Tuesday, December 27, 2011

Help Dr. Dalai Quiz Advanced Visualization Vendors!

I'm hoping my loyal and wise readers can give me a hand. As you know, we are set to have a "shoot out" between several Advanced Visualization vendors next Wednesday. The list as it stands includes GE, Philips, TeraRecon, Siemens, and Vital Images, narrowed mostly by our initial look at CT scanners.

This is a big decision with lots of money involved, and we want to do it right. Therefore, I'm turning to my friends out there for advice. Here are the basic questions we are asking the vendors. PLEASE let me know if we've left something out...
  • Please provide a brief overview of your system. A drawing would be great.
  • What is your licensing scheme for both thin and thick clients? 
  • Are there two tiers of functionality? Please elaborate on which functions are included for each level. In particular, do you offer on thick and/or thin client:
    • Coronary/cardiac evaluation
    • Stent planning
    • Brain perfusion
    • PET/CT with automatic registration and propagation of lesion ROI’s from prior to new study
    • SPECT/CT processing
    • Fusion of any two modalities
    • Creation of report-quality AVI’s
    • Transparent/translucent bone rendering
    • Vessel seeding/growing
  • Is any special hardware required for the thick client?
  • How many servers are required for full functionality? Is there a user or a slice limit per server? Please outline or provide a table to illustrate.
  • Does the thin client require any additional software to be installed, i.e. Java, .NET, etc. If so, what version?
  • Will the thin client work on a MacOSX, iOS, Android? Does either thin or thick client function well in a Citrix environment, the latter utilized on desktop machine or mobile device with iOS or Android?
  • How does the user login to either product? Does the system have its own user database or can it authenticate to Active Directory? 
  • Has your product been fully integrated with IMPAX 6.5? Please describe the usual workflow we would experience when accessing a study on your system via IMPAX.
  • How will we handle routing of separate datasets to your system as opposed to PACS? (We will likely want to send full thin-slice images to your server but not to PACS itself.)
Have I forgotten anything? Oh, yes...Happy New Year, everyone!!!!

ADDENDUM

Here are the questions in final form as sent to the various vendors:


Advanced Visualization Demonstration Questions
General
  • Please provide a brief overview of your system. A drawing would be great. Handouts are appreciated.
  • How many servers are required for full functionality? Is there a user or a slice limit per server?
  • Please outline or provide a table to illustrate.
  • What is your licensing scheme for both thick and thin Clients?
  • Are there 2 Tiers of functionality, as in Thin and Thick Client? Please elaborate on the functionality available for each Tier.
  • Will both clients function well in a Citrix environment?
  • What is the client to server ratio for each type of Client?
  • Does the thick client require any special hardware?
  • How does the user login to either product?
  • Does the system have its own user database or can it authenticate to Active Directory?
  • What type of auditing functionality does it have?
  • Has your product been fully integrated with AGFA’s IMPAX 6.5? Please describe the usual workflow we would experience when accessing a study on your system via IMPAX. (Any images created on your system would be stored on IMPAX.)
  • How will we handle routing of separate datasets to your system as opposed to IMPAX? We will likely want to send full thin-slice images to your server but not to IMPAX.
Thin Client
  • How do you access the thin client?
  • Is it URL based?
  • Is it dependant on a specific browser or require any additional software to be installed, i.e. Java, .NET, etc? If so what version?
  • Will the thin client work on a MacOSX, iOS, or Android?
  • How many concurrent users can it support?
  • In situations with low bandwidth (outside the Hospitals) how does the thin client perform?
  • What happens if the connection between server and client times out?
Hopefully we haven't missed much.

My primary goal is to see how these various systems will perform in a pseudo-production environment. I do realize that some of the demonstrations will be hobbled by the restraints WE have placed on the vendors. We are asking them to use data from OUR scanners (which include both GE and Siemens), and we have NOT given the cases to them in advance. Some vendors noted that their automation depends on "learning" the scanners from their DICOM headers, and I almost caved on this issue, but ultimately decided to keep the playing field completely level, for better or worse.

Staging this sort of comparison is quite interesting, and the emotions and actions inspired can be amusing as well. One vendor wanted to place servers in our data center as a long-term demo. Another, as above, wanted the data in advance to train its automation on our particulars. Several requested connections to IMPAX for the demo. We said "no" to all of these, although I'm still wondering if we needlessly limited some of the vendors in our efforts to be "fair" to all. We'll see.

Doing my research at RSNA was fun as well. I had the chance to meet several of the CEO's of the companies involved, some after more or less showing up at their carpeted ranches unannounced. (I did not get to GE's mega-booth, which took some maneuvering to avoid, but I'm sure Jeff Immelt had better things to do than talk to me anyway.) All but one vendor seemed quite interested in making sure I saw what I needed to see; the outlier found an apps person who was clearly brilliant, knew the product inside and out, and barely spoke a word of English. Next time, I'll be courteous enough to make an appointment.

In the end, we probably won't go wrong with any of these fine products. I'm just hoping to find the marriage made in I.T. Heaven, although those are probably contradictory terms...

1 comment:

ReverendMD said...

Thin client specific issues:

1) Scalability.

How many concurrent users can it support? Most (though not all), thin client viewers do server-side rendering which kills concurrency. In that scenario you're looking at around 10(!!) concurrent users per server. Usually this isn't enough so scaling horizontally is required to actually meet the needs of the institution - what's the cost for that?

2) Mobile support.

Is there a mobile strategy? If browser-based, how does it actually work on a mobile browser (as those are usually slower than their desktop counterparts). If app-based, is it iOS only? Does it support Android?

3) Low bandwidth.

If rads and other clinicians are going to be using the product outside the hospital, how does it perform? Is it usable on low bandwidth and spotty connections (what if a connection waves out - are you done? does it gracefully degrade or does it lock you out immediately?)

4) Virtualization.

Can the server virutalize? Usually virtualization makes IT departments happy as it allows for easy management, and facilitates fail-over, testing and deployment of the product. A number of solutions use server-side GPU rendering where you trade virtualization for performance and cost (usually more expensive hardware). Is it worth it? Maybe - but something to keep in mind.

5) Integration.

Every vendor will claim some sort of standards-based integration, but it's never that simple. Have them actually bring a box to the hospital and show a test, or proof-of-concept, integration on live data. There's no substitute for this.

Happy New Year.