As one of several members of the Visage Imaging (“Visage”) team with both clinical and business backgrounds, I am privy to seeing “the good, the bad, and the ugly” when it comes to customer implementation processes. With the knowledge of having a clinical background and participating in numerous technology implementations, I’ve seen what worked and what didn’t, and it has given me an interesting perspective. My multi-decade clinical background covers multiple modalities (CT, MR, Diagnostic Radiology, and Angiography), as well as administrative roles as a modality manager and department management. The business side of things often conflicts with the clinical side, but must align in the end for the greater good of the department and ultimately the institution.
Over the course of the last 20 years, user expectations in the PACS world have grown exponentially. Ultimately, we all want our cake… and we expect to be able to eat it too. But, like a cake, if you don’t know the ingredients to use, don’t have access to all of the ingredients, have poor quality ingredients, or have an incomplete recipe, the final outcome may not be very palatable. Beyond ingredients, execution of your team, including preparation of your oven, are critical. Perhaps your oven temperature is consistent, but what happens if no one is watching the oven? Or maybe a timer isn’t being used? Or maybe your pan runs hot or it wasn’t properly greased? There are many ways to screw up the cake, or make it flat out delicious.
We've finally arrived at our last post in our "speed" series of blogs, “Can you? Visage can.” In our last chapter, we discussed how how legacy solutions haven't handled multiple workflows very well, requiring third party software, additional licensing and servers required to support the additional requirements. In contrast, Visage 7's elegant architecture eliminates redundant dataflows, streamling the enterprise imaging infrastructure.
In today’s Imaging environment, interoperability reigns supreme. Radiologists don’t read off of a series of displays in a vacuum, they read in an integrated cockpit. Surrounded by multiple large format, high resolution displays, multiple applications perform an orchestrated ballet in patient context with each and every new study launched. Within a 180 degree glance, the radiologist typically has visual access to their reading worklist, their reporting application, their diagnostic viewer, the EHR, as well as other diagnostic and clinical software applications.
And that brings us to our next topic in Chapter 11: Interoperability.
Welcome to the second to last post in our "speed" series of blogs, “Can you? Visage can.” In our last chapter, we discussed how most people think about speed in terms of the front end (e.g., the viewer(s)), but don't adequately consider the speed of the backend (e.g., the server(s)).
A good way to look at speed is that they are two sides to the same imaging coin. If either is slow, it's going to slow your imaging organization down. If you're an organization with significant incoming volume, the slower the backend, the likelihood your radiologists will be working from behind is high. If both sides of the Imaging coin are slow, then you'll likely have a slew of problems organizationally that only get compounded with scale. One measure of backend speed is study ingest performance, or how quickly can the server(s) process incoming DICOM studies. Visage 7 is scaled to support massive ingest performance, supporting tens of millions of studies annually. It's also important to repeat that Visage has never encountered a PACS, viewer, archive or VNA that can even come close to the speed, ingest performance and scale of Visage 7.
Most legacy PACS architectures do not have streamlined architectures, meaning they require multiple servers, with a variety of functions, networked together in order to deliver the total requirements of the PACS. When institutions want to add (for example) additional locations, add multiple new modalities, add mobile imaging access, and support new -ologies, additional servers are typically required. These add to the architectural complexity that must be supported, but how does it impact speed?
And that brings us to our next topic in Chapter 10: Multiple Workflows.
As many healthcare institutions look to assemble governance, obtain budget and execute strategies for their enterprise imaging programs, I’ve observed a common barrier in crossing the chasm from planning into reality: perceived risk.
Risk is something that has not happened (yet) and it may never happen. It’s a potential problem. When used to evaluate an enterprise imaging strategy, several key decisions must be made:
Thank you for your interest in our "speed" series of blogs, “Can you? Visage can.” In our last chapter, we discussed how access to prior exams at the point of interpretation is a continuing challenge for many institutions. There's numerous reasons for that struggle, from the inability to access the priors from their originating institutional archive(s), to the massive aggregate size of multiple priors (particularly for multi-slice CT and DBT studies). In contrast, Visage 7 has an all priors philosophy, without any sacrifice of quality or speed. In addition to Auto Prior rules for current/prior display, all priors in Visage 7 are always immediately available for display. Radiologists deserve to have immediate access to all priors, whenever and wherever required, in order to deliver optimal patient care. That is the standard Visage 7 provides, for each and every interpretation. Just last week Visage 7 went live at an esteemed regional institution, and for the first time in their history, radiologists have immediate, routine access to all patient priors at the time of interpretation. We'll explore this story in a future blog post, but once again speed is the enabler.
And that brings us to our next topic in Chapter 9: Study Ingest Performance.
We've arrived at the eighth chapter in our "speed" series of blogs, “Can you? Visage can.” We've got just two more chapters to go, so thank you for your continued interest.
In our last chapter, we discussed how thin-slice reading using Visage 7 enables radiologists to read faster and to provide the best possible patient care. While in recent years thousands of institutions have spent tens of millions of dollars each on the latest thin-slice scanners, their viewers and diagnostic workstations only support reading "thicks" and secondary capture reconstructions created in the hope they are acceptable to the reading radiologist. These legacy viewers don't support thin-slice reading and choke on the data. And by choke, I mean they just won't work.
No one wants to put a speed limiter on a sports car, so why have healthcare institutions put a "care-limiter" on their significant scanner investments? It is because traditional PACS technology has not kept pace, but there is a better way...with Visage.
Only Visage 7 enables institutions to get the greatest value from their scanners, enabling radiologists to read faster, with greater clinical accuracy. If one considers thin-slice reading to be cutting edge for primary interpretation, how about access to prior imaging? Pretty basic, wouldn't you think? Think again.
And that brings us to our next topic in Chapter 8: Priors.
Thank you for your fantastic feedback about our "speed" series of blogs, “Can you? Visage can.” I've received a number of e-mails complimenting Visage on the insights we're sharing, explaining that it's much easier to understand the value of speed with actual clinical and technical examples from other imaging organizations. We'll do our best to keep this blog fresh, and I think you'll equally appreciate today's update.
In our last chapter, we shared how regional enterprise imaging is redefining reading relationships. Consolidation is transforming the logo landscape, but behind the scenes the technology is more often a mismatched quilt of this and that. You'll get your images read, but not without a lot of moving parts, manual intervention, and sweating administrators. We elevate "mediocore" to "high-quality" across the imaging landscape and truly represent breakthrough, enterprise-class solutions. Everyone is trying their best to provide a consistent, quality product for referring physicians, but with variable underlying technologies that's easier said than done. With Visage, we've proven and delivered what others have said isn't possible. There's lots of vendors that do plenty of talking, Visage prefers getting things done....with differentiation.
And that brings us to our next topic in Chapter 7: Thin-Slice Reading.
With this post, we're starting the home stretch of our "speed" series of blogs, “Can you? Visage can.” In our last chapter, we shared how even in 2017, most diagnostic viewers are not ambidextrous. Meaning, unlike Visage 7, most diagnostic viewers do not perform as well at-home for remote reading as they do local at the hospital or imaging center. Given how mobile today's healthcare professionals are, that's an unconscionable limitation and should not be tolerated for today's standard of care.
Over the past several years, consolidation has truly transformed the healthcare landscape. Community hospitals have been acquired and merged to create large regional networks, many with academic medical centers as their flagships. Outpatient imaging chains continue to grow, many via merger and acquistion. Additionally, many radiology groups have been acquired into regional and national networks, creating massive radiology organizations of hundreds of radiologists, performing millions of new studies with hybrid models of outsourced, onsite and remote teleradiology reading services. But when we speak with many of these growing regional and national organizations (inpatient/outpatient/hybrid) their technology stack is all too frequently a heterogenous mix of legacy solutions. It's a mishmash of disparate technologies that offer no consistency, no foundation for streamlined operations and economies of scale you'd otherwise expect to see in a large network. When we talk to these groups, many don't think that a single, regional or national enterprise imaging platform is even remotely possible.......until they learn about the capabilities of Visage 7.
And that brings us to our next topic in Chapter 6: Regional Enterprise Imaging.
Thank you for continuing to stay with us, as we're halfway through our "speed" series of blog posts, “Can you? Visage can.” In our last chapter, we discussed how In-Viewer Workflow differentiates truly fast viewers from viewer pretenders, exploring the elusive "start of interpretation" that many lessor viewers struggle overcoming. These are topics that most don't consider when initially thinking about speed. Speed is an emotional topic, you know it when you see it, but there's even more to it than "surface" speed. And that brings us to our next topic in Chapter 5: At-Home/Remote Reading.