It just isn’t FAIR!!!!!
Hat tip to Dr. Sanity.
It just isn’t FAIR!!!!!
Hat tip to Dr. Sanity.
Nanak, my PACS guru, recently asked for permission to attend a MERGE PACS training session. The description looked so good, I wanted to attend as well:
Merge Healthcare, the leading developer of information technology to create a better electronic healthcare experience, invites you to attend a specialized training session. During training, our technical experts will walk you through a deep dive of the technology’s features and functionality so you gain the critical skills necessary to maximize your investment in Merge solutions.
What: MERGE PACS KNOWLEDGE QUEST – SUPPORT 2011
Where: Daytona, Florida
- Systems Overview – PACS Components
- Server Maintenance
- Definition of logs and what they mean
- Advanced trouble shooting techniques
- MWL Filtering (how it works)
- Creating advance transfer rules
- Managing Image volumes and watermarks
- RTWL filtering
- Management Tools
The two-day session was held at Merge Southern Headquarters in Daytona Beach, Florida:
As it turns out, this is also Merge’s main support site, and so we got to see the “prairie-dog village” as Nanak calls it, where the support folks do their thing:
We had the opportunity to meet in person many of the folks who had been taking care of us and our system for the past few years. We also discovered the secret of their seemingly unlimited energy:
We also got the chance to have dinner with my friend Mike Cannavo, the PACS exec formerly known as the PACMan. (Mike now works for The Man at a big-name vendor.)
The course itself was frankly slightly above my level. While I do have administrative privileges, I don’t dabble too much in the back-end of our system (presently Version 5.0) or the hospital’s (version 6.0.4), but I did find it quite valuable to learn more about what goes on there. There are some places I’m not going to tread, and even Nanak doesn’t like to dive into the DB2 database, which can be dangerous indeed, but we now know more about how to do so if need be.
One major change between our 6.0.4 and the latest 6.2 is that the name AMICAS is slowly being relegated to the trash bins of history and my failing memory. The new sign-on screen reads thus:
A true PACS guru is worth his/her weight in gold.
In Nanak’s case, that’s a lot of gold. But still absolutely true.
Apple had some rather spectacular failures as well. The Newton (of which I was an early adopter) never really worked as desired. Here’s an article about the Newton and seven more Apple goofs. Anyone remember the Pippin? At least I never succumbed to that one.
The recent release of the iPhone 4S, Steve’s last imprint on Apple, shows that Apple still may not predict the market with perfect accuracy. The remake is really much more phenomenal than it originally seemed. Better processor, better camera, more memory, better antenna system, and Siri, the latter of which in some ways brings to fruition some of the original magic conceived for the Newton projects. See this video from 1987:
It only took about 25 years to bring this futuristic technology to the future.
But Apple is taking somewhat of a hit over what is really a significant upgrade…because users were expecting a new screen and new case. A 4 inch screen and a more streamlined case would have gotten big accolades; huge new tech innovations are getting a “meh”. You can rest assured that the iPhone 5 will have a new form-factor, hopefully not introduced too late to smash the competition. Personally, I’m satisfied with the iPhone 4 housing. As Steve once said, it is “like a beautiful old Leica camera”.
My friends (and even Mrs. Dalai) have asked me what I think will become of Apple now that Steve is gone. I’m hoping for the best, really. Steve must have left some documentation of how he thought things should work, and his hand-picked successor, Tim Cook, seems quite qualified to carry on the traditions. There are enough brilliant people working for Apple that I can’t imagine it will founder much, if at all. I have great faith in their people to carry on. You can rest assured that the motto for the foreseeable future will be: “What Would Steve Do?”
Perhaps my greatest regret about Steve’s untimely passing was voiced by AuntMinnie user Elegiac:
Imagine what he might have accomplished had he focused his creative energies on developing solutions for medical informatics. It is hard to imagine how much more productive we all would be if we used a unified and properly designed PACS/VR/RIS/EMR system created by people who placed value on an integrated work environment which just works. What could have been.
Indeed. PACS vendors take note.
A hat tip to Radio17 who reminds us on the AuntMinnie thread that 3D advanced imaging is one of Steve’s Pixar legacies as well. From an ACR article about Elliot Fishman, M.D.:
The Brooklyn native (and Yankees fan) arrived at Hopkins in 1980, and by the mid-1980s, began working in 3-D medical imaging. He characterizes the state of the art back then as “pretty limited.” Looking around, Fishman approached and began partnering with Pixar Image Computers (and later, with Siemens), where a cadre of elite researchers was doing seminal work on computer visualization using ultra-fast proprietary computers. Fishman’s contribution was to help Pixar adapt its massively complex technology to the medical front. Ultimately, Pixar shifted its focus away from medical computing, but its groundbreaking work opened the door for a host of scientific revolutions. In time, Pixar would enjoy tremendous commercial (and critical) success making such movies as Toy Story, Finding Nemo, and Cars.
Recalling those halcyon years of around-the-clock work, Fishman says, “The people at Pixar were the smartest people I’ve ever worked with, anywhere. I’m talking 11 over 10 — just incredibly unbelievable.” But he reserves his warmest praise for Pixar CEO (and Apple Computer founder) Steven Jobs. “He is a remarkable visionary and also one of the most charismatic people I’ve ever met.”
“One of the highlights of my career,” he continues, “was giving a named lecture at Stanford University. Steve came to my one o’clock lecture on 3-D imaging, which I’ll never forget. I figured I’d be speaking to radiologists, so even if I was wrong on some technical point, they might not know the difference. But with Steve there, I realized that if I made a mistake … ‘Oh, my God, if I say something wrong, he will definitely know.’”
Rest in peace, Steve. You will be missed.
This is Merge week, it seems, due in no small part to the Merge Live Client Conference 2011, going on right now in Chicago. I would have been there myself, except Merge accidentally scheduled the meeting right up against Yom Kippur (which begins the evening the conference ends, Friday, September 7) making it difficult to attend. No worries, RANZCR did the same thing this year.
Merge Healthcare (NASDAQ: MRGE), a leading provider of enterprise imaging and interoperability solutions, today announced Merge Honeycomb, a revolutionary new cloud-based service that will enable users to upload, download, view, and share medical images – at no cost.
“With Merge Honeycomb, we’re harnessing the cloud in a way that encourages and enables faster collaboration among all healthcare stakeholders, resulting in a true improvement in the delivery of care and reduction of costs,” said Jeff Surges, CEO of Merge Healthcare. “With the largest network of imaging clients by far, Merge is taking this important step to connect the healthcare industry and expand interoperability.”
Announced today at the Merge Live 2011 Client Conference, attended by over 500 healthcare professionals, Merge Honeycomb will be the nation’s largest medical imaging sharing network and is open to anyone. Merge Honeycomb will officially be launched at the Radiological Society of North America (RSNA) Conference in Chicago in November, 2011. Users can pre-register now for this free service at http://www.merge.com/honeycomb.aspx.
Merge Honeycomb will solve a myriad of costly healthcare challenges. It will reduce the need for duplicative scans, which costs the industry an average of $35 billion a year and exposes patients to harmful and unnecessary radiation. (According to a 2010 study by the Center for Devices and Radiological Health and the U.S. Food and Drug Administration, the radiation level in one CT scan of the abdomen is approximately the same as 400 chest x-rays.)
Merge Honeycomb will also eliminate the archaic practice of using patients as transport vehicles. The need to burn X-rays, CT Scans, MRIs and other images onto CDs will be a thing of the past. When a physician needs to view images, they can log into the image sharing network via any web browser.
It also speeds the time to treatment. Referring physicians will be able to view images in realtime and make diagnoses accordingly. And because the network is permission based, images can only be viewed by those who have been granted privilege.
It is a component of iConnect, the larger (and not free) overall package:
Merge iConnect facilitates the sharing of content and results across the continuum of care. Available in vendor-agnostic modules, Merge iConnect uniquely leverages existing investments and provides added functionality when needed to deliver access to any image, anytime, anywhere. While there are many niche imaging solutions in the market, Merge iConnect is the only comprehensive suite that delivers true interoperable image exchange and management.
With Merge iConnect, healthcare images are moving at the speed of life through the power of the cloud, enabling an enterprise imaging strategy. These images are easily archived, available on demand and accessible at the point of care, which means frustrations like waiting for images and unreadable CDs are history.
The interface looks a little “Facebook-ish” to me:
But maybe that’s the intent, as everyone knows how to use Facebook. (Let’s hope Merge doesn’t contract with Zynga to create X-RayVille or something foolish like that!)
We all know that “The Cloud” really isn’t something ephemeral in the sky, but rather a server and storage farm in some bunker somewhere. Did Merge buy its own farm (hopefully not from a Zynga user) or is it buying space from Amazon Web Services or some similar provider?
For some reason, Merge takes its time in posting its own press releases on its own site. Global News Wire has this October 6 release:
Merge Healthcare (Nasdaq:MRGE), a leading provider of enterprise imaging and interoperability solutions, announced today that it has selected Dell as a preferred provider of cloud computing services, storage and enterprise hardware products to simplify information access, management and archiving among its portfolio of image interoperability solutions.
Through its secure cloud-based Unified Clinical Archive solution, Dell manages more than 4 billion medical images and studies for healthcare organizations. Utilizing its cloud-based health information technology, Dell will host Merge Healthcare’s Project Honeycomb, the nation’s largest medical image sharing network. With Project Honeycomb, providers can upload, download, view and share diagnostic quality medical images – at no cost.
For providers who want on-premise image management, Merge has certified its iConnect Vendor Neutral Archive (VNA) on Dell’s DX Object Storage platform, providing intelligent access, storage, protection and distribution for the fixed digital image content managed by Merge Healthcare’s iConnect VNA. The data and storage management features inherent in Dell’s systems combined with Merge’s iConnect offering will enable healthcare providers to manage their critical medical images in a highly secure and efficient manner.
Merge will integrate its solutions within the DX platform, using Dell’s capabilities to provide a highly-available, cost-effective VNA offering. By utilizing the data management features of the DX, iConnect VNA will offer advanced features such as federated storage, business continuance and nested image retention and deletion strategies.
Anyway, why again do we want this?
With Merge Honeycomb You Can:
• Eliminate the need for patient-borne CDs
• Provide VPN-free exchange of images
• Share diagnostic images securely via the Internet
• Easily view outside studies
• Eliminate waiting for images
• Eliminate image format incompatibility
• Reduce duplicate exams
• Speed time to treatment
• Increase referrals
• Reduce IT complexities associated with sharing exams
Hmmmm…sounds a lot like the mission statement for LifeImage:
lifeIMAGE enables the secure and on-demand exchange of medical imaging information from anywhere and with anyone. We provide a multi-purpose, SaaS platform to healthcare institutions, physicians, and patients to exchange information directly or integrate the information with their EHR or PHR systems. Our goal is to eliminate the need for duplicate imaging exams and avoid unnecessary radiation.
To do this, we offer applications that can be incrementally adopted to help with the transition to electronic exchange of imaging information. Our services solve image accessibility challenges inside and outside a facility’s firewall. Throughout, we are meticulous about confidentiality, privacy and HIPAA compliance.
Their solution is not free, but I have this sneaking suspicion that Merge Honeycomb, while a stand-alone module, will be far more useful and usable in the context of iConnect, and in the end won’t be quite free either.
Having no hands-on experience with the new Honeycomb, I can’t begin to tell you which is better, and no doubt both Merge and LifeImage will prosper with these approaches. To me, Dr. Dalai, Average Radiologist Extraordinaire, the key will be transparency. In other words, the system that gets the foreign images into MY PACS most easily wins.
Honeycomb? The folks of my generation might think of the cereal first:
The younger, more tech-savvy set might associate the term with the latest flavor of the Android OS.
I’ve never understood much about marketing or name-selection.
Oh, by the way, at the bottom of the press release, in the fine print, we see this disclaimer:
Merge Honeycomb as described herein is a works-in-progress. Merge Healthcare is not legally obligated to develop or continue to develop such works-in-progress that may include the features and functionality described herein.
Perhaps that’s standard boilerplate language, but it seems a bit strange in a big announcement such as this. Oh well, never hurts to cover one’s bases, eh?
Hat-tip to Mike Cannavo, the Once and Former PACSMan, since I don’t seem to be on Merge’s e-mail list these days.
Fellow blogger PACSMatt (Matt Granger) attended the Merge Live! event, and adds much to our knowledge of Honeycomb:
Many thanks for the info, Matt!!!!
I received a comment as well from an anonymous reader (no one wants to admit reading my stuff, it seems):
What I’m curious about, is that lifeIMAGE already announced a similar offering to the American Society of Echocardiography (free), with plans to expand it to all? Not sure.
I’m not sure, either. I’ll post what information I find on this. Sounds like LifeImage may have something up their collective sleeves…
A friend received this press release early today, and ironically, it is not yet anywhere to be found on the Merge.com website (as of 9:30 AM EDT) (UPDATE: It’s finally online.)
Merge Healthcare Announces Creation of Clinical Advisory Board
Expert Panel to Provide Patient-Centric Solutions to Improve and Streamline Delivery of Care
CHICAGO, Oct. 4, 2011 (GLOBE NEWSWIRE) — Merge Healthcare (Nasdaq:MRGE), a leading provider of enterprise imaging and interoperability solutions, announced today the development of an Advisory Board to share clinical expertise and provide consultation on new models of care and emerging trends focused on the patient-centric experience.
The Merge Advisory Board will focus on the fact that diagnostic images make up a significant and critical part of the diagnostic process, yet today, the exchange and sharing of these images is inefficient. This inefficiency fragments the healthcare process which contributes to delays in care and skyrocketing costs. The Merge Advisory Board will also address patient safety and quality of care through, among other things, focusing on the fact that patients’ radiation exposures has doubled over the past 20 years and developing solutions that reduce such exposure.
Consider the realities of diagnostic imaging:
- Healthcare organizations generate nearly 600 million diagnostic imaging procedures annually;
- One CT scan of the abdomen exposes a patient to the same amount of radiation as approximately 400 chest x-rays; and,
- $100 billion of annual healthcare costs are related to diagnostic imaging tests – but an estimated 35% ($35 billion) represents unnecessary costs for US patients and insurance providers.
The Merge Advisory Board is led by Dr. Cheryl Whitaker, Merge’s Chief Medical Officer; co-chaired by Dr. Paul Chang, Professor of Radiology and Vice Chair, Radiology Informatics at the University of Chicago Medical Center; and, Dr. Keith Dreyer, Vice Chairman of Radiology Informatics at Massachusetts General Hospital.
“We are extremely fortunate to have experts from these prestigious organizations advising the Merge team,” said Jeff Surges, Chief Executive Officer of Merge Healthcare. “We look forward to the clinical dialogue that will develop, and to incorporating their knowledge and expertise into the image interoperability solutions we provide to clients and the healthcare marketplace.”
“Merge believes in a patient-centric healthcare experience, and empowering physicians, patients and providers to proactively manage this healthcare,” said Dr. Cheryl Whitaker, Chief Medical Officer at Merge Healthcare. “I look forward to working with this distinguished group of leaders to ensure we continue to develop solutions that simplify and improve the care process.”
The Merge Advisory Board consists of the following imaging and healthcare experts:
Dr. William Boonn Chief of 3D and Advanced Imaging Lab Hospital of the University of Pennsylvania John A. Carrino, MD, MPH, PhD Associate Professor of Radiology and Orthopaedic Surgery Johns Hopkins University School of Medicine Dr. Paul Chang Professor of Radiology Vice Chair, Radiology Informatics University of Chicago Medical Center Dr. Keith Dreyer, MD, PhD Vice Chairman of Radiology Informatics Massachusetts General Hospital David Mendelson, MD Chief of Clinical Informatics MSMC Professor of Radiology The Mount Sinai Medical Center Eliot Siegel, MD Chief of Radiology and Nuclear Medicine Veterans Affairs Maryland Healthcare System Timothy Zoph Chief Information Officer and Senior Vice President of Administration Northwestern Memorial Hospital
What? No Dalai?
To be fair, this is a list of PACS luminaries, the likes of which you will find nowhere else, and the likes of me probably doesn’t belong even reading such a list.
We see some very familiar names here. Dr. Chang is quite famous in this space, in no small part for creating Stentor, developed at the University of Pittsburgh for $9 Million, which was bought by Philips for $45 Million and became iSite. He’s now at the University of Chicago, and wouldn’t you know it, they use iSite, according to one of my readers. I do not know offhand if Dr. Chang has had much hands-on experience with
AMICAS Merge PACS.
Dr. Dreyer does have time on
AMICAS Merge PACS, as Mass General uses AMICAS Merge PACS 6 as their web-client, something their old but functional Agfa 5.x doesn’t have. His contributions to PACS are multitude as well, and he is perhaps the best choice to help Merge navigate the Meaningful Use maze. Dr. Dreyer has been a big proponent of Visage, so we may get to see how these two products play together.
Dr. Siegel is very well known in this venue. Rumor has it he will be sending Watson to the Advisory Board meetings as his proxy. The Baltimore VA has Centricity, and the University of Maryland has Agfa IMPAX.
Johns Hopkins still has Emageon PACS as near as I can tell, but the one really BIG NAME radiologist I don’t see on the list, Elliot Fishman, M.D., complained (in 2007) about Emageon’s inability to handle more than 100 slices before choking. Of course, that led him to use the Siemens Leonardo InSpace workstation. I don’t know what PACS is in use at Hopkins today, however.
Dr. Boonn’s University of Pennsylvania appears to have Siemens PACS, although I don’t know if it is the new syngo.plaza or some older product. (UPDATE: I’m informed that U Penn now has Centricity.) As far as advanced imaging, the HUP website notes quite an arsenal:
Post-Processing: GE Advantage Windows, Vital Images Vitrea2, TeraRecon AquariusNet and INtuition, Siemens MMWP (Leonardo) and syngo.via, and QMass. Our 3D and Advanced Visualization Lab is staffed by four dedicated technologists who assist with workstation training for visiting fellows.
I couldn’t find any reference to the PACS used at Northwestern (UPDATE: Northwestern uses Centricity), and Mount Sinai uses GE, I assume Centricity of one flavor or another, although I found mention of the use of OsiriX as well.
I certainly cannot fault Merge for choosing this very impressive panel as its Clinical Advisors. I don’t think one could do much better, and this is the level of expertise I would expect to work with Messrs. Surges and Dearborn, not to mention Mr. Ferro, assuming he’s working on this stuff at the moment.
I will certainly offer my services should there be some minor subcommittee formed that concerns itself with day-to-day operations of PACS software out here in the boonies. On that, I am somewhat of an expert myself. (Just ask Agfa.) I’m at your beck and call, folks. You know my number.
I’m currently trying to drop a few pounds, in hopes of looking a bit less Buddha-esque. I’m following a program that encourages more plant-based foods, less meat and dairy, and more exercise. It’s working, by the way, but don’t expect me to provide Biggest Loser-style weigh-ins for your viewing pleasure.
Our ever-travelling First Lady, Michelle “Let Them Eat Arugula” Obama, has been quite involved in nutrition as well, and has helped publicize (if not develop) the new My Plate concept, replacing the old food pyramid:
Do I want the government telling me what to eat? No, but I do appreciate the research involved, and I might look at what they have IF I decide to do so. That’s where it stops. The government is NOT invited into my kitchen.
But thanks to our friends at GE, and Mr. Immelt’s friends in Washington, the government is about to take a little bitty baby step into your kitchen, should you purchase one of several new GE microwaves. From GE’s appliance website:
1.9 cu. ft. capacity
1000 Watts (IEC-705 test procedure)
Circuwave™ 1000 cooking system
Cooking system provides more power for fast, more even cooking results
Built-in sensors monitor the moisture level in food and automatically adjust time and power to deliver perfect cooking results. One touch is all it takes.
Sensor cooking controls
Automatically adjusts time and power for delicious cooking resultsPorcelain enamel interior makes it easier to clean dried-on foods. Non-porous surface also makes cleaning spills and splatters a snap.
Power Saver mode
Makes it easy to wipe up spills, splatters and dried-on foods.
This mode delivers a reduction in standby power while the unit is not in use. The clock continues to operate on schedule, while Power Saver is activated and during power failures.
Reduces standby power while the unit is not in use.
Ummmm, wait just one minute. What was that last one? MyPlate.gov? Yes, indeed!
GE has kindly provided us with a button to access a U.S. Government-approved menu. GE is quite proud of this:
“Our goal with the MyPlate feature is to give consumers an easy way to choose and tastefully cook foods that are healthier for them, using graphics and instructions that are easy to understand,” Susan Gregory, product manager for GE microwaves, told Business Wire. “Providing quality cooked food for a wide range of items is a huge part of the MyPlate feature.” According to Business Wire, GE “worked closely with the USDA to ensure the MyPlate feature in their cooking products is in step with dietary recommendations.”
Here’s how it works in practice:
Crazy? Paranoid? Maybe. But when two and two add up to five, I smell a rat. BiGE Brother might well be watching you, or at least your microwave. I’m going to stick with my old Sharp oven, which has been running well for 16 years, and doesn’t transmit anything back to Japan as near as I can tell.
In honor of tomorrow’s scheduled introduction of the iPhone 5 (or maybe the iPhone 4S?), Next Media Animation out of Taiwan presents this unauthorized preview. I’ve got a couple of partners who are anxiously awaiting the new iPhone; their resemblance to one of the main characters in this cartoon is purely coincidental.
WARNING!!! THIS VIDEO IS NOT FOR FAMILY VIEWING!