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In most countries, healthcare is currently undergoing major changes.
First of all, in addition to the recent technological advances such as monitoring, laser or endoscopic surgery, CT and magnetic resonance scanners, etc... and which have deeply modified medical practises, the power of information technology is now emerging. New information and communication systems open a new era which will considerably extend the means of intervention of the physicians and enable them to provide care beyond the traditional realms of the hospital.
Secondly, the economic and budgetary constraints influence, and will influence even more, the methods for delivering care to patients as well as the financing modes of medical institutions.
These fundamental evolutions are enforcing the development of strategies enabling to provide high quality care in an efficient and cost competitive manner.
For instance, the trend in northern Europe is to replace the old system of repayment based on hospital day rate by an agreed fee corresponding to the medical service performed. In the, US, following the, reform of the Health System, the number of people enrolled in HMOs grew by more than 40% between 1993 and 1994 and reaches to-day some 70 million i.e. a quarter of the population. By reducing the length of hospital stay, the progress of home medicine has resulted in a decrease in the number, of in-patients and an increase of of-patients, the hospital becoming more and more a technical center, requiring important equipments which need to be amortised.
Hence, the structures and behaviours of the concerned parties undergo significant modifications such as groupings of hospitals and medical practices, as in the US and in Europe, or vertical concentrations of insurance companies, HMO's and medical centers. In addition, the notion of healthcare networks and capitation, initiated in the US, are progressing in many other centres.
However, beyond the search for improved productivity while retailing quality of care, which remains a preoccupation of politicians in all countries, the main objective is to ensure that the health of the population be managed on a lifetime basis by a variety of medical providers according to defined standards.
Such a change can only be achieved by calling on powerful information systems.
Therefore, the, quick and efficient management of information becomes a critical element of the new healthcare industry. This requires applying the most advanced electronic, technologies to interdepartmental transactions. This also implies the transmission by networks of data, images and sound throughout the hospital as well as to the various links of the healthcare chain in the outside world.
In 1994, hospitals in the US have spent 5.4 billion US $ on information systems and intend to invest 8 billion US $ in 1997. The medical information softwares alone represented in 1995 a market in the US of no less than 2.7 billion U S $ of which 38% went to financial data processing, the balance, i.e. more than 60%, being devoted to the patient (care, laboratory, pharmacy, radiology).
Client/server based systems and their powerful relational data-bases are now capable of processing and storing the large information volumes necessary to develop and manage computer-based patient records.
However, until now, if many companies, mostly in the US, have focused on data processing software systems they have of endeavoured designing imaging software much more complex to develop.
Indeed, if the transfer of information, in the form of data, between different systems has become easy, the sane does not apply to images. These are provided according to several modalities, by diagnostic equipment, from various manufacturers. Over the years, these sophisticated instruments have incorporated computers of different generations from a variety of suppliers operating most often under proprietary languages making them incompatible and preventing any dialogue between departments Moreover, some manufacturers, forced to ensure the support and maintenance of their products during their lifecycle, are reluctant to open their systems in order to keep their customers captive.
It is inconceivable, in the perspective of integrated information available instantaneously, to manage patient files in which the images would be stored, under the form of film,, in folders archived in the hospital basement... as it is presently the case.
Therefore the PACS (Picture Archiving and Communications Systems) market is bound to grow at a very fast rate, above 50% yearly, to reach 1 billion US $ by the year 2000. More than half of sales will be generated by the US, Europe representing approximately 200 million US $ in 1998. The improvement of performance and the flexibility of workstations will favour the installation of MiniPACS instead of large systems, more difficult to install and operate.
The scientific computing expertise of MEDASYS DIGITAL SYSTEMS in the field of Education and Research and more precisely its competence in graphics, imaging and communications have naturally led it, as early as 1989, to involve itself in the management and processing of medical images on workstations.
The Dx Multimodality software was released in 1993. It is a universal system enabling acquisition, interpretation, archival and transmission of images supplied by all imaging modalities, Designed from the start in a global perspective around the international medical standards, DICOM 3 and HL 7, this system which is based on world-wide recognised softwares uses object-oriented languages and can easily be adapted to any particular application. Open, it can be linked to any imaging equipment (MRI, CT Scanner, Nuclear medicine, Angiography, Ultrasound, Digitizer,...) from any supplier brand.
In a class by itself, Dx Multimodality is different from other Mini-PACS in that it can process both radiology and cardiology images, black and white or colour images, still or animated images with built-in voice comments. In addition, it is unique as it incorporates clinical protocols such as cardiac ultrasound and particularly nuclear medicine, an area in which the experience and the medical connections of MEDASYS ACQUISITION Corp., the US subsidiary, are essential.
Evolutive, it allows to start at first with a single station, then to expand the network to a complete department, to the whole hospital and ultimately to a regional or a national group of medical institutions. The dialogue between practicians is then established by way of telecommunication links such as ATM giving access, in real time, to a more specialised diagnosis level.
Images are stored in digital format on optical disk memories which can exceed several Terabytes in capacity, sufficient to archive 20 years of data from all patients in a hospital. They are retrievable almost instantaneously at any moment.
The filmless mode translates into major savings for the hospital, the cost of processing a digital image being approximately 50 times less than that of a conventional film (0,06 US $ compared to 3 US $). The diagnosis equipments can be used more intensely and more efficiently while radiologists work is optimised. The space devoted to archives is freed and the time lost in searching them is eliminated. The need for duplicating exams, either because films cannot be found or are not available, or because the patient seeks advice from several sources, is suppressed. Remote transmission of images can help deciding whether a patient should be transferred or not, eliminating undue transports.
Finally, the high quality of the displayed images, the user-friendly operation of the system and the quick access it provides to the radiology history of the patient, the correlation of analysis between the various modalities and their clinical interpretation, the ability to receive distant specialised advice reduce risks of malpractice and extend significantly the diagnosis tools of the practicians.
By bringing multimedia techniques to the medical field, Dx Multimodality opens new perspectives to the healthcare industry.
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