Large Scale Vendor Neutral Solutions

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1 Friday August 28 Large Scale Vendor Neutral Solutions Mathias Prokop, MD PhD Chairman, Department of Radiology and Nuclear Medicine Radboud University Medical Center Nijmegen, The Netherlands

2 Disclosures Mathias Prokop Research support Toshiba Medical Systems Speaker bureau Bracco Toshiba Department Thirona (Spinoff; COPD analysis) Veolity (Screening CAD software; licensed by Invivo)

3 Large Scale Vendor Neutral Solutions The Deconstruction of PACS

4 PACS The Current Situation Storage Viewing Osirix

5 PACS The Current Situation A/I US Storage XR RIS EPR Workflow manager Viewing Osirix

6 PACS Functions Storage Fast access to relevant data Short-term / long-term storage Workflow manager Gathers and combines information from various sources Presents images and information for reporting Viewing Focuses on viewing of (2D) images Various amounts of processing / intelligence integrated

7 PACS The Issues Fragmentation of storage solutions Radiology, radiation oncology, cardiology, ophthalmology, pathology, dermatology, endoscopy, DICOM and Non-DICOM formats Cost Exponential growth of image data (path >> radiology) Upgrading software and hardware: migration of PACS applications and data every 7-10 yrs Data security

8 From PACS to Vendor Neutral Archives The Idea Concentration of storage solutions Single storage for whole organization DICOM and Non-DICOM formats Images but also other non-text formats Simple data exchange non-proprietary, interchange formats agnostic to storage vendors and their hardware devices

9 Large Scale Vendor Neutral Solutions Vendor Neutral Archives (VNA)

10 Vendor Neutral Archive (VNA) The Concept Definition* Medical device that stores medical images in a standard format with a standard interface, such that they can be accessed in a vendor-neutral manner by other systems Neutrality Comply with enterprise workflows standards Store information in non-proprietary interchange formats Can employ a tiered storage architecture, moving data across existing or new storage assets *Wikipedia

11 Workflow PACS-centrered DonDennison.com

12 Workflow VNA-centrered DonDennison.com

13 Vendor Neutral Archive (VNA) The Market AuntMinnie.com

14 Vendor Neutral Archive (VNA) The Market AuntMinnie.com

15 Vendor Neutral Archive (VNA) Cloud Storage Solutions o Regulatory compliance necessary o Optimized backup / data safety o No need to upgrade hardware / software o Pay per use

16 Large Scale Vendor Neutral Solutions Viewing Solutions

17 Viewing The Issues PACS Viewers Optimized for (stacks of ) 2D images Designed for comparing series / studies 3D functionality slowly integrated Image registration rudimentary (multi-phase exams, follow-up) 3 rd party software integration suboptimum No significant CAD functionality

18 Viewing The Opportunities Zero Footprint Clients Require no local software Work via web browsers Optimized for (stacks of) 2D images 3D / advanced functionality need to run via server Network speed essential

19 Viewing The Opportunities Thin Clients Require minimum local software Share work between local and server Optimized for any functionality 3D / advanced functionality need to run via server Network speed essential But Classic PACS functionality underdeveloped Workflow not standardized across applications

20 Viewing The Future Improved workflow Intelligent detection of study type / organ region Non-rigid registration for comparisons Off-line preprocessing for complex CAD solutions Integrated reporting functions Image data mining Variants for cardiology, pathology, ophthalmology

21 Viewing The Future Improved workflow Intelligent detection of study type / organ region Non-rigid registration for comparisons Off-line preprocessing for complex CAD solutions

22 Large Scale Vendor Neutral Solutions Summary

23 Large Scale Vendor Neutral Solution Summary Migration to VNA Move towards VNAs driven by o Access to (non-)dicom data from clinical departments o Cost of migration of current PACS o Separate optimization of tasks integrated in current PACS Multitude of implementations o VNA-centric o PACS-centric

24 Vendor Neutral Archives Summary Opportunities Cloud storage solutions o Optimized backup o No need to upgrade hardware / software o Regulatory compliance necessary Optimized Viewers o Zero-footprint clients o Thin-clients with smart workflow CAD integration and preprocessing

25 Vendor Neutral Archives Summary Questions Will Radiology still dominate the hospital information? Who will win the market? o PACS vendors o EPD vendors o Specialized vendors o Image data mining

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