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RSNA 2011: The Communalization of Imaging?

December 3, 2011
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Expanding the social nature of imaging

Another Radiological Society of North America (RSNA) annual conference has come and gone. So what did Santa bring the Radiology community this year? In one word, my answer is the “communalization” of imaging! From my perspective, the major imaging emphasis is very much on expanding the social nature of imaging in a changing healthcare environment. The following are my first impressions from the meeting that relate to this trend.

Continuing PACS Modularization

Last year I reported a trend I called “PACS Modularization.” In the growth days of Radiology PACS, vendors sold complete systems that acquired, stored, and communicated images. With a saturating market, not everyone is in a position to discard an existing PACS. The emergence of enterprise archives and advanced visualization products allows facilities the opportunity to add capabilities to an existing PACS without throwing away the basic system structure – a far more economical approach! The addition of more enterprise archive vendors and expanding image visualization options continues the trend in 2011.

Cloud Proliferation

Continuing a trend from 2010, one could say that 2011 was very cloudy! It seems that the “cloud” is the buzzword for 2011. Practically every PACS vendor in addition to the classical “VNA” (Vendor Neutral Archive, and yes, I really dislike this term as it is nondescript!) vendors announced some form of cloud. Even the Advance Visualization vendors such as Terarecon ( and Ziosoft ( are in the game, with cloud based image rendering capabilities. Having a cloud capability is imperative to the communalization of imaging, as it acts as the conduit for accessing images remotely, or with remote devices.

Expanding Image Accessibility

Last year the device of choice for image access mobility seemed to be the Apple iPad. This year Fuji, Carestream, Infinitt, and McKesson, to name a few, added Android tablets as well. McKesson was even able to demonstrate their application on a Kindle Fire! While Apple is prevalent throughout healthcare, Android seems to be growing, and it will be a significant addition for image access mobility. Coupled with the cloud, the ability to access images on tablet-type devices opens up an array of new applications involving the use of images.

Another growing development is CD replacement applications. Prior to the RSNA, Merge Healthcare ( introduced their Honeycomb application for image sharing, including a free service for images in the cloud. The expectation was that this would be a game changer for some of the more established vendors such as LifeImage (, eMIx (, and Accelarad’s See My Radiology ( In reality, Merge’s “free” access is limited and did not seem to be a major differentiator to others. What is intriguing about these services is the similarity to other “social networking” applications such as Facebook and LinkedIn. The user interface and methodology for sharing a study either with a sub-specialist or another facility is enhanced by the simplicity of the social networking approaches and will foster their acceptance.

Meaningful Use and Decision Support

Last year several vendors emphasized decision support applications to reduce the ordering of unnecessary studies based on rule sets. This was further expanded this year with the addition of MedCurrent’s OrderRight application ( MedCurrent’s differentiator is a Rule Authoring Studio which enables the facility to modify the ordering rules to their specific needs. For example, assume a facility doesn’t have an MRI. It would be advantageous to modify the rules so that an MRI is not specified. Other vendors argue this is not an issue as their rule sets can recommend multiple options should one not be available. Regardless, the opportunity to generate significant improvement in orders is both favorable from cost and quality perspectives.