Friday, July 15, 2011

A Challenge to GE and AGFA

Yes, GE, and AGFA, I'm throwing down the gauntlet. It's time. It's really way past time I do this. 

Here's some background. My group covers a number of hospitals. The two largest in our system use AGFA IMPAX 6.5. We also cover a very busy oncology clinic that uses Centricity 3.1. As you might imagine (and one of you claims to have a Healthymagination) patients bounce back and forth between the clinic and the hospital. Mr. Jones might have had is last three CT's at the clinic, but now presents the the ED with intractable pain, and must of course be scanned STAT! Mrs. Smith's tumor was discovered on scans at the hospital several months ago, and now is a patient at the clinic where her followup imaging will take place.

We deal with this scenario about ten times per day. The problem is, we don't always know that the patient has had an old study, and more often than not, the oncologists call us, boldly telling us that we didn't go where the patient had gone before, and would we please be so kind as to re-read the rather complex CT's of the head, neck, chest, abdomen, pelvis, spine, and extremities now that we know about the comparison studies. This comparison has to be done on two different systems, which is a pain in the gluteus maximus even if I knew about the old study in the first place. It's enough to make me drink...more than I already do. This is a patient-care issue, and a rather serious one at that.

Your mission, Vendors, should you decide to accept it (and I'll bet you won't...) is to solve this problem for me. WORK TOGETHER and create a solution. I need some form of Enterprise viewer to link or overlay or somehow mate the two systems, something that will find a patient's exams performed at either site, and let me know, and more importantly, let me read them side by side as if they were done at the same institution.

I really don't care which viewer ends up doing the job, although if GE wanted to do this right, they would leverage in the Centricity IntegradWeb client somehow. Otherwise, IMPAX 6 would probably be the next best choice. (Don't anyone get a swelled head; I still don't much like IMPAX OR Centricity 3.) 

This is not rocket science, boys and girls. Smaller companies like Intelerad and eRad, and bigger folk such as Carestream can do this. AGFA advertises their enterprise capability. So. It can be done. Now, figure out the way to do it for me.



Anonymous said...

Are your facilities using Global Patient ID's? Has Relevant Prior rules been configured correctly? How about Body Part/Specialty mappings? Are the studies being routed between GE <-> Agfa? Is prefetching enabled? This sounds more like a configuration error then a lack of functionality by either vendor....

Xray4u said...

Not configuration that is for sure! Even between impax spokes your average radiologist has to log in and out in order to check for a patient in spoke type architecture. This is an issue of a vendor or vendors not understanding how to move into a restful state architecture. A unified worklist is possible in many types of applications. These PACS vendors have chosen not to change from the 'old way' to the ' current way' . Direct database calls are old school!

GE Healthcare IT said...

Thanks for raising an issue that you’re certainly not alone on. GE Healthcare offers a broad portfolio of solutions aimed at solving this problem which, we agree, is one faced by many Radiology department operations. For example, our Centricity OneView solution is currently enabling our customers to share historical images, for comparison, between multiple PACS vendors including Agfa.

For more information on this or any of our other solutions, please contact GE Healthcare Centricity Imaging at .

Chris Wood said...

We believe a separate, unified worklist from an independent group like us (we don't sell a Pacs) is the way to go. No PACS vendor can build a unified worklist properly because they will always try to get rid of the other vendors in a mixed vendor environment. Welcome to the world of middleware. Chris Wood, CEO of Clario

Hussein Alsayiegh said...

Dear "GE Healthcare IT"

I don't think that Dr. Dalai is asking if you can; technically, do it or not, I think he is asking if you can do it using existing PACS/RIS with reasonable cost ! not to invest in a brand new system + migration + integration, etc..

Dr. Dalai am I right ?

Anonymous said...

We are faced with the same dilema but not as the reading group. But one of the PACS admins that the rads want to fix this issue. Are these two facilities owned by the same corporation? If the reading group has contracts with two seperate entities is it the actually the reading groups responsibility to pay for this interfacing? If we agree to work together with the competing entity are there HIPPA issues or Stark issues that we may put ourselves at risk of violating? Any comments are appreciated.

Anonymous said...

@Xray4u, that is not true. It's still a config issue. IMPAX provides remote query capabilities. IMPAX can query an unclustered, unlinked, known DICOM entity upon every search. It's called Remote Queries, it can be configured by your site admins within the IMPAX client config screen (per user), and it uses standard DICOM (CFIND/CMOVE)to do so. The pitfall is searches take longer as IMPAX needs to wait for the results from the third party system.