RSNA Rising

With its 60,000-plus attendees, several hundred vendor exhibitors and hundreds of scientific sessions, the annual Radiological Society of North America (RSNA) Scientific Assembly and Annual Meeting took over Chicago's McCormick Place convention center Nov. 26 through Dec. 1.

And while radiologists and nuclear medicine specialists crowded the 217 scientific sessions held in one section of McCormick Place, attendees swarmed over this year's 764 exhibitor booths, some of which were longer than a full city block, that filled the 521,000 square feet of exhibitor space in one of the world's largest convention venues.

Significantly, this year's RSNA exhibit floor was more IT-oriented than ever. While some of the pitches pushed by vendors had a new ring to them, overall, the exhibit side of the convention seemed to further a growing trend towards more blending of modality management, image management, and information management.

RIS and PACS (radiology information system and picture archiving and communication system) offerings have become more integrated by more vendors. Integrated workstation capabilities have advanced and a broader theme of integration met the themes of workflow and productivity improvement across the exhibit floor.

With 64-slice diagnostic imaging equipment proliferating; the economics of PACS implementation growing more favorable to smaller hospitals; and the cost of storage plummeting, the data load of radiology- and cardiology-based images is now expanding dramatically.

"As we move from 16- to 64- to 256-slice modalities, and move to faster scan times, with the ability to scan quickly from head to toe, the amount of data we're collecting is exponential compared to a couple of years ago. And we haven't seen the disaster recovery and backup preparations put in place" to support that level of data, "yet patient care organizations are forging ahead to create more data," says Scott Grier, a Sarasota, Fla.—based director in the IDEAS (Integrated Digital Enterprise and Solutions) unit at Long Beach, Calif.-based First Consulting Group.

Says Vincent Norlock, a Whitefish Bay, Wis.-based managing consultant in the IDEAS group, the exhibit floor at RSNA is becoming more and more a CFO and CIO show, rather than a radiologist show.

In fact, says Jeffrey Bauer, Ph.D., a healthcare futurist at Dearborn, Mich.-based ACS Healthcare Services, CIO-led moves toward greater integration of diagnostic imaging, imaging management, and information management are becoming crucial at a time when huge amounts of data are about to join radiologic and cardiologic images on PACS systems. Right over the horizon, he points out, is the expansion of what is now in digital images, to pathology slides, dermatology slides, audio files, and "anything that can be recorded digitally."

Not surprisingly, CIOs are alarmed.

J.P. Fingado, vice president and general manager at Kansas City, Mo.-Based Cerner Corporation, says he recently brought together the CIO and the chairman of pathology of a major hospital. When the pathology chair estimated that 450,000 lab slides a year could go online at the hospital, at one megabyte per slide, Fingado says, "The CIO went completely white."

Indeed, numerous conversations this year centered around the concept of patient care organizations moving towards storing not just hundreds of terabytes of data in the near future, but petabytes of data (1,000 terabytes), with those loads being driven partly by PACS systems and diagnostic imaging work. As such, storage management was a highly discussed topic this year among visitors to all types of vendors, as was a further move toward thin-client facilitation of image viewing by clinicians.

Quality methodology-based improvement of workflow and patient care processes was also a theme this year, as budget-conscious hospital executives are having to get as much throughput as possible out of diagnostic imaging equipment and optimal use (and clinician satisfaction) out of PACS systems. As a result, notes Michael Jackman, general manager of healthcare information solutions and vice president at the Rochester, N.Y.-based Kodak Health Group of the Eastman Kodak Company, "A significant proportion of our clients are working on process issues with us, using Lean management concepts and tools along with their IT implementations in radiology and elsewhere."