Leaders of the PACS

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In his Eugene P. Pendergrass lecture, Paul Chang, MD, opened with an anecdote about his father’s retirement from radiology last year. He told his son that he was glad he was getting out of radiology because “you PACS people” ruined it.

Since PACS became pervasive, radiologist productivity has at least doubled and possibly even tripled in some settings—as reimbursements declined—and no amount of nostalgia for the days when rounds began in radiology will take us back. What we can look for from the technology that facilitated that transition are even greater productivity enhancements, new communications strategies, and hopefully better access to the great storehouse of institutional clinical data.

With names like the Comparator, Slicer, and Sector MPR, the tools in Fujifilm’s Synapse PACS greatly expanded toolbox of advanced visualization tools intend to put AV at the interpreting physician’s fingertips with no need to open a separate application or—worse—go to a different workstation. Rolled out in September, the set includes basic tools (including 2D, 3D, 4D and dynamic viewers, fusion and the aforementioned); advanced cardiac tools (cardiac fusion, CTCA), and advanced radiology tools (CT liver angiography, brain vessel analysis, lung nodules, CT brain perfusion). “You can have six applications open at one time,” explains Mike Cyganowski, who demonstrated the tools at the show.

Siemens extends access to seven advanced visualization applications via its new zero-footprint Web Viewer, says Rik Primo. The viewer is designed for iPad and iPhone use; Primo notes that the user is not necessarily a radiologist. “The iPad was important in addressing the changing landscape of PACS,” says Primo. “PACS is no longer a radiologist tool, it’s an enterprise tool.” The AV applications are cloud-based and users log on via an ELDAP server.

Yet another established PACS company has its eyes squarely on the enterprise: Agfa just announced a relationship with Cleveland Clinic to help hospital customers reach the goal of aligning all image-producing departments—radiology, cardiology, ophthalmology, pathology, dermatology, etc—to develop a single longitudinal imaging record linked to a patient’s EMR. It’s all about the metadata, says Agfa’s Lenny Reznick.”It’s not just about getting the image into the EMR; to get them in at the right place at the right time, you need metadata.”

Back to Dr Paul Chang’s father: PACS undisputedly has complicated radiologist communications—particularly with referrers, patients, and each other. Leveraging social media technologies, Intelerad launched RadVoice at the show, a radiologist community with a separate section for Intelerad users where radiologists can share experiences, access webinars, and get questions answered. Intelerad also bundled its reading, reporting, and communications tools into one solution called Flow® to provide enhanced distributed reading workflow with assignment and allocations, unified worklist, and enhanced communications tools like instant messaging.

Look for communications in radiology to get some serious attention in 2013.