Saturday, April 28, 2007

Here Wii Go!
...A new pointing device for PACS?

There has been much discussion of how to point at your CT on the workstation. Most of us still use the venerable old mouse, while some have graduated to trackballs, joysticks, jog-shuttle dials, and even roller-mice.

An Italian college student by the name of Giorgio has come up with something new, that I think has great promise. Some of you have probably succumbed to your kids' pleadings for a new Nintendo Wii, which isn't all that expensive at around $200. The Wii's claim to fame is its entirely different approach to game control: the Wii-mote, consisting of a wand or nunchuck, and a little joystick control on another little pod:

You control the various games by moving the nunchuck in a natural manner. For example, hold it like a golf-club or a tennis racket and swing appropriately. A tiny accelerometer inside the nunchuck translates the motion into control signals for the Wii. Note the included wrist-strap designed to keep the nunchuck in your hand after a vicious slice, thus avoiding injury to yourself, others, and your TV.

Giorgio has hacked the Wii-mote and via a control system called GlovePIE, he has made it operate a CT display. Based on his video, he hasn't yet tried it on 3D renderings, MPR, etc, but that would be the next logical step.

Now can I get a Wii, Mom?

Wednesday, April 25, 2007

OOPS....We had a little downtime today...

Fortunately, I'm on vacation this week, and I didn't have to deal with the joys brought about by downtime. According to Dalai's First Law of PACS, "PACS IS the Radiology Department," and so when PACS is down, the department is down, and the patients can just cool their jets (or their hemorrhages, or whatever) until it's back. The good news is that the rads can go on a prolonged coffee break if there isn't any way to get back up again.

I don't know all the details at this point, but I do know that our newly-upgraded Impax went down from 8AM until 10AM today. Not the best time for that to happen, if there is a good time. We are assured by our vendor, however, that the same problem will not occur again (any time soon, I assume). I find the whole situation sort of confusing, because we have three parallel production servers, and I don't really understand what took them all down at once. Maybe the Oracle is at it again?

Since the upgrade was fresh, no one thought there would be any problem of this magnitude this soon (about 52 hours after completion), and so the backup plan wasn't fully on-line. Now, we do have a test server, which was used during the upgrade itself, but I guess the scanners weren't still pointing to it. We actually had to use the venerable old (gasp) Web 1000 to get anything read during the dark age of the downtime. Fortunately, the servers where good old Web 1000 live haven't been wiped as yet; I think they are going to be converted to Impax 6 servers eventually.

Well, we survived, and we are stronger for it. Can't wait for the next episode of "As the PACS Turns (Off)".

Monday, April 23, 2007


Never let it be said that whining doesn't get you somewhere. We complained, and Agfa listened (to a significant degree, anyway). As noted in the sign-on screen above, our Agfa site bumped up to version (6.2 for short) from 6.0.x over the weekend. The upgrade went without a hitch. Well, that was my view, because I'm on vacation, and no one bothered me! I'm told there were some problems here and there, causing the install to be completed at about 4AM this morning, instead of the anticipated 8 or 9 PM last night. Something with Oracle, I hear. (IT folks are rather like doctors. If you come in with some weird disease, it somehow is always due to a virus. A problem with Impax somehow always relates to Oracle. Personally, I would prefer the Oracle from the movie "300" but she might not prove quite as operational as what we now have. I digress....) To add insult to injury, something happened to the power at the data center this morning, and shut the darn thing down again, but that was NOT the fault of Oracle, as near as anyone can tell. I find it interesting that someone on the team was checking my blog at 1AM this morning to see if I had said something bad about them yet. Who, me???

Not counting some patches and service upgrades, this is the first major revision we have had in the six months since go-live with Impax 6. I have a list of the 113 things that were changed, but I'll spare you the joys of reading that. Let's just concentrate on what directly affects me, the target audience (at least that's how the folks from Waterloo explained the requirement of affixing a big red bull's-eye on my back...)

The single greatest accomplishment as far as I'm concerned is the reintroduction of the "simple search" for "simple-minded radiologists." Instead of the incredibly powerful but incredibly obtuse "advanced search", the easy version lets me drill down quickly to what I need. The Agfa folks were absolutely flabbergasted that we end up searching by the patient's name about 90% of the time. Well, now I can do that without going through the gawd-awful drop down menu of 100 different criteria. Unless I really want to, that is, because the advanced search is still available. See? An easy solution! Here is how it looks today (compact and expanded'll have to click them to see everything):

The list of improvements goes on for 112 other items, give or take. I do think there are some duplicates on the list, for what that's worth. Some of the other highlights include:

  • Available Series Tray is now embedded based on User configuration. It was previously stuck at the left side.
  • Hotkeys should now "stick", and not be erased after logout.
  • Various causes of crashes have been eliminated.
  • Cursor mode line now upgrades in orthogonal views.
  • Should be able to open larger number of studies without slowdown.
  • There is now permission to configure one's own station (and take back some RAM!!)
  • New/upgraded versions of the client will download automatically when the new version is recognized.
  • Column changes in Worklists are immediately saved, and applied to ALL worklists (hopefully that's what we wanted..)
  • The automatic brightening and dimming of the Prior list is shut off.

Now, here are some of my pet peeves that are not yet fixed:

  • Handling of two rads trying to dictate the same study. There is a temporary fix with a warning message, but an insistent rad can still override the settings.
  • No easy way to get back to the last study that was on the screen. Yes, there is a somewhat hidden "history" tool, but it only works on studies that have been clicked off as dictated.
  • Spine labelling. There isn't any.
  • Voxar button still stays active, leading to repeated activation of Voxar3D when you were just trying to get back to the original study.
  • Comparison windows still based on the cloning concept.
  • Black screen when images of a series are loading.
  • Thumbnails in the Series window can be easily, inadvertantly resized, to the point of being unusable.

I could go on. 6.2.1.x represents a significant improvement, at the very least many glitches have indeed been fixed. The underlying philosophy of the program remains what it was, however, and that is something the potential buyer should be very, very comfortable with before, well, potentially buying Impax 6.

Thursday, April 19, 2007

Thirty-Five Thousand Hits!

Visitor 35K came to my site at 1:40PM EDT today, and stayed an impressive 18 minutes, 25 seconds. He or she must have fallen asleep at the keyboard! Anyway, he is from Bekond, Germany, and was searching for the phrase "Oracle buys Agfa". It seems takeover rumours are rampant these days. As near as I can tell, Oracle is not buying Agfa. Agfa isn't even for sale, is it?

Monday, April 02, 2007

Hospital Mentality

The above is an unretouched and unedited video shot in the departmental restroom at one of our hospitals. You will note the obvious dilemma. Ah, hospital mentality...

Sunday, April 01, 2007

GE Buys Agfa PACS!!!
....Centri-PAX to debut soon

Just when I think there are no more surprises left in this game, something comes at me from left field.

I have it on good authority that GE and Agfa have had high level talks over the past six months, and they have agreed to merge their PACS products. The new flagship offering, Centri-PAX (Centricity is GE's system, IMPAX comes from the Agfa side) should offer the best of both worlds, without carryover of the deficiencies of each. The new hybrid will be web-based, and run on Microsoft's .NET platform. It will eliminate the need for the separate Centricity-Web now required for web access on the GE side. Centricity users will note similar DLP's (hanging protocols). 3D options will include the GE Advance Workstation (AW) platform, long promised to be ported to Centricity, or the Voxar/Barco 3D program. TeraRecon or Vital Images' Vitrea may also be purchased.

Spokespeople for both companies note the unprecedented nature of this cooperation between giants in the PACS field. "This is like Ford and GM working together on a next-generation vehicle," says Robert Pryor, President of Agfa Health Care. GE's David Henriksen, head of GE's PACS and IT division agrees: "For the first time in the history of PACS, the two biggest names in the business will cooperate to provide the best program available."

Competing companies had no comment, except to urge you to note the date of this posting. Have a happy one.