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RSNA Presumptions

November 26, 2014
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The 100th anniversary RSNA meeting is upon us. What new IT developments will set the stage for the 2nd 100 years?

Well, tomorrow is Thanksgiving, and that means only one thing … the Radiological Society of North America (RSNA – is not far behind!  This weekend marks the start and the 100th anniversary of the RSNA.  While I’ve only been a party to the past 37, I can attest to the changes over the years. 

When I started attending, the meeting was largely film-based and the only computer screens were promotional material.  Today, I defy anyone to find film, and everything is digital.  So, where do we go from here?  The following are a few of the presumed items of interest that I will be paying attention to.

The Changing Role of RIS

I will be particularly interested in the different vendor perspectives to the role of a Radiology Information System (RIS) going forward.  Some vendors are dropping the RIS, as they feel the Electronic Medical Record (EMR) systems have taken over.  Others feel there is a continuing role for the RIS, emphasizing the pre and post procedure workflow.  Still others feel there are alternative products that will eventually take the place of the traditional RIS, also emphasizing workflow.  Who is right?  Is there only one right answer?  I will be paying close attention to the vendor’s positions, and how they differentiate themselves.

Visualization Convergence

PACS workstations have certainly evolved over the years, as have dedicated applications for advanced visualization.  There seems to be a trend toward convergence of workstation capabilities, as PACS workstations take on greater advanced visualization applications.  Parallel technology advancements may be a contributing factor, as advanced visualization applications that in the past required dedicated high-end graphics processing are capable of being addressed by more off-the-shelf hardware.  That coupled with streaming and “zero footprint” viewer technology have further contributed to the ability to do more with common computer architectures.  Consequently, I expect to see vendor applications that encompass more advanced processing within the same workstation application, resulting in greater diagnostician flexibility.  Conversely, it will be interesting to see how the dedicated advanced visualization companies are address such trends. 

There is also the question of whether such processing applications will extend backwards onto imaging equipment.  The case could be made that certain applications such as virtual colonoscopy are becoming routine, and therefore why not include the advanced processing capability directly into the imaging acquisition device?  This certainly would give the imaging equipment vendors a leg up in terms of such applications, but will users see sufficient benefit to warrant the added cost?

ARRA/MU Emphasis

Each year since its enactment, I have been anticipating more emphasis and messaging around Meaningful Use.  While imaging IT applications are not themselves EMR’s that require certification, there are some areas such as RIS products that can claim MU contributions to the point that some vendors have achieved certification. 

As MU moves into Stage 2, and eventually Stage 3, the question is, will there be greater emphasis by the vendors in their messaging.  To date, this has not been the case, but with the advent of ancillary developments in dose management and analytics, I would expect to see greater emphasis this year.

Enterprise Imaging Emphasis

As its name implies, the RSNA is mostly about Radiology Services.  However, it is also an opportunity for vendors to highlight their developments in related imaging areas, as technology that has previously been radiology’s domain expands to the enterprise.  The Vendor Neutral Archive (VNA) and Universal Viewer (UV) are examples of technology that is already moving across services boundaries to an enterprise emphasis.  I expect to see more activity amongst the vendors in this area, including applications for non-radiology image capture, such as in dermatology.  The IHE (Integrating the Healthcare Enterprise) profile for managing image data beyond DICOM (Digital Imaging and Communications) standard, known as Cross Document Sharing (XDS) will probably receive greater emphasis as well, as more vendors introduce compliant products.

Overall, this should be an interesting meeting, marking 100 years of progress and pointing the way to the next 100 years.  I will have more to say post-RSNA.  Enjoy Thanksgiving!