The Smart Magazine About Medical Technology Innovations
Clouds on the Horizon
Five billion US dollars spent on cloud-based healthcare services in 2017. Funneling data in and out of the clouds, both private and public, is a medical industry mega-trend.
In this 29th issue of MedicalExpo e-Magazine, the pros will talk about cloud-based mobile apps and how to protect your cloud data. But if you’re hesitant, you can read our interview with a ProMedica PACS administrator in which he explains why he won’t use the cloud.
The migration of medical data onto the cloud presents challenges for both healthcare and cloud service providers.
Today healthcare providers are increasingly integrating the cloud into their workflow. According to market research firm MarketsandMarkets, 2017 will see such providers spend upward of $5 billion on...
Radiologists on staff at ProMedica, a not-for-profit, 12-hospital healthcare organization serving northwest Ohio and southeast Michigan, may not know how spoiled they are. Working remotely, they can call up real-time diagnostic images from the Emergency Department or archived data from four years ago without logging into several systems to find what they need.
“Our radiologists are doing real-time radiology here,” said Free Beck, Enterprise Imaging PACS Administrator at ProMedica. “If our radiologists had to wait a few seconds, they would see that as an issue.”
Beck, whose system generates 60,000 studies a month, said that slow retrieval of images represents a care issue for patients and doctors, who may need answers quickly. In addition, he said, “Time is money.”
The PACS and VNA approach
Beck added that health information technologists debate the fine points of approaches to image retrieval. A common solution is combining a PACS (picture archiving and communication system) with a separate VNA (vendor neutral archive). The former offers short- and long-term storage, retrieval, management, distribution and presentation of medical images. The latter stores images with standard format and interface, making data accessible via different PACS.
The terms expensive and complex are often part of the conversation.
But Beck maintains that this approach is unnecessarily complex and costly.
“When you speak with people who have both a PACS and a VNA as separate systems, the terms expensive and complex are often part of the conversation. It is expensive to manage both systems and complex because you must manage your images and archive in both locations,” he said. “Slowdowns in image viewing via the VNA are another common concern. That’s probably the top complaint that I hear from people who have a VNA.”
He said a VNA typically costs a minimum of $1 million. Such systems were originally promoted to eliminate problems migrating to a new PACS because they store images in a standard format.
“Most people had a hard time justifying that because there was no guarantee that you’re going to migrate. Over the years [the argument] evolved, [stressing that] the VNA could also store non-DICOM images, not just for radiology, but for cardiology, ophthalmology or even visible light images for wound care and such.”
“I could not find any reason to justify our institution buying an entire separate VNA,” Beck said.
A Double Duty PACS
Instead, ProMedica adopted a different approach: an enterprise PACS system from the Swedish firm Sectra doing double duty as a PACS and a VNA.
“Our health system’s Sectra enterprise PACS fills the roles of both PACS and vendor neutral archive. A VNA stores images in a central location in a vendor neutral format, as well as providing a universal viewer to be used anywhere. We have an integrated zero-footprint viewer of our PACS integrated with our EMR system, so those images can be viewed right from the portal,” Beck said.
“Our enterprise PACS sits at the center of orders, image viewing, reading and archiving radiology, mammography, cardiology and ophthalmology images.”
ProMedica will soon add cardiology, maternal-fetal medicine, wound care and pathology images to its PACS.
What about cloud?
Beck said, “I am not a fan of cloud solutions. Cloud solutions give you the advantage to offload certain support responsibilities, but if you have radiologists reading those images, they are likely going to notice significant performance issues.
“Our radiologists don’t like when there is even a few second delay, so pulling data down from the cloud would only increase the time to look at images, as well as the support complexities. Personally, I like total control of our support solutions. I am also more in favor of having as few break points as possible in IT solutions. If you have radiologists finalizing reports in real time, then I do not think a cloud-based image solution is even an option due to performance issues.”
One of the highlights of conhIT is the AppCircus, a contest where various digital healthcare companies showcase mobile apps designed to make the lives of medical professionals a bit easier. Contenders in the third edition of the contest included:
Teleclinic, a mobile app for telemedicine
D-EYE, an app for retinal...
Nosocomial infections continue to constitute a major health threat for both patients and caregivers. A French startup, MediHandTrace, intends to fight back with computer chips and radio waves.
We interviewed company general manager Francine Lanceleur-Brenning to find out more.
MedicalExpo e-Magazine: How did MediHandTrace get started?
Francine Lanceleur-Brenning: The startup was launched in 2015, but grew out of a consortium created in 2009 by medical personnel. Right from the planning stage, we chose to include sector professionals.
The idea came from a nosocomial infection our director had 10 years ago. Around that time WHO issued its five recommendations for hand hygiene.
ME e-Magazine: How do you ensure proper hand hygiene?
MediHandTrace MHT Fixe Courtesy of MediHandTrace
Francine Lanceleur-Brenning: Our MHT Fixe solution consists of a floor antenna linked to a connected hydroalcoholic solution (HAS) dispenser. It also includes RFID chips beneath the door and not just in the caregivers’ shoes. This provides continuous tracking of what’s going on—whether the dispenser is used at each entry and exit.
This also reassures the patient. We can install audio and visual warning systems informing the patient as to whether or not people entering the room used the hydroalcoholic solution.
ME e-Magazine: How have caregivers reacted? The chips in their shoes must make them feel as if they’re under surveillance.
Francine Lanceleur-Brenning: That’s already the case. Today, most caregivers already wear tracking badges. We’re starting from the assumption that the situation is bad.. When I visit a hospital, 90% of the HAS dispensers I check at random are empty. The software that centralizes chip information can also make it anonymous. However, by displaying overall results at the nurse’s station, we found that they checked to see if they were doing better than the doctors.
After six months, some nurses contacted us to ask for individual feedback. We answered with congratulatory SMS texts or suggestions for improvement, but without individual use rates.
ME e-Magazine: After initial trials in France, you installed your system in other countries. What’s been the response?
Francine Lanceleur-Brenning: Our solution is more readily accepted in northern Europe—in Sweden and Germany—than elsewhere. They saw that it enabled them to demonstrate compliance and to determine if something more needed to be done. In Lebanon, our solution will be used to promote medical tourism.
Glasschair, a new application developed for Google Smart Glass at the Technical University of Munich, offers hands-free operation to wheelchair-bound individuals. This could be a real boon to amputees or those who have lost the use of their hands due to injury or disease.
Linked to the wheelchair through an adapter and a Bluetooth connection, the app enables chair control via intuitive head movements and voice commands. The user can modify speed and direction, as well as call for help by sending an emergency message to a predetermined contact.
The message is accompanied by a Google Maps link indicating the location of the wheelchair. The system is compatible with most modern electric wheelchairs and is available for testing in Munich. Still in its evaluation stage, Glasschair is not yet available for purchase.
It soon may be possible to travel around polyps, over tumors and through lesions. GE designers Ludovic Avot and Yannick Le Berre combined detailed 3D data from CT and MRI scans with virtual reality design and game software to create a tool enabling physicians to journey into the deepest recesses of the body.
The system can be used to prepare for surgery or examine organs for evidence of disease. Using it is akin to walking through a room, but the room could be a patient’s brain. The prototype can be used with readily-available VR headsets, and tests with a French customer are scheduled for this year.
The two developers are also considering the potential of augmented reality—projecting technical information into the doctor’s field of view. Such technology might someday help guide operations by displaying the surgeon’s tool within the body in real time.