Dalai In Paradise

For my BIG birthday, one of those that end in zero, Mrs. Dalai and I had to go somewhere special. I had first heard of Anse Chastanet in St. Lucia many years ago, and had even seen it from the deck of a cruise ship back in 1995. It seemed to be just the place for some rest and relaxation, somewhere to get away from it all. This is a wonderful village of unique and eclectic rooms built up the side of a mountain facing the beach, and overlooking the Piton, the twin peaks of southwest St. Lucia.

In doing my due diligence prior to booking, I discovered that Nick Troubetzkoy, the visionary architect behind Anse Chastanet, had just opened a sister resort above the first, called Jade Mountain. It seemed to be a magical and wonderful place from the description and the reviews (something like 99% positive on TripAdvisor.com, an unheard of validation in this industry.) Figuring that due to the economy and the coming changes in medicine, this would be our last blow-out for a while, we decided to splurge for that big birthday and went for the Jade.

You can read many reviews and descriptions on line, and I won’t bore you with my feeble attempts at describing paradise, but suffice it to say, that’s exactly what we found here: Paradise. The rooms (appropriately titled “sanctuaries”) at Jade Mountain have one completely open wall, and most have infinity pools, which overlook the Piton. This is the view from within our sanctuary:

From the Anse Chastanet beach, you can see the Jade Mountain complex at the top of the hill. There is a restaurant and bar at the very top, with several levels of sanctuaries below. Each sanctuary is completely private, and you can’t see into your neighbor’s. However, because of the generally open design, you can hear them if they make too much noise. This hasn’t been a problem, as the ambient sounds of birds, frogs, and the rush of water through the adjacent fountains covers everything with a soothing backdrop.

A view from the other side, the entry to the Sanctuaries, reveals a spidery network of bridges, each room having its own private walkway. “Sanctuary” as I noted above, is the proper term for the rooms. There is an spiritual air about this place that reminds me of nothing so much as a Buddhist Temple, not that I’ve ever seen one, and the network of bridges brings to mind Hogwarts Castle of Harry Potter fame.

There is open steel rebar coming out of the pillars, apparently a deliberate design touch, looking somewhat like a flare, some decorated with glass sculptures, giving Jade Mountain somewhat of an unfinished look. We have heard that there are plans for expansion, which would build upon these unfinished columns.

My description and these photos do not begin to do the place any level of justice.
We did a few of the touristy things, visiting the volcanic park and viewing the sulfur springs and such in nearby Soufriere, as well as the botanical gardens and Diamond Falls.

St. Lucia has a long history of occupation and colonialism, having been traded back and forth (more accurately captured) between the French and British fourteen times. Marie Antoinette was actually born here, and not on nearby Martinique, or so they say. Sugar plantations formed the major industry for many years, eventually replaced by fruit exportation, and now tourism. We had a fascinating little journey into St. Lucia’s past on a walk through the rainforest and the ruins of a sugar plantation on the resort property. Meno, our guide, was the descendant of the slaves that worked the plantation, and lives today in a one room house in which his grandmother raised him. While touring the remains of the boiler-room in which the cane was rendered down to molasses, and in which many slaves endured a horrible existence, Meno said something quite profound in his heavily-patois-accented English: “It does no good to ignore history, to ignore what happened here. We must remember it and deal with it, and then go on with our lives.” I couldn’t have said it better.

I’ll leave you with one word that sums up Jade Mountain: Paradise. Trust me on this. Save your pennies and come spend some time here. This is one of the most relaxing, restful, spiritual, and romantic places on Earth. I have never, ever, seen anything like it.
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Agfa Gets Canadian Bailout Grant

Agfa-Gevaert is a Belgian company, but it has a major presence in Canada, specifically in Waterloo and Toronto.

I have reported here and there about Agfa’s Imaging Division being for sale, but so far, it remains as it was. I suspect that it will continue for a good while longer, thanks to the Province of Ontario, Canada:

BRUSSELS, Jan 19 (Reuters) – Belgian imaging technology group Agfa-Gevaert (AGFB.BR) said on Monday its healthcare unit had received a grant of 29.6 million Canadian dollars (US$23.6 million) from the Ontario government to aid its growth there.

Agfa Healthcare, which provides hospital imaging systems and other information technology services, said the money would support its research and development and regional operations in Toronto and Waterloo, Canada.

The grant will be part of an increased investment by Agfa Healthcare in its Ontario operations, creating 100 new positions, Agfa Healthcare said.

Ontario’s Premier, Dalton McGunity, seems to enjoy playing Santa Claus, as he is also behind a $4 Billion (Canadian) loan to Chrysler and GM. The grant (not a loan, apparently) to Agfa will:

. . .help fund the development of new software that allows radiologists to share digital images across a regional network, instead of having to develop X-rays and physically transport them between facilities.
Those types of investments, McGuinty said, are also important to ensure the province’s economy bounces back.

“We’re doing both at the same time,” McGuinty said. “We’re lending a hand to Agfa, we’re lending a hand to the auto sector as well.”

Let’s do some math here, shall we? $30 Million (Canadian) for 100 jobs. That would be $300,000 per job, yes? Should I ask my friends up in Waterloo if they’re getting $300K at the moment? Probably not. Maybe they would consider hiring only 90 people and working really, really hard on some of my Impax issues?

Oh, Canada! Can I have a grant, too? Please?

Connectivity Banisher

In the world of Agfa Impax, a “Connectivity Manager” is:

. . . a middleware component in the integration between HIS, RIS, modalities, and PACS systems, linking patient and study data with images. To display the information available from a non-Agfa RIS in the Text area of IMPAX, connect to the Connectivity Manager. . .

The main purpose of the Connectivity Manager main purpose is to take data from one system, such as a HIS, and translate it into a format that another system, such as a modality, can understand. Connectivity Manager accomplishes this translation with mappings. The mappings tell Connectivity Manager how to translate incoming and outgoing messages to external systems. The following mappings must be configured so that Connectivity Manager knows which report source to go to for each study, and how to translate messages sent from IMPAX. . .

Map a reporting name into the Data Store by identifying the sending facility in the Connectivity Manager database. Identifying this value means it will work regardless of whether the sending facility sends their name along with the message or not. Also, if the sending facility changes their name at some point, mapping or configuration changes will not be necessary. The Default Assigning Authority identified in this mapping is the name of the report source entered in the Business Services Configuration Tool.

The sending facility is required to view reports in IMPAX. Connectivity Manager uses the Entering_organization and Requesting_Service mappings to populate the sending facility field. These mappings should include the Default Assigning Authority so that every report contains a sending facility.

Our Connectivity Manager was upgraded last night. And again this morning. From the rad’s point of view, this means:

During this time Modality Worklists will not be available and Technologists will have to manually input ALL Patient Information. Studies sent to IMPAX will Fail Verification, and will not update with Reports until the downtime is ended.

I drew the short straw, and experienced the joys of the upgrade. Fortunately, the downtime lasted less than one hour, and not two. Of course, only a few of the techs got around to manually inputting ANY Patient Information. Still, we were OK. Until this morning, when this information (including the accession number by which we dictate) was suddenly absent once again. The culprit was, of course, the Connectivity Manager, which seemed to be confused by “multiple” inputs for the same patient. Now that’s a problem, which we hope will be fixed by the experts before too much longer.

As usual, Dalai’s Laws of PACS apply. In particular, the First and Third Laws are applicable:

I. PACS IS the Radiology Department.

III. Once PACS, never back.

When PACS malfunctions, the department malfunctions, and don’t even consider asking anyone to go back to a manual process. It ain’t gonna happen.

So, in the ideal land of Dalai-wood (Hooray for Dalai-wood!), PACS should never break. Since that isn’t achievable, these thing need to be created with an eye toward simplicity and functionality. Based on what the “Connectivity Manager” is supposed to accomplish, I’m not really certain why it has to be a separate program or computer or whatever it is. Shouldn’t the simple, basic, core PACS be able to talk to others? OK, provide a look-up table (user-configurable, of course), but do we have to have a big, separate, grandiose module that manages to bollux up the works when we upgrade it?

Yes, I know…”simple” and “basic” aren’t in the vocabulary of a lot of PACS vendors. Neither is “easy”. And “uptime” can be defined to the preferences of those making the definition. But as far as I’m concerned, if it isn’t totally “up,” then it’s “down.” (Which happens to be true for many things in life.) So, today, we were “down,” courtesy of our dear Connectivity Manager.

And Now Khan Is Gone….

Today we lost yet another famous Star Trek actor. Ricardo Montalban passed away in Los Angeles at age 88. Montalban is most famous in the non-Star Trek world for his multi-year stint as Mr. Roark, the host of Fantasy Island. To us Trekkies, however, he will always be Khan Noonian Singh, the genetically-engineered superman seen first the Star Trek TV episode “Space Seed” and reprised in Star Trek II: The Wrath of (who else?) Khan.

He had disappeared from the screen for the past many years, save for some voice-overs for animated roles. Sadly, Montalban had been wheelchair-bound for many years following back surgery in the early 1990’s.

Montalban also founded Nosotros, which attempted to fairly represent Latinos in the media.

He will be missed. But perhaps one of his last lines from “The Wrath of Khan” is appropriate: “No. . .the game’s not over.”

Lying Headhunters

I just received a call from “Kristen Scott” who told our receptionist that she “needed a radiologist to look at a plain X-ray.” When I picked up, she started into her spiel about a “radiologist who is interested in moving into our area…” I cut her off and told her not to call here again. However, the more I think about this, the angrier I get. She lied to get through to me, and I don’t like that at all. Actually, I think this might be the same person that called me a while back and pretended to be a military official with a big federal hospital. Isn’t that a felony?

Message to radiology headhunters: Don’t even bother to make a cold-call, at least not to anyone in South Carolina. The vast majority of radiologists are NOT going to use your services, and will NOT waste time talking to you. Especially if you call and lie to to us or our staff.

Do I need to make it any clearer than that?

Still Following The Green Brick Road

My friend Brad from Dynamic Imaging, oops, I mean GE Healthcare, noticed my queries about the “hybrid” Centricity offerings, and was kind enough to fill us in on the latest. He attached some brochures that are not yet available online, but perhaps those links will be forthcoming. Here is the new deal:

We’ve heard from the PACSMan at RSNA, and read several recent AuntMinnie.com postings that you’re interested in an update about the “hybrid” Centricity PACS and Centricity PACS-IW technology that GE was showing at this past RSNA. We’re happy to provide you with an update, as well as provide collateral documents (See attached) that go into even greater detail.

Introduced at RSNA 2008, Centricity PACS Web Diagnostic (“Web DX”) provides a Web-based diagnostic viewer for Centricity PACS 3.0 users. Web DX has been developed using groundbreaking technology, leveraging the Centricity PACS trusted backend infrastructure, advanced patented streaming capabilities, and the award winning Centricity PACS-IW viewer. Web DX has received clearance from the FDA (510K) for primary interpretation, and is available for sale worldwide today (English-version).

Web DX delivers the speed and functionality of the PACS-IW viewer through the use of advanced streaming technology connected directly to the Centricity PACS backend. The potential workflow of a Web DX user is multi-fold — any user who seeks anywhere access to all studies and reports on their Centricity PACS system, a radiologist who seeks to interpret studies from home or at the imaging center away from the main hospital, sophisticated clinicians (oncologist, orthopedist, neurologist) seeking advanced 3D tools wherever they need them (e.g., in the OR, at home, at the office), or for referring physicians simply desiring images and reports wherever they are.

The Web DX Study List is populated directly from the Centricity PACS database, and just like PACS-IW, the Study List is easily customized with a tabbed interface, and imaging studies are viewed on-demand. Quickly loaded with advanced streaming, the studies are hung across the single or multi-monitor screen real estate using comprehensive hanging protocols. All of the feature-rich viewing tools of PACS-IW are available, to include 3D (MIP/MPR) and the innovative (patent-pending) SNAP! Tool for rapid study layouts and series hanging without the need for the traditional drag-n-drop. The user can also display an unlimited number of relevant prior studies and their reports for comparison. Once an unread study is loaded into Web DX, study locking mechanisms are in place so users on Web DX and Centricity PACS cannot both dictate and change the study status to “read” (Note: Centricity PACS v3.0.5 is required to use this exam locking feature). In addition to the above, four (optional) clinical applications are also supported via Web DX today: Orthocrat TraumaCad for orthopedic templating and surgical planning; Barco Voxar 3D and Terarecon AquariusNet integrations for advanced visualization; and peerVue qiVue for peer review, critical results management and ER discrepancy reporting.

We’re truly excited about Web DX and the functionality it can bring to our worldwide Centricity PACS customers. Please encourage your readers to contact their GE Sales Executives for more information.

Translation: GE has grafted IntegradWeb onto Centricity 3.x, theoretically for use as a web viewer. This was certainly an immediate need, because in my humble OPINION, the only viewer worse than Centricity RA-1000 is Centricity Web (the old version). IN MY OPINION, that is.

I, for one, will lobby hard for the use of WebDX as my main reading client, and I’ll bet I’m not the only Centricity user who will do so.

Many thanks, Brad!