Viewing PACS in a whole new light

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 - Jim Morgan
Jim Morgan, Vice President, Medical Informatics, FUJIFILM Medical Systems, USA

When we unveiled the next-generation upgrades to Fujifilm’s broad, integrated Synapse portfolio at RSNA last fall, our newest enterprise imaging technology Synapse 5 was the hit of the show. This wasn’t surprising. After all, PACS represents the cornerstone of the comprehensive Synapse line of solutions—a product family that also includes innovative VNA, 3D, RIS, cardiovascular and mobile offerings.

Our latest Synapse PACS has beefed-up archival and worklist/workflow-engine capabilities—from unique sharing features to EHR interoperability tools to workflow-optimizing options that take integration beyond the enterprise, into the cloud and, from there, wherever collaboration is happening—or should be happening.

We should note the special interest at RSNA many people showed in our completely re-thought PACS viewing platform.

The heightened attentiveness makes sense if you consider the changes the PACS market has seen over the past couple of years and how critical the viewer is to the overall PACS user experience.

Consider the most formidable challenges facing radiology users:  

  • The need for speed has gotten more acute. As reimbursement continues to move from volume-driven to value-based, radiologists need to boost their efficiency, their productivity and—not least—their accuracy. The challenge is to be a speed reader who, despite the high velocity, doesn’t miss a single abnormality on a single study.
  • Datasets have continued to grow. Traditionally, when you talked about large imaging datasets, you were talking about CT. Today, with PET and MR and 3D reconstructions, all producing massive image files, the drive is on to manage large imaging datasets as a normal, everyday—and multimodality—task.
  • Viewer portability has become ingrained in the culture. Mobile devices are only part of the equation. The deeper need is for more choice on where and when users wish to view diagnostic studies. After all, PACS workstations—not to mention desktop PCs and Macs—haven’t been replaced. They’ve just welcomed plenty of company (or competition, depending on your point of view).

In a nutshell, the need today is for a diagnostic-level PACS workstation that extends through the PACS to any desktop that a PACS might touch. That’s why the Fujifilm team came up with the Synapse 5 PACS viewer. It’s designed to help users keep up with the changes that have already taken place and, more importantly, to help them stay out ahead of what comes next.

Brilliantly simple

William Lacy, Division Vice President, Informatics Marketing and Enterprise Sales, FUJIFILM Medical Systems U.S.A., Inc.

Going into the Synapse 5 PACS design phase, our team knew the only way to achieve sub-second image access while also virtually caching large datasets and enabling reads from wherever, whenever—including with 3D—was to approach server-rendering technology in a whole new way. That’s why we came up with not just a new viewer but a next-generation viewing application, one combining architecture changes as well as technology advancements.

With the new Synapse 5 technology, there’s no client at the desktop, and the image rendering occurs on the server. This allows the technology to be far less dependent on the viewer side, and it allows users to simply log in and choose their interface as well as their screen—Explorer or Firefox or Chrome, desktop or smartphone or tablet—or work with any combination of preferences.

The study doesn’t have to move and cache to the desktop. The user can be anywhere. The datasets can be any size. The experience is entirely browser-agnostic. And there’s no falloff in performance and display speed.

This represents a sweeping change from so many legacy PACS designs, which are resource-intensive and, for example, often can only be upgraded by IT staff touching hundreds or even thousands of desktops.

One of our favorite aspects of Synapse 5 PACS is its brilliant simplicity. Like most cutting-edge websites and more than a few apps, it uses HTML5 and was largely inspired by what you’ve seen in the world of e-commerce. It’s got a user-friendly, intuitive GUI, with high performance, limitless scale and strong security.

In fact, if you consider it from the perspective of existing PACS at most provider sites, you wouldn’t be exaggerating if you called Synapse 5 PACS a disruptive technology. Because of the way we are managing the imaging from the server side to the display—on demand and as needed, versus moving studies and caching them—we are actually seeing early indications of at least 50% less network utilization with this technology.

This means Synapse 5 PACS stands to save hospital IT organizations significant dollars, thanks to a huge reduction in the bandwidth many are currently consuming with last-generation PACS technology.

Planned non-obsolescence

Here’s another reason we were so busy answering questions at RSNA 2015: As “disruptive” a technology as Synapse 5 is, it’s barely a disruption at all for existing customers. It’s not a forklift of a database or a migration or a platform change. It’s just an upgrade to our current Synapse 4 platform. Current Synapse users will be able to light up an entirely new viewer that will work off of the existing database they already have.

This, too, is very different from the newer technologies that PACS vendors have introduced when they have made a change this sweeping. With all due respect to our competition,, theirs typically obsoletes their current platform. They effectively come out with a new product that you have to buy as if you never owned the previous version. Not so with Synapse 5 PACS. It’s an upgrade like any other upgrade for our clients.

What’s more, the rumors of PACS’s death have been largely exaggerated. PACS isn’t going to die. It’s not going to become obsolete. It will continue evolving, much like the mobile phone evolved into a device that did all sorts of things—yet you still use it for phone calls. In like fashion, PACS will continue to be a critical diagnostic tool, but users will tap it for many other things, from critical results management to workflow optimization to ED discrepancy oversight to seamless collaboration.

We haven’t forgotten to take what we’ve heard from radiologists and apply it. That means, among many other things, that our new viewer makes it easy to look at a screen for eight hours a day. We’ve thought through ergonomic implications, right down to details like minimizing wrist strain, and we’ve geared everything toward greater efficiency and productivity.

It’s all part of our drive to rethink PACS as a whole. How do we handle interruption workflow? How do we integrate and work with 3D components? How can we reinvent the way worklists are handled? All of these go well beyond the traditional viewer component itself, so we have incrementally improved everything to do with the user experience.

Deconstructing PACS deconstruction

There’s been a lot of talk lately about “deconstructing PACS” in order to free it from silo-ed systems. Customers want fast image viewing, diagnostic integrity, flexible worklist, integrated 3D, platform independence and information lifecycle management. Legacy PACS does not perform all of these functions well, which is why Synapse 5 is so different.

Synapse 5 PACS inherently does what PACS deconstructors would do if they could: It helps transform healthcare organizations as they enhance collaboration and optimize workflows across the enterprise.

Synapse 5 will increase your organization’s efficiency, boost your productivity and, along the way, help you improve the patient experience, lift the health status of the populations you serve—and do it all while reducing costs.