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IT Matters – Which of today’s universal clinical viewers have the potential to be tomorrow’s radiology diagnostic viewers?

April 03, 2015
Michael Gray
From the April 2015 issue of HealthCare Business News magazine
Over the past four years, there has been an uptick in EMR deployments, as hospitals, clinics, and physicians prepare themselves to meet the Meaningful Use requirements mandated by the government. Not long after the physicians get comfortable using the EMR to access the wide range of unstructured data (procedure reports, lab results, care summaries, etc.) associated with a patient’s episode of care, the inevitable question arises, “where are the actual images?”Accessing the usual diagnostic images through separate interfaces to the organization’s individual department PACS viewers has produced less than satisfying results.

Multiple PACS viewers means separate viewing sessions for the physicians, one to review the radiology images and another session to review the cardiology images. The performance of the typical clinical PACS viewer is compromised by high latency broadband connections, and the PACS viewers usually require Windows platforms, thereby excluding most tablets and smart phones tucked into physicians’ pockets. An even larger drawback is the PACS viewer’s restriction to DICOM images.

Today’s clinical viewer is expected to support the fullest range of user platforms including mobile devices, perform incredibly well over broadband, and access and display the complete range of clinical images from radiology to dermatology, the burn center, and surgery. That means displaying DICOM as well as JPEG and MPEG. Yesterday’s clinical PACS viewer has given way to today’s UniViewer.
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The UniViewer as I refer to it, is the ideal display application for image-enabling the EMR. This new generation of clinical viewer features a zero or near zero client that communicates with the server-side rendering application that actually executes the image manipulations and then streams the resultant image to the user display platform. This technology is already a major improvement over any of the thin-client clinical viewers featured by most Radiology PACS. Expanding access beyond radiology images is yet another major improvement, as this potentially gives the radiologist access to the patient’s complete medical image record including those clinically relevant images previously trapped in specialty workstations, on thumb drives and in mobile devices.

The first wave of UniViewer introduced back in 2010 has evolved from the simple objective of being a more efficient and performant clinical viewer for a radiology PACS, to a multi-object viewer capable of accessing, managing and displaying any DICOM and non-DICOM image that has clinical relevance to the latest radiology study being interpreted. The further the UniViewer can reach outside of radiology, the more appropriate it is to serve as the universal viewer for the EMR.

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