25,000 Hitsand some RSNA tidbits

Visitor number 25,000 comes from algx.net (XO Communications) in Hampshire, Illinois. Sadly, he or she only stayed on the site for a second, but still, a hit is a hit.

Four days at RSNA can go very quickly, although it's enough time to thoroughly wear you out. I had the honor (and I'm not being sarcastic) of rooming with Mike Cannavo, the One and Only PACSMan, since he couldn't find another room in Chicago. If you can imagine walking the Technical Exhibits with someone who spots every little advertising discrepancy and innuendo, well, that's what it's like strolling the GE Boulevard with Mike. Check out his (in)famous 2006 PACSMan Awards and keep in mind that I was along for the discovery of a few of the winners.

I actually tried to attend as many educational sessions as possible this RSNA, which didn't allow a lot of time on the show floor. I still managed to see and learn a few things... In no particular order:

1. Cardiac CT is probably going to be as big for radiology as for cardiology; we just need to market it correctly and do it perfectly.



2. To actually achieve that perfect cardiac CT takes a 64 slice CT (or beyond). Toshiba announced for the 7th time a 256 slice scanner, which may actually sell in a few years. GE is using some clever "step and shoot" techniques to lower the dose on its 64 slice unit, and GE promises to emphasize spatial resolution. Siemens offers the Somatom Definition which has two separate X-Ray sources. The Definition has the best temporal resolution in the business, but its price is about double that of the others (although no one knows how much Toshiba's opus will cost). I now have to convince the hospitals that the cost is justified. Wish me luck.



3. I finally got to look briefly at McKesson's Horizon PACS. We never were allowed to consider McKesson because we had just dumped HBO as our HIS. I really didn't have enough time to do it justice, nor to do a proper write-up. Some of the big names from McKesson (many of them were from the original ALI team) gathered 'round the Dalai (who is already pretty round himself) for the demo. Again, I am humbled and honored by such attention! I have always heard good things about Horizon, and I found the stories to be well-founded. This is a very solid, usable program, which I would trade Impax 6 for in a minute. Horizon is a Smart-Client, but it is a Windows application, and does not utilize .NET. In my brief demo, I could see a lot of potential. Particular highlights include a nice streaming protocol that loads the images of a series based on which one your mouse is hovering over, and good hanging protocols. My one complaint is my usual whine: the system has a zillion configurations, and feature-fatigue could be imminent. How about keeping it simple?



4. Rumour: A big Amicas client may bail and go with Fuji. Bad choice in my humble opinion.



5. After sitting through umpteen educational sessions, I'm now worried about the last 100 cases I read before coming to RSNA.



6. A meeting of radiology bloggers didn't go off quite as planned, but I did get to meet Steve Severance, formerly of the Baltimore VA, but now a consultant at http://www.ivirtuoso.com. We had a great talk about PACS, and having worked with the luminaries such as Eliot Siegel, his perspective is amazing.



7. The first session I attended was about PACS workstation design, and I'll probably write a full post about that alone. Suffice it to say some of my ideas aren't that far off the wall.



8. In the not-so-sexy but still interesing department, a Korean company that makes backlights for high-res monitors showed a prototype monitor that uses LED's for backlighting. This allows uniform lighting with easier calibration and much longer life. I hope to see a production version soon.



9. GE's booth was larger than ever, easily covering several city blocks. Sadly, I didn't have time to see their "Future Theater" which supposedly showed what CT will be like in 10 years. No doubt GE will play a critical part.



10. As if McCormick Place isn't large enough already, there is a new West Building under construction that will probably double the available floor space. Attendees will need to steal Agfa's Segways to get around.



11. Amicas continues to progress nicely. A year ago, I had hoped to debut Version 6.0 (rather unfortunate title given the other Version 6.0 I deal with) at this RSNA. Well, it isn't ready yet, but the prototype gets better and better. I'm proud to say that it even incorporates a few of my suggestions, among a host of much better ideas. I truly think this system, written from scratch, will trump the other systems out there. It keeps the look and feel of the older product, while adding fantastic functionality, including some I can't talk about under NDA. I have two requests of Amicas on this topic: First, devote all possible resources to getting Version 6.0 out the door as soon as possible. Second, don't do an Impax and deploy it before it's ready. Trust your developers, and don't even think of running out of Red Bull! As for the near future, I got a chance to demo RadStream as integrated with LightBeam in prototype form. I was not a RadStream fan at first, since it seemed to mainly add an Amicas-like worklist to Centricity, which badly needs one. But, in its Amicas integration, it provides an incredible communcation system from tech to radiologist, and from radiologist to an "operator" who is in charge of getting reports out to referring docs. I just needed to see how it would work, and now that I have, I am a big fan. This is the most straight-forward approach out there, and it will work beautifully. Anyone want to be my operator? The communication package is rounded out by the VisionReach system that will allow automatic e-mailing, among other alerting, of properly equipped clinicians or their designates. I'd say Amicas is in for good times.

No doubt I've left something out, and I'd love to hear about your favorite booth or session. Next year in Chicago! (They might have the snow shoveled out by then!)

Oh, and by the way, I had to take call the day after I returned from RSNA. My Impax 6.0 station crashed about every 30 minutes throughout the evening. I wish I could report more progress from Agfa. Maybe next year.....