Tuesday, November 02, 2010

Incensed Nonsense

Dr. Lisa from points west emailed me the other day:

OMG!


I am a gynecologist who has left my big practice to start one on my own. I want to use technology to the fullest and have only looked at web-based EMR systems. I have not rented a big space, thinking that I was going to be cloud based and didn't need a chart room or a computer room.

I am looking at leasing the GE Voluson-e laptop ultrasound and GE is trying to upsell me a $12K software package that is essentially a hardwired PACS system. I can only hardwire a computer to it AND, if I want to look at images, must walk to that computer to pull them up. I really want a web-based system to store my images and the GE sales rep was 'incensed' that I would even try to find something like this.

Am I crazy? Is there something out there for gynecologists to use with our ultrasound machines? Do you have any referrals for me or areas you believe I need to do further research?

 I am looking for a web-based PACS for the following reasons:

My new office will be web based and I am only looking at products that have redundancy (more than one storage server and these servers must be in two independent locations - many EMR companies offer this), mirrored data (data is stored simultaneously), and secure. I will not have to lease any extra space for computers; have to worry about losing data with two separate servers (a flood could take out one and I'd have a back up in a different location - can your office server do that?); save on file room space and staff, and will be able to send reports and images on-line to referring docs;subspecialists; or to the patient, if she wants. I am a firm believer that web-based can be safe, secure, and a part of our future.

Thank you so much! Your website and blog are intensely helpful and I was relieved and grateful to find it!
Thanks for getting in touch, Dr. Lisa!  Welcome to the world of EMR, PACS, and the vendors thereof.
 
I'm not all that familiar with the Voluson-e, but it looks interesting.  Nice and compact. 


I'm also not familiar with this package they are trying to sell you for viewing.  However, your instinct is correct concerning a web-based PACS.  For the time being, your volume won't justify owing your own PACS, but the advantages of sending the images out to the web (or to the cloud if you prefer) are multitude. 

My group owns an AMICAS PACS which we farm out in this manner, and one of our clients is indeed a small portable (actually mobile) sonography service.  This sort of thing is certainly do-able.  We would be glad to help you out, although you would probably be better served by someone closer to home.  Alternatively, I believe some of the larger storage companies such as Co-Activ or InSite One could be of service here.

Best of luck with your new office!  And tell Mr. Incensed from GE that you're going to look at Siemens/Acuson:

4 comments:

Anonymous said...

There are a few free/open source pacs packages, google for "pacs open source". You will need some technical know-how though.

SBG23 said...

Gosh I thought all pacs systems were supposed to be web based.. otherwise what's the point?

Rob Dejournett said...

I think the open source ones are not FDA approved (but I could be wrong). We at Connect Imaging sell a web based PACS but right now we don't have a business model to put it in the cloud (our clients usually have the server on site). I'm not an expert in the area though, I know Carestream has a cloud based service and have a thin client setup.

Novarad has a redundant setup like you described. Maybe check them out. Sorry, I'm still pretty new to the field. I'll look around at RSNA and post back.

Anonymous said...

Dr. Lisa,

Check out Pixmeo, www.pixmeo.com, the FDA approved version of the well regarded OsiriX system. It is web enabled, networkable, and can handle millions of files/cases. It can also expand further over time with open source archiving software.

Also check out the Apple white paper Transforming the Medical Imaging workflow, which shows some examples.

http://images.apple.com/science/pdf/ImagingWorkflow_White_Paper20100621.pdf