Best of the Blogs

The following commentaries are the most read postings from HCI's Blogosphere. To read other postings and leave your comments and questions, visit http://www.healthcare-informatics.com/blogs, register with a username and password, and blog away.

Enterprise PACSPosted on: 12.29.2007 1:50:38 PM Posted by Marc Deary

My first PACS consisted of a Token Ring FDDI network with three diagnostic workstations in the radiologists reading room, one QA workstation in my office and four clinical review workstations located in the ER, MICU, CCU and SICU. Images were auto-routed to the defined areas providing access to radiology images only. The year was 1995, the site was a 300-bed single-facility hospital and the PACS was homegrown using software from a software-only vendor and a 250GB optical jukebox for storage.

Today's PACS are Web-based and light years away from my first PACS. Networking technology has grown tremendously along with computing power and software development platforms. Modern PACS are designed for large enterprise implementations including WAN connectivity to serve multiple facilities providing access to images from radiology, cardiology, pathology, endoscopy, dental, medical photography and other clinical areas. Today's PACS environment includes seamless integration with HIS/RIS and EHR systems providing access to a variety of images and patient data at virtually any PC or workstation within the hospital or health system.

Storage for the modern PACS is usually allocated from a much larger enterprise storage solution designed to be scaled up to meet future data storage needs. These intelligent storage systems can assign priorities to certain data and create rules for data management between different media types. Unlike my 250GB write-once read-many jukebox from the '90s, today's PACS archive is only a portion of the enterprise storage system consisting of multiple technologies ranging in size from Terabytes (TB) up to Zettabytes (ZB).

PACS is no longer an acronym synonymous only with radiology. Today PACS actually stands for Enterprise Images and Data Archiving and Communications System, but PACS does sounds better than EIDACS.

Name That Vendor?Posted on: 12.19.2007 9:40:01 PM Posted by Marc Deary

Radiocontrast agents (also simply contrast agents or contrast materials) are compounds used to improve the visibility of internal bodily structures in an X-ray image. — Wikipedia, May 2007

If you're wondering why a PACS guy is talking about contrast media, well I am an RT and Anthony Guerra at HCI recently brought my attention to an article about the sale of Bristol-Myers Squibb's medical imaging unit to a private equity firm. This unit of BMS owns the short-lived patent on Cardiolite, a contrast agent for Cardiac SPECT studies.

This started me to thinking about the endless sales and mergers of medical imaging and imaging supply companies. I can name at least 10 sales or mergers of medical imaging companies in the last three years. This constant changing of the guards has a definite influence on the operations of radiology departments and imaging centers worldwide.

These multi-million dollar sales and mergers may have positive financial outcomes for the companies involved, but this has a negative impact on day-to-day operations for radiology departments and imaging centers. Radiology managers and imaging center directors have to deal with the steady changes in name brands and the services they provide. I guess we will have to wait and see how the sale of BMS's medical imaging unit affects the quality and delivery of Cardiolite and other contrast agents.

What do you think about the constant acquisitions and mergers of medical imaging companies? How is this affecting your daily operations?

Philips PhilanderingPosted on: 12.29.2007 12:50:41 PM Posted by Vince Ciotti

Netherlands-based Philips has made 3 acquisitions this month:

Emergin - a Boca Raton-based maker of wireless alarms for hospitals, doing about $20M in annual revenue; probably petty cash for Philips…
Visicu - a Baltimore-based provider of patient monitoring systems, a deal worth about $430M, maybe requiring two signatures on the check…
Respironics - a $5.1B deal for this respiratory-support system vendor, enough to distract even Bill Gates from giving our money away…

What's up? The weakened dollar (buy any French wine lately?) makes U.S. firms very attractive to foreign investors, with the Euro now worth almost double its value of a few years ago. Philips has dabbled in the U.S. IT market before, when it tried to do a deal with Judy Faulkner's cult and re-brand EpiCare as Xtensis for small to mid-size hospitals. That deal went nowhere, so I guess now Philips has now decided to buy, rather than “partner” with U.S. firms.

Future prognosis? I wish someone in Philips or another giant multi-national would wake up and smell the Quadramed roses. Affinity is an excellent core HIS with 200 happy clients, adding Misys' Patient One (the old UltiCare) gives it an excellent EMR/CPOE front-end, and their stock price is so low they're buying it back themselves…

Anyone know how to say “wake up” in Dutch?

Save print $$Posted on: 12.5.2007 11:05:27 AM Posted by Vince Ciotti

A piece on the tube this morning caught my eye: A utility called "Green Print" that eliminates the wasteful blank pages that pour out of so many print jobs, choking trash cans and costing money. It's pretty cheap (single user = $30), plus an enterprise license option, and claims to save $90 per user per year. With the hundreds or thousands of PC users at most hospitals, the savings would be 5 or 6-figures per year!

Plus, I think you'd get a lot of brownie points for your IT shops in this increasingly "green" world, from users and executives who hate to cut down trees needlessly! Web site = http://www.printgreener.com

PS: I don't own any stock nor have any relatives working there! Sadly, they don't have a Mac version I can use - Windows only!

Oh no… (more on security): UK lost 25,000,000 records!Posted on: 12.24.2007 10:37:04 AM Posted by Jim Feldbaum

The confidential medical records of hundreds of thousands of patients have gone missing from nine NHS trusts, the Government has admitted.

Hospitals around the country owned up to security breaches as part of the investigation into data protection in all areas of public life triggered by the loss of 25 million child benefit records by HM Revenue and Customs.

Looks like the blame has been placed on a missing computer disc. The conservatives said the serious breach of patient confidentiality called into question government plans for a national database containing the records of every NHS user in the country.

Andrew Lansley, the shadow health secretary, said: “This is further evidence of the government's failure to protect the personal information which we provide. For over two years we have argued for data to be held locally, with networking, rather than on one central database. The government should accept that this would offer us greater protection.”

Any way you look at this mess it is a serious blow to the NHS and to patient confidence in the promised security of their personal health information. There can be little doubt that this experience will cast a shadow on what we do here in the United States.

“Civilization is the progress toward a society of privacy. The savage's whole existence is public, ruled by the laws of his tribe. Civilization is the process of setting man free from men.” — Ayn Rand (1905 - 1982), The Fountainhead (1943)

More on SecurityPosted on: 12.6.2007 10:39:34 AM Posted by Jim Feldbaum

Just after I posted my last blog on security, The Wall Street Journal came out with a report “Medical Companies Form Group to Protect Electronic Health Records,” By Ben Worthen.

A consortium of nine companies in the healthcare industry are banding together to create a set of security practices to better protect the information in electronic medical records. Take a look at: http://www.online.wsj.com/article/SB119688167856214731.html?mod=googlenews_wsj