solution that is able to support a range of clinical applications, including neurology, orthopedics, angiography, cardiology, and oncology, among others.

“I think it will be an enabler for many that have not been able to afford quality high-field MR imaging,” Marshall said. “In many settings, that has been a showstopper for quality expeditious health care in many regions throughout the world. This technology is affordable, quality, customer friendly, and site friendly.”

Imaging Center Gets Remote Connectivity and Rapid Delivery

When diagnostic imaging service provider River Radiology, based in New York’s Hudson Valley, made the decision in November 2006 to expand its MRI capabilities to patients at a hospital 2 miles away, time was a key factor in finding the connectivity solution that linked the two facilities.

More specifically, the imaging center considered not only the uptime of scans, but also the amount of time it would take a system to be installed in time for a January 1 launch date.

Unimpressed by limited and costly options that barely met bandwidth requirements, River Radiology ultimately discovered that an AR60 gigabit wireless system from BridgeWave Communications would solve its high-speed network needs and, even better, be ready to run by the deadline. “Connectivity between the two sites is completely transparent; you can’t tell if an image originated 200 feet down the hall or 2 miles across town,” said Alice Omichi, IT systems and PACS administrator for River Radiology. “With BridgeWave, we have ample network capacity for at least the next decade, reinforcing River Radiology’s ability to deliver diagnostic services and imaging reports in a timely manner while providing extremely responsive, top-quality patient care.”

Despite unfavorable weather conditions, wireless network solutions provider Webjogger, of Tivoli, NY, braved the snow and worked diligently to install an antenna on the hospital’s roof. They also traversed the hospital’s complicated infrastructure to put in internal fiber runs in the building. The radio was installed in a single afternoon, and since implementation 13 months ago, Omichi is happy to say that there has been zero downtime.

The narrow antenna beam width on BridgeWave’s GigE wireless link offers enhanced security and interference immunity. Moreover, the AR60, which has exclusive AdaptRateT capability, momentarily switches transmission from GigE to 100 Mbps data rates during episodes of intense downpours in order to maintain “five nines” network uptime. The ultralow latency on the BridgeWave high-capacity, secure link allowed River Radiology to add VoIP services between the two imaging centers.

Due to its speed and reliability, and the ability to exhibit a degree of control over the system without waiting for a phone company to repair the situation, the BridgeWave solution has found satisfied customers and a happy home in River Radiology. The center, which offers a complete range of radiologic services such as bone densitometry, CT, digital mammography, MRI, nuclear medicine, ultrasound, and x-rays, has been able to consistently deliver and receive its all-digital PACS files speedily and securely, Omichi said.

“Our turnaround time for the radiologist to read it or referring physicians to get results is cut by more than 50% than if we had a conventional method of doing this,” Omichi said.