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
Disclosures Mathias Prokop Research support Toshiba Medical Systems Speaker bureau Bracco Toshiba Department Thirona (Spinoff; COPD analysis) Veolity (Screening CAD software; licensed by Invivo)
Large Scale Vendor Neutral Solutions The Deconstruction of PACS
PACS The Current Situation Storage Viewing Osirix
PACS The Current Situation A/I US Storage XR RIS EPR Workflow manager Viewing Osirix
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
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
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
Large Scale Vendor Neutral Solutions Vendor Neutral Archives (VNA)
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
Workflow PACS-centrered DonDennison.com
Workflow VNA-centrered DonDennison.com
Vendor Neutral Archive (VNA) The Market AuntMinnie.com
Vendor Neutral Archive (VNA) The Market AuntMinnie.com
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
Large Scale Vendor Neutral Solutions Viewing Solutions
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
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
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
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
Viewing The Future Improved workflow Intelligent detection of study type / organ region Non-rigid registration for comparisons Off-line preprocessing for complex CAD solutions
Large Scale Vendor Neutral Solutions Summary
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
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
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