Wednesday, March 30, 2016

PACS Tidbits

New stuff in PACS seems to be overwhelmed somewhat by the Trump-like stampede of EHR data. Still, I've got a couple of items which might interest my loyal readers, all four of you.

Let us start with GE. Our Universal Disappointment Viewer should be updated to the next version sometime in the next few weeks. For those who haven't heard, our current UV has a number of problems, not the least of which involves not displaying one or more slices from a CT series when scrolling through. Fortunately, we do see a blacked-out pane with the phrase "0% loaded..." to let us know that we might be missing something. That is a major step up from our earliest go-round with Centricity 2.x years ago, which would skip images and not be kind enough to tell us it had done so.

As it stands, the "0%" thing happens on nine out of ten CT's, forcing us to close and reopen the exam, sometimes three or four or five times.

So...let's run some numbers. It adds 30 seconds to the exam each time we have to go through the close-and-reopen cycles. The busy site has maybe 40 CT patients per day (I'm underestimating), and for simplicity's (not Centricity's) sake, let us say they operate 5 days per week, and 50 weeks per year. That would be 10,000 patient-exams per year. So that's 9,000 exams that need to be reopened, wasting 4,500 minutes or 75 hours wasted for this year of Universal joy. At $200/hour (EXTREMELY reasonable rate), that would be $15,000 blown because of this poor coding.

I am hereby submitting a bill for this amount, $15,000.00, to General Electric for our professional services and time lost. I would urge all other departments experiencing this sad software error to do the same.

GE, please contact me for the address to send the check. I'll let everyone know when it arrives. Or if it doesn't.

While we are waiting on the check that's certainly in the mail by now, let us turn our attention to Agfa. You haven't heard much from me about our situation there, and you won't for a while. But in my search for an image-sharing solution (I still favor lifeIMAGE for this purpose) I stumbled across the fact that Agfa has an offering in that realm. Which has been deployed exactly never. I've learned not to beta (or alpha) test when patients are involved, thank you. Also, I'm hearing that Agfa plans to standardize and unify all of its installations onto one uniform platform. I'll assume this platform will be Agility, but I have no confirmation of that as yet. Good luck.

Onward and upward. Apparently Fuji has released Version 5.0 of Synapse PACS, and in an article on, (which was sponsored by Fuji and written by Fuji USA V.P.'s), it was the "hit" of RSNA 2015. I must have missed that somehow, perhaps because I rarely wander over to the Fuji booth. But the Veeps do make the new version sound quite intriguing.

Our latest Synapse PACS has beefed-up archival and worklist/workflow-engine capabilities—from unique sharing features to EHR interoperability tools to workflow-optimizing options that take integration beyond the enterprise, into the cloud and, from there, wherever collaboration is happening—or should be happening.

In a nutshell, the need today is for a diagnostic-level PACS workstation that extends through the PACS to any desktop that a PACS might touch. That’s why the Fujifilm team came up with the Synapse 5 PACS viewer. It’s designed to help users keep up with the changes that have already taken place and, more importantly, to help them stay out ahead of what comes next.

Nice to hear this from the company that has the reputation of taking years to update things.

When I first saw Synapse in action in the early 2000's, I was told that the local group had insisted on three-second transmission times for any study. Of course, it turns out that the group itself figured out how to accomplish this without help from Fuji. But speed is indeed an important factor today:

Going into the Synapse 5 PACS design phase, our team knew the only way to achieve sub-second image access while also virtually caching large datasets and enabling reads from wherever, whenever—including with 3D—was to approach server-rendering technology in a whole new way. That’s why we came up with not just a new viewer but a next-generation viewing application, one combining architecture changes as well as technology advancements.

With the new Synapse 5 technology, there’s no client at the desktop, and the image rendering occurs on the server. This allows the technology to be far less dependent on the viewer side, and it allows users to simply log in and choose their interface as well as their screen—Explorer or Firefox or Chrome, desktop or smartphone or tablet—or work with any combination of preferences.

Yup. Server-side rendering and a zero footprint client. Nothing novel, but Fuji is the first of the big-iron companies to implement this on this scale. I think it's a good idea if done right.

One of our favorite aspects of Synapse 5 PACS is its brilliant simplicity. Like most cutting-edge websites and more than a few apps, it uses HTML5 and was largely inspired by what you’ve seen in the world of e-commerce. It’s got a user-friendly, intuitive GUI, with high performance, limitless scale and strong security.

Can you say "Hyperbole?" I knew you could.

Here’s another reason we were so busy answering questions at RSNA 2015: As “disruptive” a technology as Synapse 5 is, it’s barely a disruption at all for existing customers. It’s not a forklift of a database or a migration or a platform change. It’s just an upgrade to our current Synapse 4 platform. Current Synapse users will be able to light up an entirely new viewer that will work off of the existing database they already have.

An upgrade? Definitely. I'll bet money it is a HARDWARE upgrade, requiring a new server (or more likely many servers) added to the back end. I could be wrong.

We haven’t forgotten to take what we’ve heard from radiologists and apply it. That means, among many other things, that our new viewer makes it easy to look at a screen for eight hours a day. We’ve thought through ergonomic implications, right down to details like minimizing wrist strain, and we’ve geared everything toward greater efficiency and productivity.

Oh, still my beating heart! Someone cares about us poor rads? That would be nice...

But now a thinly-veiled slap at our competitors...

There’s been a lot of talk lately about “deconstructing PACS” in order to free it from silo-ed systems. Customers want fast image viewing, diagnostic integrity, flexible worklist, integrated 3D, platform independence and information lifecycle management. Legacy PACS does not perform all of these functions well, which is why Synapse 5 is so different.

Synapse 5 PACS inherently does what PACS deconstructors would do if they could: It helps transform healthcare organizations as they enhance collaboration and optimize workflows across the enterprise.

I'm not seeing anything that says Visage and TeraRecon can't do all that, too. In fact, Fuji's non-deconstructed PACS sure sounds a lot like Visage's deconstructed PACS. But I'm sure there are differences.

Remind me to stop by Fuji's booth next RSNA. If I'm still in the business, that is.

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