Vue Motion: Connecting Technologies, Physicians and Patients
White Paper | Vue MotionTechnical Brief SeriesVue Motion: Carestream’s Enterprise Access ViewerConnecting technologies, physicians, and patientsABSTRACTTo improve productivity and minimize patient exposureto ionizing radiation, healthcare providers’ use ofmedical imaging must be prudent and efficient. Thecornerstone of such efficiency is technology thatprovides broad access to patient reports and images,enhancing communications among physicians andpatients, while protecting patient data. Embeddedseamlessly in an EMR system or operating remotely on aweb-enabled device, Carestream’s Vue Motion viewerexemplifies this balance of access and data protection.Using HTML 5 technology allows Vue Motion to launchfrom virtually any web browser, enabling thetransmission of requests to a server that retrieves thedata, processes it, and transmits the image. Carestream’sVue Motion provides on-demand access to patientimages throughout and beyond the healthcareenterprise. It is simple to deploy and maintain, with littletraining required. And it is easily adapted to work withhealthcare IT systems already installed.THE INFORMATION GAPThe most crucial aspect of every radiology report is theimage. Yet, referring physicians and other clinicianstypically see only words—the written reports andconclusions dictated by radiologists. Some radiologyinformation systems, such as the Carestream RIS, allowthe embedding of images in reports. Even then,however, referring physicians generally see only selectedviews of the images.To meet this challenge, clinicians may receive digitalimages stored on portable media, such as CDs. Providingdigital images this way represents an improvement overfilm; still, like film, CDs must be physically delivered,risking damage or loss. In addition, there’s no guaranteethat referring physicians will be able to actually see theCD images—due to the multitude of viewing softwareapplications, file formats, hardware configurations,security settings, and types of media in use today.Noncompliance with the DICOM (Digital Imaging andCommunications in Medicine) standard or correspondingIHE (Integrating the Healthcare Enterprise) profile is alsoa concern. These problems may delay the delivery ofappropriate clinical or surgical care and could potentiallyhave a detrimental effect on patient outcomes.1Minimizing cost and radiation.Providing easy access to patient images can cut down onthe ordering of duplicate, unnecessary imaging exams.This helps contain rising healthcare costs and minimizesthe exposure of patients to radiation.These potential benefits were documented in a study ofpatients transferred from one hospital emergencydepartment to another. When a system for uploading CDimages was implemented at Brigham and Women’sHospital in Boston, the rate of redundant imaging examsfor transferred emergency patients fell by 17%.2If theresults from the Brigham study are extrapolated to the2.2 million patients transferred between emergencydepartments in the U.S. each year, the study indicatesthat importing images to PACS would result in 484,000fewer CT scans.Direct access to images using the web rather than CDsmight broadly extend these benefits—not only acrossthe U.S. but to all segments of medical practice.An electronic bridge.Electronic access to reports and images promisesincreased efficiency and a high likelihood that theimages will be readable. This promises to benefit the
White Paper | Vue Motion2patient, whose therapy or intervention might beginmore quickly, or whose concerns might be alleviatedsooner.Radiology has long sought to develop networkingsolutions that support the easy and widespreadtransmission of images.3,4However, setting up networkswith separate access to PACS has proven challenging.5The need for software and hardware dedicated to imagetransmission and processing bogs down the retrieval anddisplay process. Moreover, the additional effort and timeexpended by the physician reduces efficiency andproductivity; this runs counter to the ObamaAdministration’s recent initiative to streamlinehealthcare. This initiative has increased interest inmaking medical images part of the electronic medicalrecord.Designed to encourage the use of medical informationsystems, the initiative encourages, as part of its“Meaningful Use” criteria, the exchange of “key clinicalinformation” among healthcare providers. Radiology hasyet to be formally included in this initiative; however, ifit is, it will likely increase the digital transmission ofmedical images—the cornerstone of modern diagnosisand decision making.INTEGRATING INFORMATION SYSTEMSThe ideal solution is to make patient data and imagesstored on the RIS/PACS integral parts of the electronicmedical record. Successful integration depends onfinding a way to merge the operation of multiplemedical information systems—particularly EMR(electronic medical records) systems, but also hospitalinformation systems such as RIS and PACS.One answer is the “zero-footprint viewer,” so-namedbecause, like a web browser, it does not requiresoftware installation on the user’s device to process anddisplay data.Simplicity is the key to the success of zero-footprintviewers. Unlike dedicated viewers, which may requireextensive training to run software to process data, zero-footprint viewers use an enterprise-based server tohandle this function. An intuitive interface complementsthe simplicity of the no-footprint design, allowingimmediate use by just about anyone familiar with webbrowsers and the Internet.The Missing Link.Simple to deploy, simple to learn, and simple to use, thezero-footprint viewer is designed to serve as anintermediary between the RIS/PACS and EMR, affordingreferring physicians convenient access to their patients’images.To fulfill this potential, the viewer must be availableremotely to enhance physician access to all PACS images.It must allow embedding in an EMR system, to provideaccess to reports and images alongside the patient’sother medical information—without requiring the userto open a new application and leave the medical record.Moreover, the viewer must provide access to DICOM, aswell as non-DICOM image related data, such as JPEGimages and PDF documents.The viewer’s use must not be restricted to a single IT-system or facility, but offer extensive compatibility toprovide secure access to images across and beyond theenterprise—for physicians and patients alike.A Universal Solution.Improved communications may be especially beneficialin emergency medicine. A study, conducted at theUniversity College Dublin School of Medicine andMedical Science in Dublin, Ireland, found that handhelddevices may be particularly helpful for emergencyteleconsultation purposes—supporting detection of basicorthopedic injuries and intracranial hemorrhage.6A zero-footprint viewer may prove valuable in othermedical settings as well— notably in rural medicalsettings, where primary care physicians often need toconsult with specialists such as neurologists. At facilitieswith electronic medical records, a zero-footprint viewer,embedded in the EMR system, could provide readyaccess to images in the context of other patient data.And, it could do so easily, without the training, expense,or time that would otherwise accompany the installationof interfaces between PACS and other informationsystems; this could potentially help drive the adoption ofEMR systems.THE CARESTREAM SOLUTIONOur Vue Motion zero-footprint viewer exemplifies aneffective zero footprint viewer. It provides on-demandaccess to patient images, yet is simple to deploy and
White Paper | Vue Motion3maintain, works with IT equipment already installed, andrequires no specialized training.Widely compatible with mobile and personal computingplatforms, Vue Motion allows widespread adaptability,just as its intuitive interface is proven to eliminate theneed for specialized training. Vue Motion is inherentlyeasy to understand, unlike dedicated and complexviewers requiring hours or days of training; while thistraining requirement may be expected in the radiologydepartment when learning to use new visualizationtools, it is very likely a deal-breaker for otherdepartments and physician offices.Vue Motion launches easily and quickly withoutrequiring extensive computing power or requiring theuser to log into another system. It leverages the PACSserver to do the vast majority of the rendering, therebysignificantly reducing the volume of data to betransmitted. And, because rendering is done on theserver side, there are no data storage requirements onthe zero-footprint side. This enables easy deployment ofVue Motion, as it requires no processing or archivalsoftware. The zero footprint also makes upgrading asnap, as software enhancements are done on the server.In this way, Vue Motion affords easy access to patientimages, reports, and other supporting data throughoutand beyond the healthcare enterprise, enabling real-timecollaboration among clinical users. It can be embeddedseamlessly in an EMR system. Or, it can operateremotely, integrating with other healthcare IT systems toboost workflow.Vue Motion is a true universal communications andproductivity tool. Delivering reports, images, and otherpatient data to the referring physician, it focusesattention on pathologies, allowing the physician tovisualize patient problems. And, it enhancescommunications, allowing the physician to more readilyconvey particular medical concerns to the patient.A Look under the Hood.Using HTML 5 technology , Carestream’s Vue Motionzero-footprint viewer launches from a variety ofoperating systems and devices, using only a webbrowser. Requests are sent to a server, which retrievesthe data, then processes and transmits the image.Consequently, Vue Motion requires minimumbandwidth—despite its high performance and rapidaccess to images.Collaborative Workflow.An intuitive user interface is employed to viewenterprise patient data in DICOM, non-DICOM, and othersupporting file types. Vue Motion further enhancescollaboration by supporting the transmission ofelectronic sticky notes, critical results findings, and emailmessages with embedded links to relevant patientstudies.IT-agnostic.Vue Motion bridges information technologies, just as itconnects radiologists and referring physicians, physiciansand patients. It is IT-agnostic, connecting not only toother vendors’ PACS, but to DICOM archives and XDSrepositories. Because this viewer can be easily integratedwith diverse departmental systems, clinicians andreferring physicians gain fast and easy access to patientdata and images.Vue Motion can be embedded in EMR and HIS portals toaccess images contained in the PACS, thereby image-enabling the enterprise. The viewer can be launchedwithout calling up a separate application or logging intoanother system. Alternatively, it can be launched in aseparate window without requiring a separate log-in,using a URL from within the system. Thus, it enhancesthe exchange of information and understanding ofmedical conditions. This potentially satisfies a keymeaningful use criterion of the Obama initiative, bypromoting the exchange of key clinical informationamong physicians.To PACS and Beyond.Vue Motion can be embedded in the Carestream Vue forEnterprise Workflow powered by SuperPACS™Architecture, providing access to multiple PACS atdifferent facilities. Vue Motion can be complemented bythe Carestream Vue Archive, offering immediate andsimple communication of images from a vendor-neutralarchive to authorized physicians locally, regionally andnationally.
White Paper | Vue Motionwww.carestream.comCarestream Health, Inc., 2012. CARESTREAM is a trademark ofCarestream Health. CAT 300 1004 2012/01While optimized to retrieve and display DICOM data,Vue Motion can display non-DICOM data, including JPG,AVI, DOC, and PDF files that may have been stored onVue PACS or Vue Archive.Encryption using the SSL (Secure Sockets Layer) protocolensures data security. HIPAA compliance is supportedthrough permissions tools that restrict access to referringphysicians—so only they can see data pertaining to theirpatients. In addition, a built-in auditing tool trackslogins, data accessed, how data were used; it documentsfiles viewed, who viewed them, and what was donewith the data. Audit files can be exported into differentformats, including Microsoft Excel for offline analysis.What’s next.Carestream’s Vue Motion provides the missing linkbetween your PACS and other healthcare informationsystems, as well as between radiologists and referringphysicians. To learn how this zero-footprint viewer canmeet your needs, visit our website athttp://www.carestream.com/healthIT.html.CITATIONS1. Kalia V, Carrino JA, Macura KJ. Policies and Procedures for Reviewing Medical Images From Portable Media:Survey of Radiology Departments, Journal of the American College of Radiology 2011, 8:39-48).2. Sodickson A, Opraseuth J, Ledbetter S. Outside Imaging in Emergency Department Transfer Patients: CDImport Reduces Rates of Subsequent Imaging Utilization. Radiology 2011 Apr 19. [Epub ahead of print])3. Yoshihiro A, Nakata N, Harada J, et.al. Wireless Local Area Networking for Linking a PC Reporting System andPACS: Clinical Feasibility in Emergency Reporting RadioGraphics 2002, 22:721-728.)4. Nakata N, Kandatsu S, Suzuki N, et.al. Informatics in Radiology (infoRAD): mobile wireless DICOM serversystem and PDA with high-resolution display: feasibility of group work for radiologists Radiographics. 200525:273-83.)5. Raman B, Raman R, Raman L, Beaulieu CF. Radiology on handheld devices: image display, manipulation, andPACS integration issues Radiographics 2004 24:299-310.)6. Toomey RJ, Ryan JT, McEntee MF, Evanoff MG, et.al. Diagnostic Efficacy of Handheld Devices for EmergencyRadiologic Consultation AJR 2010; 194:469-474)