Well, it’s almost that time again! The annual Radiological Society of North America (RSNA) is the largest radiology meeting of the year, and typically the place where vendors tend to introduce new technology. This year should be no exception, and it should address some interesting areas as both technology users and vendors cope with a changing healthcare regulatory environment.
What do I expect to be hot topics? The following are on my radar for this year’s meeting:
A very popular topic this year has been mHealth, or the use of mobile devices in healthcare. For several years, virtually everyone has had an iPad application. Last year Android devices joined the fray. With the introduction of Windows 8 (which I have been using now for over a month!), it will only be a matter of time before Windows 8 devices are demonstrated. Given that they were just introduced in October, there are not likely to be many on display this year. If the technology catches on, there are likely to be significantly more Windows based tablet devices in 2013. As facilities wrestle with security and compatibility, Windows-based devices could be a boon to mobile health.
The proliferation of “zero footprint” viewing technology should continue to make inroads into radiology image display devices and greatly enhance image accessibility as ACO’s and HIE’s expand.
Over the past few years the trend has been toward server-sided advanced visualization applications that offer expanded access to 3D computational power and capability. The past has been discrete workstations that performed the 3D analysis and then provided summary results to other users. With client-server technology multiple users can perform complex 3D analyses using simplified hardware on the client side. As imaging applications become more image processing intensive, client-server technology seems to be an effective way to expand its application.
With greater pressure on controlling healthcare expenditures, will client-server advanced visualization technologies be squeezed? I am particularly interested in how advanced visualization companies will present their case this year. An argument can be made that for processing-intensive applications the technology may be more cost effective. On the other hand, if cost and regulatory controls limit the number of new advanced visualization applications, will there be renewed interest in dedicated workstation applications?
The so-called Vendor Neutral Archive, or VNA continues to gain in popularity, with new announcements and relationships. Full-service equipment vendors continue to offer solutions, while PACS vendors that don’t offer their own VNA are forming relationships with VNA vendors lest they be left out in the cold.
VNA’s are still somewhat misunderstood in terms of scope. Applications range from the bridging of several local PACS to full enterprise applications spanning multiple facilities. A key objective of mine for the RSNA 2012 will be to see how consistent or divergent the messages may be. At least one vendor will be emphasizing the “big picture” in terms of how VNA’s fit into the EHR environment. Another key issue will be how open VNA devices are in terms of the ability to access stored content independent of the VNA. It is inevitable that vendors may change over time, and data accessibility can be a key factor in terms of minimizing migration.
Clinical Decision Support
In a recent blog I emphasized how the ACR (American College of Radiology) is planning to capitalize on its decision support knowledge base through an agreement with the National Decision Support Company (NDSC) to license the ACR’s knowledge base for the development of clinical decision support systems. The premise is that companies will be motivated to license the technology rather than developing a competing capability. I will be interested to see if in fact companies with “skin in the game” subscribe to this approach.
Another key issue is whether facilities will see this as “stand alone” technology or expect it to be integrated with other information system environments such as EHR’s or Radiology Information Systems (RIS). There are some promising alternative workflow developments that may represent better solutions, but can they make it on their own?
Over the past several years, dose management has become increasingly important. Several startup companies have been quick to develop applications and form relationships with established vendors. Radimetrics was the hot property last year. I will be interested to see if there are new and competing technologies this year, such as Bayer Healthcare, which recently announced a dose management application. As with Clinical Decision Support the challenge will be how well these products integrate with existing systems, or what relationships exist.
In the past few years vendors have looked at methods of addressing smaller radiology facilities as the market penetration for larger facilities is fairly high. One method to address this has increasingly been to apply a software-as-a-service approach. With the advent of ACO (Accountable Care Organizations), there may be additional benefit to tying smaller facilities to ACO’s. Understanding the trends in shared PACS will be another key area to understand at the 2012 RSNA. I will be most interested in how vendors message this.
I am sure there will be other trends and new technologies. At least one vendor has been advertising a new PACS platform, so there will be more to learn on this front as well. So, it’s off to some turkey and then the trek to Chicago for an interesting week! Stay tuned and I will have more to say post-RSNA. Happy Thanksgiving to all!