The Internet reduces teleradiology costs
The Internet reduces teleradiology costs
It may replace high-end diagnostic stations
Massachusetts General Hospital (MGH) in Boston has about 30,000 personal computers. At every PC with an Internet connection, a physician can pull up a digital medical image off a Web browser and view it.
MGH physicians were once limited to viewing images on their high-end Picture Archiving and Communications Systems (PACS). They could not view the images when they worked in areas where the machines weren’t present. Referring physicians could not view any images from their offices or homes.
This has changed since MGH began using an Internet-based software solution for the management of diagnostic medical images. The software can deliver real-time, Internet-standard services integrating PACS and electronic records from imaging facilities to physicians on-line.
The backbone of the system, provided by Amicas of Newton, MA, is the Web/Intranet Image Server, which has an interface that can integrate to radiology information system workflow with existing DICOM (Digital Image Communications in Medicine) workstations.
Facilities pay per-study for the images. Physicians who want to use the system input their user name and password and gain access to an interface similar to Yahoo!, says Hamid Tabatabaie, chief executive officer for Amicas. The physicians can search for a particular patient and find all of the procedures available to view from that patient.
"Physicians can zero in on one of many of those [images], rotating them just as any radiology tool would be used," he says. The system also allows users to view the radiologist’s notes and comments about a certain procedure.
The system has allowed images generated at MGH to be read in Turkey, says Giles Boland, MD, director of teleradiology at MGH and associate professor in radiology at Harvard Medical School in Cambridge. "All of our teleradiology clients, domestic or international, use the system, which allows them to view the images on the Internet."
Boland says the images are very clear when viewed on a PC. This type of system has completely changed the way physicians access images, he adds. "They can view everything —including the results, the images, and the lab work — on their PCs in their office or home."
The cost savings is dramatic with this type of system, too. "To have a prime-rate, high-end diagnostic workstation for radiologists is quite expensive," Boland says. "It runs into the tens of thousands of dollars per workstation."
To print film for referring physicians would be cost-prohibitive. "You would be printing as much film as you did before PACS, and therefore, you might as well not have gone down that road," he adds. "It makes no sense to spend that kind of money for distributing the images in a high-end way like that."
In a nutshell, the system is a flexible way of image distribution without additional cost, Boland says. "Almost everyone has a PC and an Internet connection."
He predicts that soon Amicas and other companies may be able to replicate the high-end diagnostic workstation, too. Already the Inter-net-based software allows primary interpretations to be made off the PC, but the system is slower than PACS. "You can now buy commercial software fairly cheaply that allows you to do what [PACS] does, but you still need something like the quick front-end to provide high-volume primary interpretations."
Amicas also recently engaged IBM to build AMICAS.NET, a Web portal designed to bring e-commerce to diagnostic image management. "The portal’s main function is to securely log and track every imaging transaction that occurs at any customer’s site," Tabatabaie says.
AMICAS.NET also provides the infrastructure for the capture and distribution of images across independent medical institutions, providers, payers, and customers, enabling the integration of images into transportable electronic medical records. The new portal will meet compliance standards for the Health Insurance Portability and Accountability Act of 1996.
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