Medting is an online platform for sharing clinical cases, medical images, and videos, aimed at physicians, researchers, and educators for purposes such as peer review, telemedicine, and decision support. The service is free and allows for both public and private sharing of medical content, enabling collaboration and education within the medical community. Founded by Miguel Cabrer and Antonio Contesti, Medting integrates various technologies to enhance clinical imaging and eHealth processes.

1. August 2008 http://medting.com Miguel Cabrer [email_address]

2. What is Medting? MEDTING is an internet website for the exchange of clinical cases, medical images and videos. Physicians, researchers and educators can use MEDTING for clinical peer review, research, teaching, second opinion and decision support purposes. MEDTING can be used as an asynchronous service , offline, but also doctors may want to create online meetings sessions through the MEDTING Virtual Meeting functionality. MEDTING is free and is exclusively for clinicians . Medting can organize clinical cases from within an organization and can store physicians’ medical images. It is also ideal for second opinions, telemedicine , teaching purposes and for decision support. MEDTING allows working with public and private content. Doctor may want to share a clinical case privately with other colleagues and can be also done with MEDTING. We strongly believe that by sharing the content in a public way we are building a helpful repository for other doctors to review samples and provide better care. Medting.com

3. What is Medting for? For Public Health, Clinical collaboration and Research purposes World wide research platform for all medical images specialties eLearning, Telemedicine purposes, CME. Image interchange, diagnosis images classification Anonymous Telemedicine Tool A service for Medical Meetings, second opinion Virtual Clinical Session Tool A repository for a medical center to classified their content and give access to their professionals

4. Founders Medting.com CABRER GONZ Á LEZ, MIGUEL Founder & President Computer Science degree. R&D grant for evaluation of Telemedicine (Stanford Medical University Center, Emory University (Atlanta). Former CIO of Son Llatzer Hospital, first Digital Hospital in Europe. eHealth Coordinator of Balearic Islands Health Service. Member of the HIMSS Europe Governing Council. Member of IMIA (International Medical Informatics Association) Web 2.0 taskforce workgroup. Digital Hospital, EHR – RHIO Initiatives, Integration Competence Centres, Medical Tourism and Health 2.0. CONTESTI COLL, ANTONIO Founder & Technical Innovation Manager Telecommunications Science degree. IT Coordinator of Catalonian Red Cross Integration specialist at Son Llatzer Hospital Image integration specialist and Telemedicine Coordinator at Balearic Islands Health Service. Director of Innovation of C2C. Member of IHE-SPAIN. Professor of Telemedicine at the UOC (Catalonian Open University) Main areas of interest and specialisation of Toni Contesti are: Digital Hospital, EHR, DICOM, HL7, INTEGRATION, WEB 2.0.

5. C2C - The eHealth company – Corporate Presentation HealthCare IT Company Innovation in eHealth Technologic solutions promoting eHealth processes optimization Our Offer: Clinic Imaging Software: MIO Ambulatory Management Software: MEDAS Technologic Integration Integration Competence Center Consulting & Development

6. A toolkit and family modules that facilitates the capture, retrieval, format Dicom conversion, communication and storage between source modalities and PACS repositories. MIO LT, MIO COMM, Server, Broker, Store, Wado, Viewer

7. Images worldwide interchange repository for clinical research and collaboration purpose Health 2.0 One vision Connecting Images in a clinical context

8. Initial idea Based on MIO Search engine Collaborative Clinical tools Imaging access Clinical Context Broadcasting Services Information QC Medting Portal Medting Repository

9. Medting The Power of Collective Wisdom Medting.com

10. Clinical Cases Medting.com

11. Atlas Medting.com

12. Multilanguage Keywords (tags) are based on SNOMED CT terminology Automatic translation of the keywords SNOMED provides a battery of more than one million clinical terms in several languages. The more SNOMED terms you use as keywords, the better your content will be indexed. Medting.com

13. Pubmed integration Medting.com

14. Repository and Tool Private and Public cases: Public cases can be reviewed from any internet user since it’s published into the platform. Private content (cases, images or videos) can be also posted and uploaded to MEDTING. Those cases will not be shown on the MEDTING website and only invited users will be permitted to review those cases. This functionality is useful for Telemedicine and second opinion services. Any user can be invited by the author to review a private case: Medting.com

15. Social components (Web 2.0) Powerful video management: transcoding and broadcast Multiple images viewers Connectors: Mash-up Social component: Vote, comment and share Medting.com

16. Atlas viewer Atlas flash viewer Upload images to Medting and show them from another website Disease atlas, specialties, organs, etc. Medting.com

17. Who can be interested? Education and training organizations Virtual Clinical Sessions (online / offline) Clinical marketing tool Telemedicine / Second opinion Independent doctors: have your medical blog Medical workgroups or researcher Media Syndication Medting.com

18. Medting for independent doctors Medting is a no cost service Premium users also free Medting is a service that can be used to post information privately or public Private information: Case: sharing a case privately only between invited users Store images on a private repository Public Case or Resource: will remain public for other users searching on Medting Medting.com

19. Enterprise Partners Health care organization, hospitals, medical centers can become Enterprise Partner Extra functionalities of Enterprise Partner White Label: use Medting functionalities with the Enterprise-only content Online Virtual Clinical Session (collaborative tools) Direct Medical modality connection (MIO) Enterprise Partner is a fee based service. Fee may depend on volume and size Medting.com

20. Medting a reference site for medical media Users don’t easily share their clinical content A win-win relationship has to be established Emphasizing the potentials of Medting is necessary Medting.com Clinical Marketing, promoting physician’s website Free Telemedicine Tool Connectors: linking Medting content from an external website

21. Medting Connectors: mash-up Medbloggers, medical magazines, forums, intranets can benefit from Connectors and show content from Medting in external websites Medting.com

22. A Multimedia European Platform for Endoscopic Surgery Knowledge Exchange (A preliminary proposal for the 7th Framework Programme of the EC) Second Opinion Expert Board Online CME Programs Objective : “To develop a multimedia, Web-based European second opinion expert board with associated CME programs specialized in Endoscopic Surgery .” Medting Technology Endoscopic Surgery network of excellence Collaborative clinical case discussion for decision-making support Focused on rare/complex cases of high academic value Online visualization of surgical interventions Interactive, multimedia Web-based CME programs High quality standards supported by a European network of excellence Integrated clinical information exchange (images and videos) Multilingual, international coverage Web 2.0 community-based approach Powerful and secure exchange of large volumes of images and videos Quick information search via SNOMED CT Low-cost, flexible integration into existing Web sites Base platform for other projects

23. In the first 3 months … 3 Enterprise Projects Medting.com

24. Medting.com Medting (MDPIXX) has been included as a relevant platform in “the next generation medicine”: Medicine 2.0

25. Challenges and Benefits Healthcare organization perspective A place to organize medical content, easy access Clinical Marketing tool A free telemedicine tool Clinician perspective Images interchange for second opinions, research, learning, etc. Data source for Clinical Tests (clinical trails) monitoring based on images Telementoring, teleproctoring, clinical comitees Medting could incorporate a real time interchange functionality (like a messenger) for real time clinical service … and free University use, big images events, … Patient perspective Open images consultation for diagnosis, before a surgery Diagnosis development and monitoring of group of patients with clinical participation Would be the start point of the future global repository of clinical data (my Health) Let’s imagine a space of US images of “coming babies” to be shared over the internet Medting.com

26. Medting Demo http://medting.com Medting.com

27. Annex Description of MIO Product Medting.com

28. Main Vision: Beyond PACS C2C - The eHealth company – Beyond PACS

29. A toolkit and family modules that facilitates the capture, retrieval, format Dicom conversion, communication and storage between source modalities and PACS repositories. MIO LT, MIO COMM, Server, Broker, Store, Wado, Viewer

30. z Market Prediction By the end of 2008, 90% of the actual needs of PACS integration, will be implemented in industrialized countries (Patient EHR, Telemedicine, etc). As minimum value, till the end of 2007, 40% of Primary Care Centers will store non-radiological images in PACS. C2C - the eHealth company – Beyond PACS

31. z Market Prediction MIO LT™ DICOM converter and PACS integration tool for a single modality. Images to be converted can be opened from a folder, captured using a frame grabber (secondary capture), or imported using DICOM SEND and DICOM PRINT services. PACS integration can be achieved by means of Worklist or through MIO Broker™. MIO Comm™ Messaging and communication toolkit for systems and modalities integration. Includes patient data integration (HTTP, SOAP, Worklist, parameter passing, manual), communication capabilities (HTTP, TCP/IP), global messaging support (XML, HL7, files), server-based centralized full DICOM services, and image editing module (anonimize, tags superimpose, etc). MIO Broker™ PACS integration tool with no RIS integration requiered. Allows to send to PACS the images coming from multiple modules MIO LT™ / MIO Comm™, without requiring corresponding agendas into RIS. MIO Server™: Automatic DICOM converter and silent PACS integration for unlimited modalities in a centralized installation at a corporate level. Allows automatic DICOM conversion of all images generated within the healthcare organization whenever they are stored into a centralized preconfigured folder. Sending to PACS can be performed in a silent way and with no user intervention. MIO WADO™ Web interface (API) for web access to PACS using DICOM communications. Allows multiPACS / multivendor / multi image Query & Retrieve. Includes full DICOM services for PACS communications and image retrieve. MIO Store™; Medical imaging storage system for departmental applications. Images to be stored can come from multiple modules MIO LT™ / MIO Comm™. MIO Viewer™: Image web viewer, to be integrated within third party applications. Includes functions for image comparison, and adjustments for zoom, brightness, contrast, saturation and hue. Fully compatible with MIO Store™ and MIO WADO™. C2C - the eHealth company – Beyond PACS

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38. Is your Hospital achieving optimum profit from its PACS? Medting.com

39. Does your hospital need to integrate non-Radiological Images into its PACS ? Medting.com

40. Does your Hospital know how to maximize profit , from the investment in Imaging Technology already in place ? Medting.com

41. Is your hospital able to incorporate Images into your Patients Electronic Health Record? Medting.com

42. Has your Cardiological Department asked for ECGs storage into your PACS ? Medting.com

43. Should your hospital centralize in just one single repository ALL Medical Imaging ? Medting.com

44. Does your hospital participate in some Telemedicine Project that requires Medical Imaging sharing ? Medting.com

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47. z Medical Imaging Global Repository C2C - the eHealth company – Beyond PACS

48. z Imaging Integration – Regional Level C2C - the eHealth company – Beyond PACS

49. z Regional Multi-PACS Project C2C - the eHealth company – Beyond PACS

50. z Telemedicine Project C2C - the eHealth company – Beyond PACS

51. z Medical Imaging Global Repository C2C - the eHealth company – Beyond PACS

52. MIO converts Intel MCA into a Dicom Device Capturing images and send to PACS Dicom Worklist HL7 & Dicom embeded C2C - the eHealth company – Beyond PACS

53. CISCO – C2C Workshop. Palma de Mallorca, Balearic Islands (Spain). 26 June 2008 The Architecture Call Manager MIO – Call Manager integration IP Phones UC CTDP

54. z Summary Client Generalitat Valenciana Consellería de Sanitat Location Valencia Community (Spain) Additional Information 22 Health Departments 27 Central Hospitals 25 Specialized Units 900 Primary Care Centers Project Development 2005 - 2008 Benefits to the Client 900 Primary Care Centers connected with 20 Central Hospitals, sharing Electronic Health Record integrated with clinical imaging and specialists informs. Huge improvements felt: workflow and patient care (Tele-neurology, Tele-mammography, Tele-dermatology…) Technologic Costs Reduction above 2 millions € / year C 2 C Solution Image/video capture from any modality, through MIO. 5 different providers’ PACS integration, through MIO. Existent applications integration, through Rhapsody and MIO (HIS LEGACY, RIS, PACS y Master Patient Index). Objectives Digital Clinical Imaging Access (radiological and non-radiological). Electronic Health Record (EHR) integration with clinical imaging. C2C - the eHealth company – Beyond PACS

55. C 2 C Solution All modalities image/video capture through MIO (ophtalmology, dermatology, ORL; anatomopathology,…) HIS / RIS / PACS integration through MIO and standards languages (DICOM, HL7,) Reports design and implementation to introduce medical information into images Summary Client Son Llatzer Location Palma de Mallorca (Baleares Islands, Spain) Additional Information European eHealth Award 2004 350 beds First Digital Hospital Project Development 2005 Benefits to the Client Global Management of all generated images at the Hospital Huge improvements: workflow and patient care Quality of health services improvement Save cost: better profit of infrastructure Objectives All non radiology images should be acceded from the same repository To ntegrate all non dicom images into GE PACS C2C - the eHealth company – Beyond PACS

56. August 2008 http://medting.com Miguel Cabrer [email_address]