Cabrer, M.MDPIXX: The Global Medical Images Repository

• This slideshow, presented at Medicine 2.0’08, Sept 4/5th, 2008, in Toronto, was uploaded on behalf of the presenter by the Medicine 2.0 team

• Do not miss the next Medicine 2.0 congress on 17/18th Sept 2009(www.medicine20congress.com)

• Order Audio Recordings (mp3) of Medicine 2.0’08 presentations at http://www.medicine20congress.com/mp3.php

August 2008

http://medting.com

Miguel Cabrerinfo@medting.com

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

Founders

Medting.com 5

CABRER GONZÁLEZ, MIGUELFounder & 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, ANTONIOFounder & Technical Innovation Manager

Telecommunications Science degree.IT Coordinator of Catalonian Red CrossIntegration 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.

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

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

Images worldwide interchange repository for clinical research and collaboration purpose

Health 2.0

One vision

Connecting Images in a clinical context

Initial idea Based on MIO

Search engineSearch engine CollaborativeCollaborativeClinical toolsClinical tools

ImagingImagingaccessaccess

ClinicalClinicalContextContext

Broadcasting ServicesBroadcasting Services Information QCInformation QC

Medting Portal

Medting Repository

Medting.com 10

MedtingThe Power of Collective Wisdom

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

Medting.com 17

• Atlas flash viewer• Upload images to Medting

and show them from another website

• Disease atlas, specialties, organs, etc.

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

Medting.com 21

• Users don’t easily share their clinical content

• A win-win relationship has to be established

• Emphasizing the potentials of Medting is necessary

Clinical Marketing, promoting physician’s website

Free Telemedicine Tool

Connectors: linking Medting content from an external

website

Medting Connectors: mash-up

Medting.com 22

Medbloggers, medical magazines, forums, intranets can benefit from Connectors and show content from Medting in external websites

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

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

26Medting.com

Medting Demohttp://medting.com

Medting.com 27

Annex Description of MIO

Product

Medting.com 28

Main Vision: Beyond PACS

C2C - The eHealth company – Beyond PACS

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

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

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

Medting.com 33

Medting.com 34

Medting.com 35

Medting.com 36

Medting.com 37

Medting.com 38

Is your Hospital achieving

optimum profit

from its PACS?

39Medting.com

Does your hospital need to integrate non-Radiological Images into its PACS?

40Medting.com

Does your Hospital know how to maximize profit, from the investment in

Imaging Technology already in place?

41Medting.com

Is your hospital able to incorporate

Images into your Patients

Electronic Health Record?

42Medting.com

Has your Cardiological Department asked for

ECGs storage into your PACS?

43Medting.com

Should your hospital centralize in just one single repository ALL Medical Imaging?

44Medting.com

Does your hospital participate in some Telemedicine Project

that requires

Medical Imaging sharing?

45Medting.com

z

z

Medical Imaging Global Repository

C2C - the eHealth company – Beyond PACS

z

Imaging Integration – Regional Level

C2C - the eHealth company – Beyond PACS

z

Regional Multi-PACS Project

C2C - the eHealth company – Beyond PACS

z

Telemedicine Project

C2C - the eHealth company – Beyond PACS

z

Medical Imaging Global Repository

C2C - the eHealth company – Beyond PACS

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

CISCO – C2C Workshop. Palma de Mallorca, Balearic Islands (Spain). 26 June 2008

The Architecture

Call Manager

MIO – Call Manager integration

IP Phones

UC

CTDP

z

Summary

ClientGeneralitat ValencianaConsellería de Sanitat

LocationValencia Community(Spain)

Additional Information22 Health Departments27 Central Hospitals25 Specialized Units900 Primary Care Centers

Project Development2005 - 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

C2C 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

C2C 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

ClientSon Llatzer

LocationPalma de Mallorca(Baleares Islands, Spain)

Additional InformationEuropean eHealth Award 2004

350 bedsFirst Digital Hospital

Project Development2005

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

August 2008

http://medting.com

Miguel Cabrerinfo@medting.com