Policy & Value-Based Care

What Do Zero Footprint Image Viewers Have to do with Kidneys?

Feb. 23, 2018

The National Kidney Foundation, in conjunction with GE Healthcare is using zero footprint viewer technology to improve transplant image accessibility.

Joe Marion

I recently became aware of a joint effort between the National Kidney Registry (https://www.kidneyregistry.org) and GE Healthcare (http://www3.gehealthcare.com/en) toward improving the speed of kidney transplant matches, which represents a novel and valuable application of zero footprint viewer technology.The National Kidney Registry was created to eliminate the problem of incompatible donors and facilitate matches by creating a national registry. One of the difficulties in matching recipients and donors involves the imaging of potential donor kidneys, as size and vascular structure are important to ensure a successful transplant. Prior methodology often involved copying the images to a CD and mailing the CD to the transplant center. Such methodology took valuable time to receive and evaluate the images. Considerable time was devoted to just getting the images transferred to a CD, as well as the time on the receiving end to load them into the local viewing environment. The whole process could take up to ten days, complicating the transplant team’s ability to access images. If the assessment resulted in an incompatible match, valuable time was lost for both the recipient, as well as for reassigning the donor. The Na

tional Kidney Registry, in conjunction with GE Healthcare and VasoHealthcareIT (VHIT) {www.vasohealthcare.com/} developed a solution utilizing GE Healthcare’s Centricity™ Universal Viewer Zero Footprint (ZFP) and Centricity Enterprise Archive Vendor Neutral Archive (VNA) to enable near instantaneous access to images across donor and recipient facilities.By capturing the images from the donor site into the VNA, transplant sites are able to quickly review the images and make an assessment relative to viability.This enables the donor to be immediately reassigned, and the recipient to access other potential donors. The National Kidney Registry estimates that there is significant operational savings from real-time image access, saving 1400 hours per coordinator per year. With at least one coordinator per participating hospital, and 80 hospitals participating in the National Kidney Registry, this amounts to a significant time and monetary savings across the network. The GE Healthcare ZFP viewer is ideally suited to this application, as it supports server-side rendering with progressive and adaptive streaming for real-time image access. Users can quickly navigate large data sets, as well as relevant clinical notes. They can also do side-by-side comparisons of donor and recipient images to enable surgeons to assess compatibility. What I find unique here is that this is a specific application of zero footprint viewer technology on a national basis. Typical emphasis has been on the improvement of image communication within an institution or region. However, as demonstrated by the National Kidney Registry application, there are clearly many opportunities to improve image accessibility on a national basis. A hidden benefit of the application of zero footprint viewer technology is that no protected health information (PHI) is transferred between facilities, reducing the cybersecurity risk. There are other potential extensions of this application that might evolve over time. For example, given the database of images in the archive, there might be Artificial Intelligence (AI) applications that could be applied to enhance the compatibility of donor-recipient matches. There might also be follow up opportunities for assessment of transplant success, which might further build on the database.I would expect to see many more such applications in the future. Kudos to GE Healthcare and the National Kidney Registry for pioneering such an important application!