Health Care I.T. May Have an Image Problem

The technology will get even better soon, say experts in the diagnostic imaging industry. In development now, for instance, are imaging devices that can spot tumors at their earliest stages by pinpointing cells absorbing glucose at a high rate.

But with the imaging advances come new challenges for software vendors and provider organization CIOs, who must ensure supporting information technologies keep pace with the change.

The challenges

At a minimum, providers in the next decade will need far more database storage and archiving capability than they currently have, and the means to transmit any image across a health enterprise upon demand.

In part, that's because new imaging technologies examine cross sections, or slices, of the body, enabling a more comprehensive examination. Each slice is an image; an imaging session can result in a dozen or more images of the same body part. "We're getting so many more images per scan," says Mona Batel, medical imaging industry manager at Frost and Sullivan, a San Antonio, Texas-based research firm.

Further, some images that used to take 40 MB of space now routinely take 100 MB because the images now are more detailed.

"As all the data starts multiplying, the amount of data will be gargantuan," says Phillip Berman, M.D., vice president of growth strategy and business development for the health imaging division of Eastman Kodak Co., Rochester, N.Y. "It will be very difficult for organizations to handle it all."

A marriage of imaging and clinical records technology could give physicians simultaneous access to images, lab results and patient histories, says Christopher Hanna, president and CEO of TeraMEDICA Inc., Milwaukee. The company sells image management and storage technology working on platforms from Sun Microsystems Inc., Santa Clara, Calif.

Hanna envisions an enterprisewide picture archiving and communication system seamlessly interfaced with a computer-based patient records system.

That access to simultaneous data, however, would be very expensive, he adds, because it would substantially increase the number of desktops requiring PACS technology.

Clinical and imaging systems will work together within five years, augmented with decision support software to assist in making diagnoses, Berman says. A clinician looking at an abnormal image could have access to medical literature "to match the image against known pathologies," he adds.

Additionally, physicians in growing numbers are adopting personal digital assistants to receive patient data at the point of care. The ability within two years to get radiology reports or clinical alerts via PDAs will make the hand-held technology common, Berman believes. "Radiology will be at the center of this because it produces hundreds of millions of reports each year."

Julie Hughes at Phoenix Children's Hospital already sees the benefits of newer imaging technology. This year the facility opened with a suite of best-of-breed equipment and software. Soon, "we'll be able to manipulate images any way we want," says the administrative director of diagnostic imaging and neurodiagnostics.

First, however, vendors must embrace true universal imaging standards, a process that will accelerate as customers and government regulators demand standardization. "There are too many variables of the DICOM standards," she says. "Other industries long ago standardized. When you buy a telephone, you don't worry about what kind of jack you have in your house. You know the phone will fit in it."

While imaging vendors talk of film being substantially eliminated in the next decade, Hughes is less optimistic. "Fourteen years ago, I heard film soon would be gone," she asserts. "Film is still here. Until prices are more affordable, hospitals will keep buying film processors instead of spending $3 million or $4 million for a PACS."