Thursday, April 30, 2009

Dalai Is On Twitter!

I've finally succumbed to peer pressure and become part of the Twitter network.  Frankly, I'm trying to figure out where it fits into my world of blogging and the occasional Facebook post.  Feel free to subscribe if you have absolutely nothing else to do.  You might find an occasional word of wisdom.  Or not.  

Tuesday, April 28, 2009

Still Following The Green Brick Road

As a frustrated Centricity user, I have been waiting and waiting for our upgrade to Dynamic Imaging, I mean Centricity PACS-IW. We just underwent the upgrade from Centricity 2.x to Centricity 3.x. I will freely admit that this was a major improvement; studies appear MUCH more rapidly on the worklist, and transfers to the AW (Advantage Workstation) occur in a few seconds rather than a few minutes. Sadly, the GUI hasn't changed much at all.

I would really like to have Web DX to replace ol' Centricity. However, it seems that legacy Centricity sites will have to buy the IW upgrade, and I don't think my site has done so at this point. Oh well. I'm finding that only a few test sites have Web DX today. Since I'm not at a pilot site (can you imagine GE using me for that?) I can't yet get my grubby paws on Web DX, even if I had the dough available. But that doesn't stop GE from advertising the heck out of Centricity IW, and even receiving awards for the integration of the DI system. From the DI, I mean the GE website (even though it is still comes the following:

“GE Healthcare is uniquely positioned in the marketplace with one of the leading edge RIS/PACS technologies and a collaborative, internal synergy within the Centricity group that continues to strengthen GE’s position in North America and abroad,” says Nadim Daher, Senior Industry Analyst, Frost & Sullivan. “The multifaceted growth strategy that GE has put into effect capitalized on the strategic DI acquisition and revitalized the company’s imaging informatics business in a mature market segment. . .”

“GE is honored to accept this award from Frost & Sullivan, which validates the success of our Dynamic Imaging acquisition and demonstrates that this was just the right accelerant to our winning business strategy,” says Don Woodlock, Vice President and Global General Manager, GE Healthcare IT Imaging Solutions Group. “This strategy includes leveraging Dynamic‘s acclaimed Web-based PACS across numerous US and global market segments, and integrating the Web-based diagnostic viewer with advanced streaming technology to Centricity PACS.” In addition to this Frost & Sullivan award, GE Healthcare’s Centricity PACS-IW was named Best in KLAS-PACS by analyst KLAS Research and has maintained a #1 PACS ranking from analyst MD Buyline for nearly 3 years.

I love how the acquisition instantly propelled the name "Centricity" from the bottom of the KLAS charts to the top, even though the product is totally different, and not even available yet. But that's show biz, folks.
Anyway, I am still eagerly awaiting my chance at Centricity IW/Web DX. Really. Bring it on! Please!

Friday, April 24, 2009

. . . Priceless

I've just returned after a few days in Naples, Florida, where we went for my Mother-In-Law's big birthday that ended in zero. (The number was somewhat more impressive than my decade-birthday of a few months ago.) Naples is a great place, with nice people, beautiful beaches, blue ocean vistas, and incredible restaurants. Many thanks to Ray and Rick for recommending Truluck's, truly a find.

Speaking of travel, I tried to discover the disposition of the flight-attendant who became ill on our return trip from Costa Rica. Delta, following strict HIPAA rules (just can't get away from that, it seems) wouldn't tell me a thing, but did send me two in-flight drink coupons for my efforts. I've heard about docs receiving free tickets and such for responding to in-flight emergencies, but that apparently is a thing of the past. But no matter. Let's see.....
  • Spending three hours standing up in the back of the plane ministering to patient with minimal equipment---$14 in drink coupons.
  • Anxiety over the patient's condition---beyond calculation.
  • Knowledge that you did the best you could under the circumstances---Priceless.

Thursday, April 16, 2009


This is an ad, obviously, for a teleradiology service called EagleEye Radiology. My Eagle-Eyed friend, Mike Cannavo, the One and Only PACSMan, noticed that the EagleEye teleradiologist is doing his teleradiology from film. Of course, the EagleEye teleradiologist also has a stethescope, so maybe he's a little confused overall.

Someone could make a killing with an ad agency that actually understands medical products and services.


Reader Mike O. spotted the intrepid "radiologist" above in a few more stock photos from

Ah, the captions that come to mind. . . "Why is my pee blue?" "Who's been screwing with my Tinkertoy?"

I'm not sure why EagleEye just didn't use the photos of their own docs. . . although we radiologists usually do like to remain in the dark.

Wednesday, April 15, 2009

Sectra Spam

Here's a bit of a lesson in how NOT to advertise.

EXPHYS07 posted a comment to my post Dalai Down South, an article which didn't mention PACS at all, but rather talked about my trip to Costa Rica. EXPHYS07 not only placed his comment somewhat inappropriately, but he managed to post the same thing FOUR TIMES. Here is part of what he said:
Sectra IMTEC, AB and Sectra, NA is a relatively small to mid size PACS company that has the second largest install base in the world. It also boasts one of the best balance sheets in the industry coupled with an intensive collaborative R&D program with top Scandinavia Universities and Medical Imaging Scholars. Their original launch into the PACS market began with a reseller agreement with Philips Medical Systems and within the last 7 years they have launched as an independent company that develops, markets and sells RIS-PACS, Mammography PACS, Ortho PACS coupled with a second division that primarily develops and markets secured communication technology to the Government Sector and boasts a contract with NATO and other ministries of defense contracts around the world...
Feel free to read the rest of the text either in one of the FOUR entries, or on EXPHYS07's blog, appropriately titled PACS, where the first and only post consists of the same text.

EXPHYS07's profile reveals that he works for. . . Sectra. No surprise there. He has even become a follower of my blog, which is very kind. So, some friendly advice in return: Please don't spam. Posting multiple copies of the same text, especially when it is your main blog page, is not cool. Comment once, and just provide a link to your page. That will suffice. And try to attach it to an appropriate post. As near as I could tell, there isn't much in the way of PACS in Costa Rica, although it is quite possible that Sectra has a presence there. Why EX chose that particular article is a mystery to me. Unless he is shooting for the Costa Rican account.

Sectra has a very good PACS, but maybe the company needs to work a little more with its reps on advertising and marketing.

Monday, April 13, 2009

MORE Reasons To Avoid Speech Recognition

A recent JACR article by Quint, et. al., noted that "More than 20% of our reports contained potentially confusing errors, and most radiologists believed that report error rates were much lower than they actually were." In response, Peter Marcovici, M.D., a radiology resident at UCSD writes about his own in-house survey. On a scale from 1-5, with 1 being "strongly disagree" and 5 being "strongly agree," his results were as follows:

1. I am satisfied with our VR software: 2.2
2. Our VR software increases my productivity/efficiency at work: 1.9
3. Our VR software decreases my productivity / efficiency at work: .2
4. Using our VR software introduces errors in communication: 4.2
5. I have seen errors in prior reports that I attribute to our VR software (not diagnostic errors): 4.4
6. I have been notified by a clinician because of an error due to our VR software: 3.8
7. I have seen an error attributable to our VR software that has significant clinical implication: 3.8
8. I have had to addend a report because of an error generated by our VR software: 4.1
9. Macros in our VR software increase completeness: 2.9
10. Macros in our VR software decrease accuracy: 3.6
11. Using our VR software enhances patient care and safety: 2.3
12. Our VR software increases potential for malpractice: 3.8
13. Our VR software allows for more time for teaching, learning, and attending conferences: 2.0
14. When reviewing reports generated by our VR software (before finalizing them), I notice errors which need correcting: 4.1
15. When comparing alternative systems (i.e., human transcription services), our VR software is . . .
a. Faster: 1.8
b. More accurate: 1.8
c. Leads to more confusing reports: 3.6
He concludes:

Does it make sense for radiologists to divert their gaze and attention to a third screen to edit thousands of words of text daily?
I conclude: NO! Which is no surprise to anyone.

Thursday, April 09, 2009

Bye Bye Birmingham

I have some sources within the newly acquired Emageon offices in Birmingham. It helps to have trained at UAB, the incubator of what eventually became Emageon PACS.

It seems that Amicas will close this office, and will let go several of the folks that work there, albeit with fair severance packages. My understanding is that user support remains pretty much intact, so you Emageon customers need not worry at this point.

No doubt this is a necessary move, and all my inside contacts are expressing understanding of this fact, and hold no ill-will toward Amicas. After all, if Amicas demonstrates the expected hybrid strength following the acquisition of Emageon, they might get the chance to return. Well, maybe. My crystal ball isn't so great with business issues. But these are good people and they will land on their feet. I wish I had enough PACS business to hire them myself!

I guess the rule in business is to do what you must do, no matter how difficult that might be. Sort of the way it is in medicine as well.

Wednesday, April 01, 2009

Dalai Embraces Agfa!

Sometimes being a pest can work to your advantage. I've been yowling for years about the various deficiencies in Agfa Impax 6. I am proud to tell you today that they have listened to my ranting, and plan to introduce Version 6.6.6, (which I affectionately call the Dalai Edition) which will solve most if not all of the difficulties we have had with Agfa. This product will supercede most of the other PACS GUI's on the market.

Let me outline what V666 will do:
  1. No more "X-box" errors.
  2. Priors and reports from the earliest days of the archive will be accessible.
  3. Proper function of worklists, with indicators for studies available and already being read
  4. Elimination of possible double-reads due to poor study sequestering
  5. Built-in MPR, 3D, etc, with intuitive function of cursors.
  6. Instant on-line priors.
  7. No decompression artifacts.
  8. Functioning and intuitive hanging protocols.
  9. Intuitive tools, with elimination of mega pallette of crap no one uses
  10. Easy upgrade/patch installation.
  11. Elimination of "toggle" mentality.
  12. Others too numerous to list.

Yes, folks, today, Agfa is my new favorite PACS. They have listened to me, and fixed everything that was wrong with their old systems. V666, the Dalai Edition, will make a believer out of you as it has with me. Starting today, I will begin replacing all of my other systems.

Yes, take GREAT NOTICE of Today's Date, because it's the only time you will hear a statement of this magnitude!