Healthcare transformation, we’ll take you... March 2013 Edition 14 8 cEnTRo dE EspEciAlidAdEs mÉdicAs 14 uc iRvinE HEAlTH, oRAngE counTy, cAlifoRniA, usA AmbulAToRiAs (cEmA), mAR dEl plATA, ARgEnTinA Unique technology in ICIS ‘connects the dots’ New diagnostic center strengthens healthcare network between EHR and patient images and enables more effective care across municipality 22 cAnisius-wilHElminA ziEkEnHuis, 24 AllEgiAncE HEAlTH, jAckson, micHigAn, usA nijmEgEn, THE nETHERlAnds On-the-go bedside imaging brings better care to CWZ Nijmegen goes beyond PACS vendor patients in ER and beyond lock-in with new Vendor Neutral Archive inTERviEw insidE wiTH: » charles morris, chris magyar & genady knizhnik, icis Experts at Agfa Healthcare Some things 4 MÁXIMA MEDISCH CENTRUM, EINDHOVEN, THE NETHERLANDS are meant Máxima Medisch Centrum buys peace of mind for the next decade to transcend 6 PIUS HOSPITAL OLDENBURG, GERMANY borders Wireless detector helps hospital address efficiency goals Anywhere in the world, the yesterday’s limits and limitations. 8 CENTRO DE ESPECIALIDADES MÉDICAS movements and rhythms of the This evolution is like a dance AMBULATORIAS (CEMA), MAR DEL PLATA, tango are unmistakable: the itself, using passion to take a new, ARGENTINA steps, the precision and, above expanded perspective on each New diagnostic center strengthens healthcare all, the perfect timing. It’s a step and movement, creating new network and enables more effective care across passionate dance, requiring meaning. municipality discipline and a search for perfection. Inside this edition of THERE, 12 AMC HOSPITAL, AMSTERDAM, you will find examples of how THE NETHERLANDS ICIS, our Imaging Clinical our own meaningful passion is Information System, translates helping transform healthcare, in Global Remote Incident Prevention services bring those same demanding real-life stories and interviews peace of mind to radiology department characteristics into the world from healthcare enterprises. of healthcare. It makes images In radiology as well as at the 14 UC IRVINE HEALTH, ORANGE COUNTY, readily available to the physician enterprise level, our solutions CALIFORNIA, USA anywhere: across the department, support physicians and hospitals Unique technology in ICIS ‘connects the dots’ enterprise, region, country, etc. to make better-informed between EHR and patient images By freeing medical images from decisions. the hospital’s “information silos”, by offering a way to capture, Under the umbrella theme 16 ENVISION YOUR EHR WITH IMAGING USING store, exchange and access these of Insight. Delivered. we will ICIS images directly through the EHR, demonstrate at ECR 2013 how ICIS gives them new meaning all our solutions help improve and perspective. And provides the delivery of patient care 19 NORWEGIAN RADIUM HOSPITAL, OSLO, caregivers with seamless access and collaboration across the NORWAY to the patient’s imaging history, department, hospital and region, Helping multi-disciplinary teams work together with as much precision and underlining our promise: “Leave more efficiently smoothness as a meticulously no image behind.” executed tango. 22 CANISIUS-WILHELMINA ZIEKENHUIS, Enjoy! NIJMEGEN, THE NETHERLANDS With solutions like ICIS, Agfa HealthCare continues to play an CWZ Nijmegen goes beyond PACS vendor lock-in important role in the changing Marc De Fré with new Vendor Neutral Archive healthcare world, which is Director Marketing always reaching farther, beyond communications 24 ALLEGIANCE HEALTH, JACKSON, MICHIGAN, USA AgfA HEAlTHcARE EdiToRiAl TEAm Marc De Fré, Editor-in-Chief • Geertrui On-the-go bedside imaging brings better care to De Smet, Managing Editor • conTEnT & disTRibuTion Agfa HealthCare NV patients in ER and beyond • Septestraat 27 • 2640 Mortsel • Belgium concEpT, conTEnT & dEsign www.livingstone.eu • pRinTing Artoos • Oudestraat 19 • 1910 Kampenhout • 27 AZ SINT-REMBERT, BELGIUM Belgium “IMPAX Agility is my office and I take it The Agfa HealthCare editorial team would like to thank its customers, staff members anywhere I want to work” and interview partners for their contribution to this publication. 30 TECHNOLOGY CORNER Agfa and the Agfa rhombus are trademarks of Agfa-Gevaert N.V., Belgium, or its affiliates. DX, ICIS, IMPAX, Agfa HealthCare introduces the benefits of IPLAN, MUSICA and XERO are trademarks of Agfa HealthCare NV, Belgium. All other trademarks are held task-based workflow engines to medical imaging by their respective owners and are used in an editorial fashion with no intention of infringement. The data in this publication are for illustration purposes only and do not necessarily represent standards or specifications, which must be met by Agfa HealthCare. All information contained herein is intended for On the cover of this edition of THERE magazine: guidance purposes only, and characteristics of the products and services described in this publication can be changed at any time without notice. Products and services may not be available for your local area. Interpreted the world over, the tango has built a cultural heritage all its own. Blending precision with poetry, the Please contact your local sales representative for availability information. Agfa HealthCare diligently dance is here performed in the old city of Split, Croatia – strives to provide as accurate information as possible, but shall not be responsible for any typographical the perfect setting for one of the world's most imaginative error. dances. 2 THERE a v o n u dr o B a n eri at K © Defying expectationS Russian artist Katerina Bodrunova explores the nature of physics in Underwater Tango, a spectacular series of photographs depicting an underwater dance performance. Transcending space, time and gravity, these dreamlike images offer a compelling visual interpretation. THERE 3 MÁXIMA MEDISCH CENTRUM, EINDHOVEN, THE NETHERLANDS Máxima Medisch centrum buys peace of mind for the next decade Rigorous tender involving all stakeholders translates global vision into smart long-term relationship inTERviEwEEs Jac Verbruggen, Purchase Manager · Jef Pluijmen, Radiology Manager · Robert Waterschoot, Functional Application Manager we wanted to move into the purchasing process.” sTRingEnT REquiREmEnTs lEAd pRojEcT TEAm To AgfA HEATlHcARE The team eventually ended up with a shortlist of five and a very long list of requirements. Says Jac Verbruggen: “We were quite thorough in our demands as we wanted to safeguard the existing functionalities and add all the attractive features from the different vendors. Our research taught us that all vendors had their own approach to PACS and their growth path for it.” Eventually, the team’s choice was Agfa HealthCare including its IMPAX 6, IMPAX for Cardiology, IMPAX for Nuclear Medicine, IMPAX Data Center and IMPAX Business Intelligence. IMPAX 6 is the latest version of Agfa HealthCare's proven image and information management solution. IMPAX for Nuclear Medicine delivers the benefits of integrated care to the nuclear medicine department and supports the When Máxima Medisch Centrum, The After thorough preparation for several patient's entire exam flow, while IMPAX Netherlands, decided to replace its RIS/ years, a project team consisting of radiology for Cardiology enables patient-centric PACS, it wanted the best of all worlds: to and purchase departments launched cardiac management with all the relevant acquire the most current, appealing features a tender to upgrade the facility’s RIS/ data promptly available. The decision from as many of the shortlisted vendors PACS, and cover cardiology and nuclear as possible. After a thorough review, they medicine as well. Purchase Manager Jac signed a contract for Agfa HealthCare’s Verbruggen: “The project group consisted IMPAX 6 solution covering radiology, of the functional application manager of cardiology, nuclear medicine; IMPAX Data radiology, the manager of clinical physics, Center; and IMPAX Business Intelligence the purchase manager and the radiology including long-term Managed Services with manager. In the course of the process, this Global Remote Incident Prevention. It is steering group was advised by clinical peace of mind for at least ten years, they specialists, ICT and radiologic technologists. say. We wanted a future-proof solution, so we involved all stakeholders in the hospital.” Máxima Medisch Centrum has two sites in the south of The Netherlands (Veldhoven The need to replace the existing PACS and Eindhoven) totaling 595 beds. Its 3,300 infrastructure had been clear for several staff members, including 210 specialists, years. “We visited numerous important “We wanted a future-proof care for about 25,000 inpatients each exhibitions in Europe to fine-tune the tender year. The medical center is committed to and establish our short list of vendors,” says solution, so we involved all implementing a hospital-wide imaging Jef Pluijmen, Radiology Manager. “This stakeholders in the hospital.” solution with high-end connectivity to was a ‘field reconnaissance’ phase, which other hospitals. allowed us to define the vendors with whom JAC VERBRUggEN, Purchase Manager 4 THERE “agfa Healthcare came with a smart deal for both of us.” JEF PluIJMEn, Radiology Manager also involves a 'smart' Managed Services nuclear medicine, cardiology, oral surgery Services as part of the list of requirements. contract and gRIP (global Remote Incident and medical photography,” explains Robert Says Jef Pluijmen: “Agfa HealthCare came Prevention), Agfa HealthCare's remote Waterschoot, Functional Application with a smart deal for both of us: we would monitoring and event management solution Manager. “We also considered expanding invest in our infrastructure, but we would for PACS and IT infrastructure. towards a hospital-wide PACS solution, have a contract that includes permanent but we first needed to quickly offer one technology updates to keep our solutions scAlAblE soluTion will ExpAnd single viewer, integrated into the Electronic state-of-the-art for as long as we continue pAcs inTo widE RAngE of spEciATly Health Record, so medical specialists could the relationship. We realized this Managed dEpARTmEnTs access all images made and stored in the Services concept would provide us with “We proved that Agfa HealthCare was the two different PACS within Máxima Medisch peace of mind for at least a decade. Even most suitable vendor to stabilize and extend Centrum. Another goal is the efficient with the equipment completely on-premise, our existing functionality and workflow. sharing of images with outside third we are assured of minimum downtime, But they can also guide our growth towards parties.” and we don’t have to continually invest in a wider PACS solution, which includes technology upgrades to prevent our system The key to the solution is IMPAX Data from becoming obsolete.” • Center, Agfa HealthCare's scalable enterprise imaging management solution, which can store imaging data from multiple AGFA HEALTHCARE’S CONTRIBUTION departmental imaging systems and disparate hospital PACS solutions. IMPAX » Solutions that meet the needs of today, while Data Center will allow doctors at Máxima laying the foundation for expansion Medisch Centrum to view images from » Comprehensive Managed Services concept radiology, cardiology and nuclear medicine that keeps solutions current from a single viewer, thereby increasing » In-depth knowledge of workflows and productivity. hospital information management needs sERvicE And budgET in linE wiTH SOLUTIONS HospiTAl's vision “Functionality, workflow and Agfa » IMPAX 6 RIS/PACS, IMPAX for Cardiology, HealthCare’s technical dimensions were IMPAX for Nuclear Medicine, IMPAX Data excellent,” Jef Pluijmen continues. “They Center and IMPAX Business Intelligence supported our vision on making workflows » Managed Services contract including Global “We found agfa Healthcare to efficient, as well as how to expand the Remote Incident Prevention (GRIP) be the best in supporting our solution to the complete organization. ambition. they make it possible They also offered an outstanding service DID YOU KNOW… organization that’s close to us, with a budget for us to grow towards the that met our needs.” » Máxima Medisch Centrum’s very existence is implementation of a closely related to the multinational concern hospital-wide pacS solution During the pre-tender discussions, Agfa Philips. Philips’ early 20th century growth led HealthCare introduced its Managed to the 1933 creation of a hospital site close using a single viewer.” Services concept, with its global Remote to the company, thanks to an initiative by Dr. ROBERT WATERSCHOOT, Incident Prevention functionality. The Anton Philips. This is still the location of the Functional Application Manager steering team decided to include Managed hospital’s facility at Eindhoven. THERE 5 PIUS HOSPITAL OLDENBURG, GERMANY Wireless detector helps hospital address efficiency goals Small device delivers big benefits including cost savings, seamless integration into workflow and sharing options for flexible use inTERviEwEEs Priv.-Doz. Dr. Alexander Kluge, Director of the Institute for Diagnostic and Interventional Radiology · Jutta Juilfs, Head Technologist imaging and pathology exams than other hospitals of this size, which means productivity is paramount. Advanced imaging technology and PACS play a key role here in creating an efficient workflow for physicians’ reports and study comparisons, and enabling a smooth interchange with clinical departments and referring physicians. Previously, a cassette-based imaging system was in place, used for mammography and in the emergency department. “We decided to upgrade from imaging cassettes to a wireless detector, which would make workflows more convenient and faster, and also save on cassette costs,” says Dr. Alexander Kluge, Director of the Institute for Diagnostic and Interventional Radiology. The DX-D Retrofit solution allows healthcare facilities to upgrade to the benefits of Direct Radiography, without having to replace their existing equipment. The solution consists of a flat panel detector, a retrofit box and an nX workstation with Agfa HealthCare’s gold standard MUSICA2 image processing “our staff is very satisfied with software, which provides excellent this detector, they appreciate contrast detail and exam-independent, consistent image quality. the quality of the images as well as the significant workflow fAmiliARiTy wiTH AgfA HEAlTHcARE improvements.” soluTions, inTERfAcEs And imAgE quAliTy PRIV.-Doz. DR. AlEXAnDER KlugE, Director Hospital staff were already familiar with of the Institute for Diagnostic and Interventional imaging solutions and user interfaces Radiology from Agfa HealthCare, having worked with them for many years. After Pius Hospital, located in the northeast Retrofit solution fits into the hospital's analyzing DR detectors in the market region of Germany, serves a wide goal of streamlining processes across the with regard to image quality, workflow geographical area, providing both general facility, especially in the ER. and cost, Pius Hospital decided in favour medical services and highly specialized of the WlAn-enabled DX-D Retrofit. expertise. Over the last 10 years, Pius The 400-bed hospital’s major focus is on “This solution has the added benefit of Hospital has gone through a process of oncology, and it offers centers dedicated not requiring any significant training for complete refurbishment, including the to breast, lung, colon and pancreatic our staff,” explains Dr. Alexander Kluge. hospital building as well as its medical carcinomas. Because of these specialty “Software and interfaces are from a technology. The introduction of a DX-D centers, the hospital performs more single source, which is a great plus.” 6 THERE “Since September 2012, we’ve used services for the ER, ICU, and the the DX-D Retrofit to perform exams intermediate care department. on approximately 30 patients daily on weekdays, and approximately TEcHnology invEsTmEnT kEy To 10-15 patients during weekends,” says HospiTAl’s posiTioning in mARkET Head Technologist Jutta Juilfs. These “Investing in an infrastructure of patients had to be examined in a very advanced medical technology is a short amount of time. Therefore, quick strategy fostered by our CEO, who turnaround was a requirement. “The clearly sees the necessity for this in the detector has significantly reduced staff context of our positioning in the market. workload for each patient.” Our staff and our technology stand for diagnostic and therapeutic competence Because it is wireless, the DX-D Retrofit in complex cases,” says Dr. Kluge. offers enhanced flexibility. Demographic data is automatically fed to the detector In working with the DX-D Retrofit, from the PACS, and acquired images are radiologists at Pius Hospital typically transmitted directly onto the detector, aim to reduce dose by approximately 20 streamlining workflow and speed to 30 percent. “our staff is very satisfied of exams. Within seconds after the with this detector, they appreciate the acquisition, technologists can pre-check quality of the images as well as the the image, approve the technical quality, significant workflow improvements,” and transmit it wirelessly to the PACS. states Dr. Kluge. Agfa HealthCare “patients profit from the The detector fits into any standard bucky has been very responsive in regard to tray, and can be used in multiple X-ray questions and with support, he says. investment by reduced queuing modalities, meaning it can be shared “Patients profit from the investment by and more time spent with them among several rooms or modalities reduced queuing and more time spent by technologists.” as needed, maximizing efficiency and with them by technologists,” adds Jutta keeping costs low. Juilfs. JuTTA JuIlFS, Head Technologist As part of the re-organization, the CR invEsTmEnTs THAT pRovidE system from Agfa HealthCare that imAgE quAliTy And woRkflow was already in place was moved from impRovEmEnTs now And inTo THE SOLUTION the ER to the radiology department fuTuRE to be used for mammography, and to Both the CR solution and the wireless DX-D Retrofit provide backup to the department. detector technologies are economically » Offers the workflow and image quality benefits Featuring a team of 25 radiologists forward-thinking investments, concludes of DR and technologists, the department Dr. Kluge. “DR detectors require a » Easy and quick to set up carries out approximately 40,000 exams certain minimum number of exams » Wireless for enhanced flexibility annually, including X-ray, 64-slice CT, to make sense financially, based on » Seamlessly connects to HIS, RIS, and PACS MRI, high-end ultrasound, as well as resource economies and productivity. » Single detector can be shared across different mammography exams. Radiologists In Oldenburg, a city with three hospitals rooms, different modalities, maximizing also work with PET/CT in the nuclear providing in-patient care, Pius Hospital efficiency and reducing equipment costs medicine department, and provide is well-positioned with its general scope, plus its focused expertise on AGFA HEALTHCARE’S CONTRIBUTION oncology,” he says. “Innovative, and still affordable, medical technology supports » Enables cost savings and efficiency us in managing this mix of patients, improvements which includes many complex cases, by » Makes workflows more convenient and providing advanced image quality and productive with technology that fits in enabling swift turnaround times. The seamlessly at all steps in the workflow process DX-D Retrofit is an excellent illustration » Develops technology that improves staff and of a solution which supports our goals.” • patient satisfaction DID YOU KNOW… » Founded in 1871 as a charitable refuge for the poor, Pius Hospital has grown into an acute-care hospital with more than 400 beds, 1,000 employees, and 13 specialty departments. » The European Medical School, newly established by Oldenburg University, integrates Pius Hospital as well as the two other hospitals in Oldenburg and local care providers into its research and teaching activities. THERE 7 CENTRO DE ESPECIALIDADES MÉDICAS AMBULATORIAS (CEMA), MAR DEL PLATA, ARGENTINA new diagnostic center strengthens healthcare network and enables more effective care across municipality Completely digital approach aligns with government’s aim to evolve towards preventive healthcare inTERviEwEEs Dr. Alejandro Cristaldi, general Manager · germán giles, Medical Technology Director Unlike other health service models in Argentina, the Centro de Especialidades Médicas Ambulatorias (CEMA, Center of Specialized Ambulatory Medicine) was designed to be completely digital, right from the start. The objective for CEMA was to support the 32 Centers of Primary Healthcare of the General Pueyrredón Municipality, along with two provincial hospitals. Through its specialized diagnostic technology and healthcare professionals, CEMA serves as a key link between the first and third levels of the healthcare system, optimizing healthcare in the public sector. The city of Mar del Plata, Argentina’s most important tourist center, is located on the Atlantic coast, about 400 kilometers south of the capital, Buenos Aires. CEMA, the area's newest and most technologically-advanced “our completely digital site is sHAping THE pRojEcT pRofilE diagnostic center, opened its doors Once Agfa HealthCare was awarded perceived as a benchmark for there in late 2012. Designed to the contract, it helped to shape that provide medium- and high-complexity healthcare in Latin america.” project profile from the earliest stages diagnostics to inhabitants of the region, of implementation. local government DR. AlEJAnDRo CRISTAlDI, general Manager CEMA will serve up to 1,500 patients administrators turned to Agfa per day. HealthCare experts to help define the technology and workflow requirements. This state-of-the-art facility features "The local team from Agfa HealthCare the latest ecologically-sustainable was of inestimable value during the building materials and systems, and process of the project, as they offered was funded by Argentina's national and different types of specialized knowledge provincial governments. Dr. Alejandro to help identify the specific needs," says Cristaldi is general Manager of CEMA, germán giles, Medical Technology and also Undersecretary of Municipal Director at CEMA. Health. "This project, included in the municipal healthcare system, was Most of the examinations performed at designed by mayor gustavo Pulti, CEMA are in the areas of CT, MRI, X-ray, and Dr. Alejandro Ferro, Secretary of ultrasound, echocardiography, and Municipal Health. We are very pleased mammography. Patients are referred with the building’s design," he says, of by physicians at any of the 32 primary the 6,200 square meter, three-storey healthcare centers in the municipality, purpose-built center. "But I always which could be up to 30 kilometers say that CEMA’s main asset is its away. Before CEMA, there were only informatics profile." four centers in this system providing 8 THERE conventional radiology. Now, there are seven centers in the network providing digital radiology, around the clock, and the images from these health centers are read in real-time by the radiologists at CEMA. digiTAl pATiEnT REcoRds impRovE sEcuRiTy And minimizE duplicATion The changes in the way healthcare is managed in the municipality go way “the digital solutions from agfa beyond this improved use of radiology Healthcare play a central role resources. Before CEMA started operations, all patient information for at the center, helping us to the municipality was handled on paper, meet our goals for high-quality including medical records, radiology diagnostics and for connectivity.” films, etc. now, this information is managed digitally. Once the patient is gERMán gIlES, Medical Technology Director checked in, the system receives their demographics and personal details, so there is no need to transcribe the mammography equipment as a donation grows, physicians, technologists, and patient's personal information or from the Buenos Aires province. Radiology administrative staff are being added to the re-perform imaging studies, improving workflow is managed with an IMPAX RIS/ network. patient security and minimizing exam PACS solution, and the center also uses duplication. iPlan, Agfa HealthCare's internet-based This is making a significant impact on enterprise scheduling and planning the health of the population. Because "The digital solutions from Agfa solution. they have access to more equipment and HealthCare play a central role at the professional expertise, diseases may be center, helping us to meet our goals TEcHnology To EnAblE pREvEnTivE diagnosed faster. Healthcare providers for high-quality diagnostics and for HEAlTHcARE are working with health protocols that connectivity," says germán giles. The In addition to all of the efficiency determine what studies are needed, and center uses a range of CR solutions from improvements that the technology how to make the best use of the facilities Agfa HealthCare, including the enables, there are also important gains and all the solutions both in the CEMA and CR 30-X, CR 35-X and CR 85-X. It started being made in the area of preventive the health centers. "This is generating a with CR to be able to use the analog healthcare. The network makes the major cultural change, not only from the radiology equipment in place in the solutions more widely available, and it technology point of view, but also on the primary healthcare centers, and also also grants access to a wider professional medical side by standardizing processes of because CEMA received some analog offer. Day by day, as the project patient care," says Dr. Alejandro Cristaldi. THERE 9 “the local team from agfa Healthcare was of inestimable value during the process of the project, as they offered different types of specialized knowledge to help identify the specific needs.” gERMán gIlES, Medical Technology Director AGFA HEALTHCARE’S CONTRIBUTION » Recognized across Latin America for healthcare technology and expertise » Strong local team provides support and The project tender required that the The implementation was very knowledge at all stages in the process IT solutions proposed for CEMA be structured, and broken into steps, » Focus on integration for more efficient based on the Project Management including progressive training steps. provision of healthcare Institute (PMI) and its high project This was helpful because the staff standards, to specify baselines for the members were starting from a variety implementation schedules, the staff of perspectives, e.g. the staff at CEMA SOLUTIONS needed and the hardware necessary were more easily trained because they cR 30-x to start this project. According to Dr. were all new; meanwhile at the health » Compact, tabletop digitizer for Computed Cristaldi, Agfa HealthCare’s solutions centers the staff were used to working Radiography where space is limited or in not only complied with the standards with conventional radiology solutions mobile environments required by the municipality; they also and protocols. cR 35-x offered a very attractive economic proposal, which facilitated the decision bEncHmARk foR cARE in lATin » Supports a broad range of applications and when assigning the tender. AmERicA provides significant results to facilities experiencing a high volume of spinal As the first site of its kind in the examinations among other common country to be developed as completely orthopaedic exams digital, CEMA is a model of efficiency and cost-effectiveness. This pilot cR 85-x project is being analyzed so it can be » Multi-user, multi-application digitizer with duplicated not only in the province compact footprint, for centralized Computed of Buenos Aires, but in other Radiography environments municipalities in Argentina as well. impAx pAcs "It is perceived as a benchmark for » Next-generation PACS, streamlines enterprise healthcare in latin America," concludes workflow and delivers increased efficiency and Dr. Cristaldi.• productivity impAx Ris » Electronically manages radiology operations, from patient registration through worklist generation and transcription, to medical reporting and business intelligence iplan » Internet-based enterprise scheduling and planning solution DID YOU KNOW… » Mar del Plata is the seventh largest city in Argentina. » In the early 20th century inhabitants of Buenos Aires began to come to Mar del Plata as a holiday resort, and it is the biggest seaside beach resort in the country today. » It is the most popular destination for conventions in Argentina, after Buenos Aires. 10 THERE
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