Author: Telerad Tech

26 Dec 2018
New Pacs

Replacing existing RIS-PACS? Or a first time RIS-PACS buyer?

Struggling with what to do about an outdated RIS-PACS? Or, planning for RIS-PACS for the first time? In either case, it is not an easy and simple decision to take. But prolonging the decision will not help either. There will always be a dilemma, for an existing RIS-PACS user, regarding whether to pay the upgradation cost and stick to the same old vendor who ask for big bucks for each single support or whether to replace existing PACS with a new system which also comes with value added features such as AI algorithms in-built into the RIS-PACS. Other factors which needs to be considered before switching to a new system include the data migration costs, training costs, opportunity costs, related hardware upgradations costs, regulatory environment., cost of upgradation versus going with a new system, all these questions have to be answered.  As per expert estimate, transition and migration to a new system may take from 30-90 days. The challenge is also therefore to identify a vendor which can fast track the transition to maximum 15 days while ensuring that the ongoing work is not affected.

Finding the appropriate RIS-PACS can be a big challenge. Few important questions that needs to be asked regarding a new RIS/PACS is that it must be affordable, faster, should have prior studies uploading feature, voice recording feature, ability to integrate with third part voice recognition system such as dragon application or PowerScribe, and ability to be integrated with the hospital information system amongst the few important pre-requisites. Growing number of RIS-PACS providers are placing emphasis on reporting on the cloud feature.

What is an Integrated Radiology Information System (RIS) PACS?

PACS, or picture archiving and communication system, is a medical imaging technology used for storing, retrieving, presenting and sharing images produced by various medical hardware modalities, such as X-ray, CT scan, MRI and ultrasound machines. While digital medical imaging has brought in enormous savings for the imaging centres in terms of archival, storing, retrieval and sharing. It is the Radiology Information System (RIS), which helps manage the radiology workflow and the business.

Older RIS/PACS consisted of disparate systems – one for archiving patient images and one for storing patient records. Often, it would be noticed that the patient data in the PACS database may not be same as the data entered in the RIS database. If there is a mismatch between patient’s name or other demographic details entered in the PACS and RIS databases, then the system will not be able to correctly access all relevant records.  Such discrepancies can cause unwanted inconvenience to patients and referring physicians while also expose the facilities to unwarranted risks and legal liabilities.

Functions of RIS

Some of the key functions of RIS includes order entry; patient scheduling, assigning studies; tracking number of exams; assistance in billing etc.  A combination of the two (PACS and RIS) is termed as an integrated RIS-PACS. An integrated RIS-PACS gives radiologists or the administrators access to evidence-based insights such as which modalities are being used the most, which referring physicians are sending maximum exams, radiologist productivity, turn-around time, busiest time, days or week of the month etc.

An imaging facility stands to make enormous gain in terms of patient and financial outcomes if they choose an integrated RIS-PACS. RADSpa is one of the best Integrated RIS-PACS available on the shelf and deployable in various situations and for different kinds of facilities.

Now, what is AI-enabled RIS-PACS?

AI -Enabled RIS PACS is a platform on which resides numerous AI algorithms developed by the RIS-PACS providers themselves or those provided by niche AI companies. For example, the RADSpa RIS-PACS platform is AI enabled. So, when you go with RADSpa, you also get access to a number of algorithms. What makes this system very interesting is the fact that there are no initial upfront investments on AI part. You pay for the algorithms, only when you use them. That, too, it is pay-per-use system.

To replace or retain?

There was a time when the average longevity of a RIS-PACS would be around 7-10 years. But now in the current fast developing diagnostic imaging space where not only the volume of imaging and its complexities are growing by leap and bound but also the regulatory and privacy requirements such as HIPAA and GDPR, which is forcing radiologists to be always hard pressed for time and for quality reporting.  Any delay or hesitation in decision making can be hazardous to imaging business.

But hesitation presents hazards

Imaging facilities need to appreciate that failing behind on modernization and working with an out-of-date RIS-PACS can have serious consequences for clinical efficiency and financial health of the centre.  In addition, sticking to system which has far outlived its lifespan can also make it tough for a facility to keep up with the expectations of referring physicians, affiliated organizations and patients.

Telerad Tech, the global health IT company and one of the leading providers of integrated RIS-PACS Workflow strongly recommends that while analyzing current RIS-PACS and its vendor, an imaging facility should do proper audit in the key areas of operations such as – administrative, clinical, information technology (IT), regulatory environment and the market.

Important points to consider

For instance, if your existing PACS or RIS-PACS chokes your competitiveness, is unable to give you important insights regarding productivity of manpower, modality machines, have a confusing user interface, or simply doesn’t give you the next generation workflow tools such as workflow orchestration that optimize your productivity, you should consider a new system. Also, you should take into account the regulatory environment such as HIPAA and GDPR and go with systems which is capable of anonymizing patient data and is able to give you patient security framework (PSF) gateway, if needed. Teleradiology companies who are either reporting or have an ambition to serve defense hospital establishments, should ideally look for RIS-PACS which comes with PSF Gateway feature. RADSpa, which comes with PSF feature, is deployed at multiple hospitals under the Navy establishment in Mexico.

Making the Switch

Finally, having decided to switchover to a new RIS-PACS, a facility should first clearly define its requirement. Talk to vendors who can help you assess your current and future growth requirements.

First Time RIS-PACS buyers

For a facility which is considering acquiring PACS for the first time, they should look for a solution which offers latest productivity tools, can integrate with the existing DICOM compliant modalities amongst other features which are explained below.

Listing the requirements

Begin your process for procuring RIS-PACS, like for any other product, by listing the requirements. If possible, involve the Radiologists, Technicians, IT Team, Operations Team, and Finance Team in the process. Your list of requirements can include:

  • RIS-PACS should easily and fast integrate with existing modality machines;
  • System should be able to integrate with existing Hospital Information System (HIS) through Health Level 7 (HL7) protocol;
  • Should be able to reduce the turn around time (TAT) and increase productivity;
  • Should be able to integrate with existing PACS, without requiring any major overhaul of the system;
  • For teleradiology companies which have complex workflow and QA requirements, the facility should look for systems which has multi-read workflow management features and whose QA and peer review module facilitates collaborations as per ACR guidelines;
  • The new system should have smart features like workflow orchestration, real-time work lists, CD burning feature, multi-monitor support;
  • The RIS-PACS should meet regulatory requirements of FDA and should be CE certified, HIPAA and GDPR compliant;
  • Should have advanced 3D DICOM Viewer Features such as Minimum Intensity Projection (MIP), Maximum Intensity Projection (MIP), Multi Planar Reconstruction (MPR), and sculpting tools;
  • Radiologists/facilities often want to customize layout in the viewport using custom feature which helps standardize the workflows as per their specific requirements. So, look for such features in the system proposed by your vendor;
  • Facilities should also look for RIS-PACS which offers hanging protocol features for each specific modality machine;
  • Vendor Neutral Archive (VNAs) technology is today a game changer. VNA is enabling imaging facilities to archive and retrieve millions of medical images generated by disparate modalities from many different vendors. So, look out for RIS-PACS which is VNA compliant;
  • If you are a new and starting small, look for solutions which will be able to grow with you, i.e., look for a solution which is scalable;
  • Depending upon your specific choice, you may go with a solution which is pure cloud so that you can jump start radiology without any major investments in IT infrastructure;
  • You may go with an on-premise solution, if your already have the IT infra and manpower in place or have the capital to invest in on-premise solutions;
  • Products like RADSpa also offers something called Hybrid solution that stores images on site in the local system, while RIS is available on cloud which gives the flexibility to report from anywhere. This type of systems can potentially reduce your investments and recurring bandwidth expenditure by up to 30%.

Timing

Regardless of the fact that whether you are switching to a new system or a first-time buyer of RIS-PACS, it is the timing which is most important. The transition should be such that the normal operations are not affected. You can also go for a trial run for about a month so that your team is well familiarized with the software. RADSpa offers free trial to most of its prospects after properly assessing the seriousness of the customer.  So, go on, and go for your new system to leapfrog your facility to an integrated and AI-Enabled RIS-PACS environment.

09 Oct 2018

Unlock productivity, quality and communication with radiology workflow orchestration

Radiology exams are typically categorized as Stroke Cases, STAT cases, Trauma cases, Emergency Radiology, Inpatient, Outpatient and ICU cases etc. A radiologist’s workflow dashboard therefore must be organized in a manner that s/he has access to all vital information with the click of a button. But, it is easier said than done!

With increased accessibility and affordability of imaging modality machines and also due to incessant endeavors of modality manufacturers and PACS companies to provide precise imaging solution, there has been a quantum jump in the number of exams to be read. Further, the advent and availability of newer modality machines has also created the need for subspecialists readings.  A radiologist dashboard is now no less than a cross-word puzzle. What is most affected are the radiologist’s productivity, quality of work, communication between different stakeholders and the overall viability of running an imaging facility.

To overcome these challenges, companies are creating workflow orchestrators. Workflow Orchestrator is a mechanism for automatically matching imaging scans with a radiologist profile in the radiologist service provider environment. So, instead of radiologists spending their precious time figuring out which scan to read, the scans look for a perfect radiologist to read them.  Workflow Orchestrator further mines for exams in terms of priority or SLA (service level agreement), right sub-specialty and the best relationships and accordingly populates them in the worklist of the relevant radiologists for their appropriate response.

RIS-PACS with Workflow Orchestration lends itself in enhancing productivity, quality and communication.  With the implementation of intelligent tools such as Workflow Orchestration, the exams are exposed to a broader audience as time goes by. To begin with, the exams are exposed to the most suited radiologists, ones that have the best expertise and the best relationship to read that exam.

The Workflow Orchestrator also ensures that all available subspecialists are taken into the fold if a particular exam is not read or taken up quickly enough. The orchestrator delivers incalculable augmentation where quality KPI is concerned. The software also organizes exams not just by clinical but also by business priorities. The most crucial exams can be seen on top followed by the emergency and STAT exams, right after that comes inpatient exams, and then outpatient exams. Each exam is tagged by the intelligent software by the SLA so the time remaining to read each exam can be seen easily.

The productivity of the radiologists can be seen clearly from the personal radiologist dashboard. Apart from other features, there is also a break glass mechanism so that if a radiologist chooses to read out of order, the system will ask for a reason to do so. With integrated communication tools such as chat or instant messaging and more, the orchestrator’s software allows radiologists and referring physicians to easily share context of exams with each other and even ask for a specific exam to be reviewed.  The workflow orchestrator lets radiologists have the right tools to manage inaccurate exams and enhance productivity.

The Workflow Orchestrator helps direct imaging exams first to suitable clinical subspecialists, and then it makes sure that the exams are made available to other radiologists as needed to satisfy desired turnaround times. Exams also can be allocated to specific radiologists according to a referring physician’s preference and existing affiliations with hospitals or healthcare facilities. The platform’s workload balancing function can optimize reporting times.

RADSpa’s Workflow Orchestrator is one such value-added capability in the ever-evolving healthcare delivery paradigm.

  • It takes care of enhanced productivity by aligning demand with supply.Dynamic assignment automatically accelerates and assigns studies to the most appropriate, available radiologists. There is better communication through associated tools and automated notifications.

 

  • With a universal worklist, the orchestrator incorporates quality and interpretations tasks in one place. Efficiency is improved by contributing to quicker turnaround times and reduced length of stay.

When a study was conducted to see the impact of RADSpa’s Workflow Orchestrator feature, the results were overwhelmingly positive.

  • Almost 85% of the radiologists agreed that RADSpa’s Workflow Orchestrator helped them to reduce the TATs and increase productivity.
  • Statistical analysis of 180 days of logs before and after automation indicated 35% improvement in overall TAT for emergency cases.
  • Radiologist productivity per case improved by 25% as every case is auto-validated for images prior it is assigned.
  • Exam Coordinators or the Assigners reported a massive 98% reduction in effort which used to go in manually eliminating errors, and thereby more time in hand for handling greater workloads.

Radiology Workflow Automation has positively impacted timely patient care specifically in Reporting Emergency cases and thereby saving lives.

  • Manual errors and allocation time is reduced by 98%, TAT is improved 35% and RAD’s productivity by 25%.
  • Zero error in case assignment to radiologists by the coordinators (assigners).
  • Radiologists receiving advance alert regarding their work list.
  • Notification to assigners regarding un-attended cases. This helped assigners to follow-up with the respective Radiologists or re-assign them to equivalent Radiologists.

This value-based care has helped radiologists achieve more and do much more. This increased cooperation between healthcare providers as well as professionals benefits all participants in the care continuum. Workflow Orchestrator is therefore a great productivity and quality boosting tool and promises to be an excellent tool for collaboration and communication.

  • It takes care of enhanced productivity by aligning demand with supplyDynamic assignment automatically accelerates and assigns studies to the most appropriate, available radiologists. There is better communication through associated tools and automated notifications.
  • With a universal worklist, the orchestrator incorporates quality and interpretations tasks in one place. Efficiency is improved by contributing to quicker turnaround times and reduced length of stay.

When a study was conducted to see the impact of RADSpa’s Concierge Automation feature, the results were overwhelmingly positive.

  • Almost 85% of the radiologists agreed that RADSpa’s Concierge Workflow automation helped them to reduce the TATs and increase productivity.
  • Statistical analysis of 180 days of logs before and after automation indicated 35% improvement in overall TAT for emergency cases.
  • Radiologist productivity per case improved by 25% as every case is auto-validated for images prior it is assigned.
  • Exam Coordinators or the Assigners reported a massive 98% reduction in effort which used to go in manually eliminating errors, and thereby more time in hand for handling greater workloads.

Radiology Workflow Automation has positively impacted timely patient care specifically in Reporting Emergency cases and thereby saving lives.

  • Manual errors and allocation time is reduced by 98%, TAT is improved 35% and RAD’s productivity by 25%.
  • Zero error in case assignment to radiologists by the coordinators (assigners).
  • Radiologists receiving advance alert regarding their work list.
  • Notification to assigners regarding un-attended cases. This helped assigners to follow-up with the respective Radiologists or re-assign them to equivalent Radiologists.

This value-based care has helped radiologists achieve more and do much more. This increased cooperation between healthcare providers as well as professionals benefits all participants in the care continuum. Workflow Orchestrator is therefore a great productivity and quality boosting tool and promises to be an excellent tool for collaboration and communication.

14 Sep 2018
RIS-PACS

Enhancing RIS-PACS solution with Artificial Intelligence

It has become fairly clear of late that using technologies is aiding radiologists in not just enhancing patient care but also optimizing their time and effort. Several universities across the globe including the University of Virginia Health System are now looking for platforms that can be seamlessly integrated with Radiology Information System (RIS) and Picture Archival Communication System (PACS) to help not just streamline the workflow but also help detect findings that could be missed manually.

For instance, with the help of Artificial Intelligence (AI), loss in bone density can be found out at an early stage. There are probabilities of missing these detections while using the traditional interpretation method. Some AI Software uses colors to denote normal and abnormal findings. This speeds up the reading workflows in the PACS. Also, this is perfect for radiologists because then they know which results need his/her urgent attention. With AI software assisting in findings ranging from chest, pelvis CT scans and abdomen, coronary calcium, liver steatosis, pulmonary emphysema, spine compression fractures and bone mineral density, healthcare is all set to get transformed and how.

Preventive Care

An exciting step in preventive care, AI enhances RIS-PACS even as it leads to early detection of various conditions as well as ailments. It is but obvious that artificial intelligence is playing a key and an extremely vital role that could also go beyond regular readings and avert serious diseases from developing.

Sophisticated AI algorithms can now go hand-in-hand with RIS-PACS and deliver the added benefit of expediting the reading process while at the same time identifying findings that may go unobserved or are hard to visualize.

Enhanced Workflow

AI software can be running in the background and putting forth clinically significant and relevant findings that could have been missed.

Some software are developed with an access to in-house AI algorithms which integrates seamlessly with its RIS-PACS. This makes it convenient to easily integrate it with the workflow and give a unified AI experience to the user. These AI tools, when executed over the scanned images, empowers Radiologists to provide increased, consistently accurate and faster diagnosis.

Even in the sphere of Veterinary Sciences, AI helps with the workflow and enables integrated image management through central­ized scheduling to multiple connecting modalities, sites or centers. 

Automation Benefits

Automation is key for many AI tools and many radiologists prefer to call it the perfect assistant technology. Many AI software take on duties that make a radiologist’s job easier. When the radiologists are overburdened with studies, they tend to be in a rush and this in turn increases the error rates. AI puts together machine and humans and makes this combination much more powerful and error free.

Enhancing RIS-PACS, AI software works in tandem to lay emphasis and focus on high quality radiology reporting and accessibility. Deploying AI for radiology will only add immense value to patient diagnosis and care.

14 Aug 2018

Breast cancer risks can be reduced with breastfeeding and AI-enabled early detections

Being diagnosed with breast cancer is a shocking experience for a woman. It can be quite difficult to handle the news at first, and even harder to know how to get on with it, no matter your prognosis. It becomes even more difficult to go through the illness if you are diagnosed and you can’t afford the treatment.

For Janet Napolitano who detected her breast cancer early, “It drove home, personally, the value of early detection and education and intervention.”

The Statistics

Approximately 1 in 8 women in the United States have an incidence of developing invasive breast cancer in their lifetime, as per www.breastcancer.org. And the World Health Organization (WHO) researches and studies have stated that irrespective of developed nations or lesser developed countries, breast cancer is on the rise and is one of the most common cancers in the world. Figures presented in 2011 were as shocking as 508 000 women dying of breast cancer (Global Health Estimates, WHO 2013). Wrongly thought of as a disease of the developed world, there are studies that have proved that almost 50% of breast cancer cases and 58% of deaths occur in less developed countries (GLOBOCAN 2008).

Early Detection Can Save Lives

Breast cancer survival rates vary greatly worldwide. The dismal rates of survival in nations that are less developed can be attributed to the dearth of early detection programmes and treatment facilities. This has resulted in a high percentage of women suffering from late-stage disease.

Breast cancer has seen a phenomenal rise in the past few years in India too. Oncologists from all across the country have reported that weekly, almost 25-30 patients visit them for breast cancer. They are of the opinion that lack of early detection, as well as treatment, is the primary reason of thousands of deaths in the country. Not just that, this number is all set to go up in the future.

A research paper that was presented By the University of Portsmouth in August 2018, said that up to 70,000 Indian women died of breast cancer in the year 2012 and anticipated that the mortality rate was likely to go up to 76,000 by 2020. The study also mentioned that even young women were likely to develop breast cancer and that the average age of incidence had moved from 50 years to 30 years.

Breastfeeding can help prevent breast cancer

Breast cancer is not something one can predict but that doesn’t necessarily mean it can’t be avoided. Although awareness is one of the means to inform the people, it is now a known fact that breastfeeding could act as one of the important preventive measures to avoid or lower the risk of breast cancer.

There are a lot of aspects that prove breastfeeding can lower the risks of breast cancer. For instance, breastfeeding women goes through lesser menstrual cycles as compared to those who don’t breastfeed. This leads to lesser exposure to estrogen, which is known to be instrumental in some types of breast cancers.

Breastfeeding also helps with making cells in the breast sturdier.  It can lower breast cancer risk, and this holds true in cases where the woman breastfeeds for longer than 1 year. There is less benefit for women who breastfeed for less than a year.

There are several reasons why breastfeeding protects breast health:

  • Making milk 24/7 restricts breast cells’ ability to behave badly
  • Many women lean towards a healthier lifestyle and eat more nutritious foods (they curtail their smoking and use of alcohol) while breastfeeding

Breast milk makes the world healthier and equal.

Mammography can help save lives

When it comes to screening for breast cancer, mammography is a painless tool and one that helps with early detection. Mammograms are extremely beneficial and safe, and can significantly improve the outcome of a breast cancer diagnosis.

Mammography screening aids in the reduction of breast-cancer-related death. Statistics show that reductions can vary from about 15 to 25% in randomized trials. Recent assessments have shown a variance of 13 to 17% in meta-analyses of observational studies too.

According to BreastCancer.org, mammograms have been found to lower the risk of dying from breast cancer by 35 percent in women over the age of 50. And that number is difficult to ignore. If we look at the 2007 UK population data, we can notice that for 1,000 women who were called for biennial mammography screening for almost 20 years from age 50, 2 to 3 women can be prevented from dying of breast cancer.

So when should one get a mammogram?

A vast majority of health organizations, including the American Medical Association, the National Cancer Institute and the American Cancer Society, say that all women begin screening mammograms at age 40 and every year after that.

If someone is at high risk for breast cancer and there is a family or personal history of breast or ovarian cancer, then the annual screenings could begin at a younger age. And it’s certainly worth it. Early detection with mammography saves lives.

MammoAssist is here to assist everyone

At Telerad Tech., we have been doing our best to enhance lives. Our best programmers have developed a solution called MammoAssist, an AI engine in a radiology ecosystem. MammoAssist algorithms analyze medical images and then combine this insight with information from the patient’s medical records to offer clinicians and radiologists support for decision making. The algorithms extract every micro information from the scanned images and enhance the ability of the radiologist to comfortably exclude negative cases, annotate the positive ones and generate a Structured Report.

Specific findings which MammoAssist detects

  • Micro calcification
  • Macro Calcification
  • Clusters
  • Lesion
  • AD
  • Bilateral Asymmetry
  • Tissue types

All the above have a specificity and sensitivity above 90%. The Radiologists get a work list which clearly indicates true negatives (nearly 100%). This allows them to prioritize studies and spend far less time on reading studies which have been classified as negatives.

MammoAssist from Telerad Tech is here to save lives.

Telerad Tech is the brainchild of a dynamic group of technology visionaries and distinguished radiologists who have single-mindedly focused on the development of products and solutions that address the gaps and needs of Healthcare IT in general, and radiology automation systems in particular.

27 Jul 2017
Telerad Tech Partnership with Zebra Medical Vision

Telerad Tech’s Partnership With Zebra Medical Vision Will Help Improve Medical Imaging Diagnosis

Telerad Tech, Bangalore, the technology affiliate of Teleradiology Solutions (TRS), and Zebra Medical Vision, Israel, announced today that they signed a partnership to bring Zebra-Med’s cloud-based deep learning analytics engine to over 20 countries and 150 hospitals and healthcare organizations.

Zebra Medical Vision has been a pioneer in the development and commercialization of deep learning imaging analytics solutions, and since 2015 has released clinical applications that automatically identify liver, lung, bone and cardiovascular disease, as well as breast cancer and intra-cranial bleeding.

“Our company, India’s first and largest teleradiology company, is proud to serve healthcare systems that treat millions of patients in over 20 countries globally,” said Dr. Arjun Kalyanpur, CEO of Teleradiology Solutions and Telerad Tech. “Our emphasis and focus have always been on high-quality radiology reporting. Zebra’s ability to produce and deploy AI for radiology is the exact type of added value we hope to bring to help fulfill our vision of impacting patient diagnosis and medical care in India, Asia, and Africa.”

AI’s deep learning capabilities enable reading and diagnosis of medical images with reduced human intervention and would assist radiologists to prioritize studies and provide a faster point of care to patients even in remote parts of India. AI algorithms will help in detecting overlooked indications and in providing insights which assist in building a synergistic preventative care program. This means improved outcomes and enhanced care delivery for patients and possibly reduced costs of treatment.

AI empowers radiologists to enhance their value and become more involved in patient care management, thereby making radiology an even more integral part of healthcare in India and abroad.

Source: Business Wire