Looking for recommendations for systems to evaluate to fulfill the
requirements shown below. Also shown are my (highly!) preliminary
evaluations based solely on reading around the internet.



If you have suggestions please email me at crwannal at central dot uh dot
edu.



I have also been working at integrating MySQL-based PACSOne with my own
custom-created elements: supplemental data in SQL Server, an ASP.NET-based
website, and C# web service/desktop client (as alternative to the website).



Some of it is in place here, but the size of the task suggests that a fully
operational commercial package could be more cost-effective over the long
term.



Your comments and recommendations will be welcomed.



Thank you.



Rick Wannall

University of Houston



Requirements:

Immediate


Store images uploaded from CD or WAN

Store data extracted from DICOM files

Store analysis files produced at UH

Store data from UH analyses

Search image and/or analysis data

Download images to workstation

Record date, time and purpose of downloads

Flag images as "checked out" and show by whom



Long Term


Receive images directly from modality







Commercial Systems



Sources. 2

ScImage. 3

PicomEnterprise. 3

Finding: Worth investigating. 3

Compressus. 4

MEDxConnect 4

Finding: Not relevant. Integrates existing systems. 4

Pacific Data Designs. 4

Clinical study data management and statistical services. 4

Finding: Not relevant. Service organization. 4

Maine Medical Center, MaineHealth, and the medical center's radiology
information system 5

Sharing a PACS for five years. 5

Finding: Worth asking about. 5

TeraRecon, Inc. 6

Aquarius Solutions: iNtuition, AquariusAPS (Advanced Processing Server) 7

Finding: Not certain. Intended for physicians. 7

Aquarius Workstation, AquariusNET server, AquariusBLUE. 7

Finding: Server may be relevant as storage component. 7

Aquarius APS (Advanced Processing Server ) 7

Finding: Not relevant unless UH diagnostic processing could be automated in
the workflow. 7

Aquarius Workstation: 7

Finding: Not relevant. "Competitors". 7

AquariusNET Server 7

Finding: Not relevant unless UH applications can be integrated as
applications. 7

AquariusBLUE Workstation. 8

Finding: Not relevant. "Competitors". 8

Aquarius GATE. 8

Finding: Not relevant unless we are collecting images directly from
modalities. 8

Commissure, Inc. 8

RadWhere Suite. 8

Finding: Minimal relevance. See comments. 8







Sources


Diagnostic Imaging/PACSWeb

http://www.diagnosticimaging.com/pacsweb/



Medical Imaging

Nov 22

announcement of PicomEnterprise from ScImage



Medical Imaging

Announcement of MEDxConnect from Compressus

"interoperability between diagnostic acquisition devices, PACS, HIS, RIS,
and all related information systems."



Medical Imaging

Readers' Choice Awards

http://www.medicalimagingmag.com/iss...2006-12_01.asp



Medical Imaging

TeraRecon Partners with Commissure

http://www.medicalimagingmag.com/MIN/2006-11-22_2.asp

"Commissure's RadWhere and TeraRecon's AquariusNET client software will work
in concert to link together multiple disparate RIS and PACS, creating a
seamless workflow for patient management, structured reporting, and advanced
visualization.

"The RadWhere Suite presents a consolidated worklist, launches an
appropriate viewer, and collects results back to the diagnostic report.
AquariusNET is a 3D enterprise server/thin client solution for integrating
advanced processing tools either in an existing PACS or as an interim step
prior to purchasing a PACS.

"This current arrangement will see Commissure providing support for the
AquariusNET thin-client as the common viewing tool for volumetric
examinations."





ScImage
http://www.scimage.com/

4916 El Camino Real Los Altos CA 94022 866.SCIMAGE

"Enterprise Imaging Solutions for Radiology, Cardiology, Orthopedics,
Outpatient Imaging and more using a shared infrastructure approach."





PicomEnterprise


Finding: Worth investigating


Our solution is uniquely designed to be used by radiology departments,
cardiology departments, orthopedic surgeons and many other sub-specialists
that are required to interpret image data for provision of care.

PicomEnterprise can acquire, store, distribute and display both standard and
non-standard clinical information in the form of both images and
information. Whether it's a Cath image from a non-DICOM device or a document
that is relevant to the patient's encounter, PicomEnterprise utilizes an
Electronic Patient FolderT or EPFT concept that organizes the data according
to encounter date by patient name and medical record number. Data can be
sorted and accessed by name, encounter date, study type, referring physician
and many other criteria."





PACSWeb





Compressus
http://www.compressus.com/publicwww4...DxConnect.html

101 Constitution Avenue, NW

Suite 800

Washington, DC 20001

Tel: 202.742.4307

Fax: 202.742.4286

E-mail: info@compressus.com



MEDxConnectT

(Formerly known as RadSight)



Finding: Not relevant. Integrates existing systems.
This is a collection of "mediator modules" and "management dashboards" you
can use to manage existing data already collected and managed in other
systems.



"seamless connectivity and interoperability between diagnostic acquisition
devices, HIS, RIS PACS, and their related information systems."



Components: Medical Message Mediator (M3), the Virtual Worklist and the
Systems Management Dashboard (SMD)



"The M3 maps the data elements, bridges isolated islands of data and
mediates interoperability between the different applications, creating a
virtual integrated information system that adheres to the IHE technical
framework."



Pacific Data Designs
http://home.pdd.net/

Frank X. Han, Ph.D
Associate Director, SAS Programming
Pacific Data Designs, Inc.
353 Sacramento St. Suite 800
San Francisco, CA 94111
Phone: 415-776-0660



Clinical study data management and statistical services
Finding: Not relevant. Service organization.


Pacific Data Designs has designs on helping you manage all sorts of clinical
data. The company provides a variety of clinical study data management and
statistical services including database design, stattistical analysis, and
quality assurance to the biotechnology, pharmaceutical, and medical device
industries. Pacific Data Design was founded in 1994.



From Feb 14 2006 posting (http://www.basas.com/pages/j_pacific_design.htm)
for SAS Programmer by F. X. Han: "Pacific Data Designs, Inc. is a service
organization that works with Biotech, Pharmaceutical, and Medical Device
companies. We provide clinical data management and statistical services to
this market. These services are critical to the development of products,
which lead to the submission of clinical trial data to the FDA and other
regulatory agencies around the world."





Maine Medical Center, MaineHealth, and the medical center's radiology
information system
From DiagnosticImaging/pacsweb :
http://www.diagnosticimaging.com/pac...leID=196600297

Nov 29 2006

Sharing a PACS for five years


Finding: Worth asking about.
".integrated 10 different business entities into a single, tightly
integrated combination RIS/PACS/Dictation system . capturing remote data in
the hospital RIS . integration engine . PACS . electronic patient index .
unites data from patients with different identification numbers from outside
facilities.

Using the multi-institutional capabilities of the medical center's PACS and
RIS, along with custom-built interfaces to the RIS systems at the remote
sites, the hospital was able to combine data from different imaging centers
and hospitals into a single, unified archive, they said. Any radiologist at
any participating site has automated access to pertinent prior studies of
the same body part from anywhere else in the system. "

Entire article:



Nov 29, 2006

In Maine, several hospitals share a PACS

by John C.Hayes

A disparate group of hospitals in Maine has been sharing a PACS for five
years, achieving the same results as newer systems with advanced
technologies such as XDS, according to a presentation Wednesday at the RSNA
meeting.

The Maine Medical Center, MaineHealth, and the medical center's radiology
information system have successfully integrated 10 different business
entities into a single, tightly integrated combination RIS/PACS/Dictation
system, said Dr. Matthew Ralston, a radiologist, and Bob Coleman, radiology
informatics director at the hospital.

Key technology solutions for the system involved capturing remote data in
the hospital RIS and then subjecting it to an integration engine before it
reaches the PACS, Coleman said. Another key element was the use of an
electronic patient index feature that unites data from patients with
different identification numbers from outside facilities.

Using the multi-institutional capabilities of the medical center's PACS and
RIS, along with custom-built interfaces to the RIS systems at the remote
sites, the hospital was able to combine data from different imaging centers
and hospitals into a single, unified archive, they said. Any radiologist at
any participating site has automated access to pertinent prior studies of
the same body part from anywhere else in the system.

Sharing images across different institutions has been highlighted at this
year's RSNA meeting. A demonstration project involving 16 different vendors
shows how a new standard for sharing imaging data, XDS-I, developed under
the RSNA's Integrating the Healthcare Enterprise initiative, allows rapid
sharing of imaging and report data among different PACS and facilities.

The experience at Maine Medical Center illustrates the advantages and
challenges of this approach. Radiologists have access to prior images and
reports that may have been collected at another, unrelated facility, making
them more efficient. But the system must link competing institutions,
overcome bandwidth concerns, involve multiple stakeholders, and unite
separate patient identification systems.

Elements of the system include a small PACS at each site connected by wide
area networks that feed into the central PACS at Maine Medical Center. The
system is operated on a nonprofit basis with a small per study fee to cover
costs.



TeraRecon, Inc.
http://www.terarecon.com/home.html

Office Phone Number . 650.372.1100

Toll-Free Number 877.354.1100

E-Mail Address info@terarecon.com

Aquarius Solutions: iNtuition, AquariusAPS (Advanced Processing Server)
Finding: Not certain. Intended for physicians.
Delivers pre-edited and pre-processed interactive scenes automatically to
physicians reading datasets using the Aquarius thin-client or workstation
software.



Aquarius Workstation, AquariusNET server, AquariusBLUE
Finding: Server may be relevant as storage component.
"real-time interactive 3D imaging solutions . efficient diagnostic workflow
and maximized throughput. interactive 3D review by radiologists and
clinicians from regular client PCs anywhere throughout the enterprise"

Aquarius APS (Advanced Processing Server )
Finding: Not relevant unless UH diagnostic processing could be automated in
the workflow.
". automated pre-processing . such as bone removal and detection of
centerlines . correction . by a specialist . allowing the reading physician
to focus more time directly on diagnosis"

Aquarius Workstation:
Finding: Not relevant. "Competitors"
". comprehensive suite of clinical applications and tools . segmentation,
editing, analysis, and region-growing tools."

AquariusNET Server
Finding: Not relevant unless UH applications can be integrated as
applications
". delivers real-time interactive 3D imaging to networked PCs running the
AquariusNET thin-client application . can be applied to any number of
suitable PACS diagnostic review stations, HIS, RIS, and other informative
systems"

"After the DICOM slices are sent to the AquariusNET server any physician can
log onto the central server for interactive review from anywhere in the
enterprise. Physicians interact in real-time with large slice studies from
any remote PC location by streaming back incoming mouse commands. All
clinical applications and diagnostic 3D tools are available including MIP,
MPR, CPR, and 3D VR viewed in any oblique plane. Multi-modalities can be
reviewed including CT, MR, PET, nuclear, ultrasound, X-A, CR, and DR."

AquariusBLUE Workstation
Finding: Not relevant. "Competitors"
addresses the imaging needs of radiology and clinical departments seeking
optimum value for advanced 2D review and 3D reconstructions.

". real-time advanced 2D review/3D post-processing diagnostic workstation .
load large CT or MR studies with hundreds of images . work in 2D and 3D at
the same time. Support is included for CT/MR, CR/DR, and angiography
studies. AquariusBLUE supports MIP, real-time 3D reconstructions,
multi-modality side by side review, and comes with a host of visualization
and editing functions."

Aquarius GATE
Finding: Not relevant unless we are collecting images directly from
modalities.
"Transfer DICOM data quickly and automatically between multiple offices and
remote sites. When sending data, Aquarius GATE compresses and forwards data
from selected modalities. When receiving data, Aquarius GATE decompresses
and forwards data to the recipient in standard DICOM format. The entire
DICOM data routing process is administered using economical PCs and a
standard web interface. Achieve time-savings by scheduling DICOM data
transfers in the background, based on your schedule, to multiple
destinations."



Commissure, Inc
RadWhere Suite
Finding: Minimal relevance. See comments.


The 19 components of the RadWhere Suite primarily address "radiology
assisted diagnosis, speech reporting, ICD9 coding, enterprise teleradiology,
quality assurance, and critical communication" as opposed to storing and
retrieving the images involved in the diagnoses. Of the components, two
might help with storing and distributing UH analysis files.

Efficient Review of Relevant Prior Exams [top]

a.. Preliminary view of prior reports with graphical indicators tell the
radiologist which exams are positive and which have follow-up
recommendations. Increase productivity and efficiency with relevant review
of prior exams. LEXIMER technology powers this component with relevancy
organization and instant reference by indicators.
Multimedia Reports Distribution [top]

a.. Imagine the advantage of producing and distributing content-rich
reports. The day has arrived. Capture images, hyperlinks, and attach files
to generate multimedia reports for the referring physician.