RSNA 2012 - Cloud Computing for Radiologists—A Primer

Cloud computing session. See below for the learning objectives of this session.
Cloud computing involves both applications and services delivered over the internet using hardware and servers in a data center.
Virtual systems and cloud based systems can be used both within radiology as well as outside. Cloud computing provide referring clinicians with both image interpretation as well as teaching capabilities.

Cloud Computing can be applied for
1) Using virtualized systems to improve access to advanced image processing tools.
2) Using cloud based systems to provide access to advanced imaging tools.
3) Getting hands on experience using 2D / 3D / 4D tools to process data in near realtime in a virtual environment.

advantages of cloud computing
1) should lower IT costs
2) automate storage management
3) improve scalability
4) improve accessibility (e.g. improve access to advanced image processing tools)
5) fast deployment of services

Currently, people are net centered and used to being online and connected at all times. This is one of the main drivers behind cloud computing since the investment in having the best technology on the serverside is the responsiblity of the service provider and not the user.

Problems or challenges in cloud computing are:
1) can the networks available service all the cloud based applications?
2) how do we ensure patient data security and privacy?
3) is it really saving money?

when using Citrix like solutions, a major problem is that Citrix will not notify that the displayed information is compressed. If the software you use is not Citrix aware then it says that diagnostic quality data without compression is displayed while it actually is compressed by Citrix to preserve bandwidth.

Trade-offs of local storage versus cloud storage should be considered in terms of reliability, latency, costs, and scalability.
Keep in mind that the bandwidth of the network is not all, the latency is dictating how much you can transfer over that network. Therefore, testing or computing the transfer time based on the latency is essential.

RSNA 2012 - RadSnap - A Free iPhone Application for Cloud Based Consultation Between Referring Physicians and Radiologists(LL-INE1245)

Interesting poster at RSNA of a iPhone application for Cloud Based Consultation. It is freely available from the appstores.

RadSnap - A Free iPhone Application for Cloud Based Consultation Between Referring Physicians and Radiologists

Roland Talanow, MD,PhD

PURPOSE/AIM

Referring physicians are often in a situation where they need a quick professional consultation for images at hand. Also radiologists in poor areas of this world may have not the expensive equipment to exchange studies with professionals. A solution is desired where radiologists or referring physicians who are in need for a quick case consultation receive such in a timely manner.

CONTENT ORGANIZATION

We developed an iPhone app that allows sending images of an indeterminate case into a dedicated section of a protected community of over 10.000 Radiology professionals. Case consultations and opinions are usually provided within a few minutes to hours. The program mask is short and intuitive and after taking the picture, it provides several options for a title, short description where a question can be placed and optional case relevant parameters. The user may choose to display their name or stay anonymous. As soon as a peer provides an opinion, the user will be notified via email. The user may also discuss this case with peers in the protected community to get more insight.

SUMMARY

RadSnap is a free clinical tool that allows receiving quickly and easily professional consultations for difficult cases sent via iPhone. This tool helps especially referring physicians and radiologists in areas of the world who cannot afford expensive PACS software.

RSNA 2012 - Ensuring Research Subject Privacy: Anonymization andObscuring of Facial Features of Shared Head Volumes Using Open SourceOnline Tools in XNAT (LL-INE1243)

One of the tricky things about anonymization of image data for scientific research is the fact that although we de-identify the DICOM header and textual content of the images, an additional issue is involved in CT and MR of the head. This issue involves the fact that based on the data acquired a three dimensional visualization of the face can be reconstructed on which the patient could be identified. This work provides a solution to deface MR data in order to tackle this problem.

Ensuring Research Subject Privacy: Anonymization and Obscuring of Facial Features of Shared Head Volumes Using Open Source Online Tools in XNAT
Mikhail Milchenko, PhD , Kevin Archie , Daniel Marcus, PhD
PURPOSE/AIM
1. To understand anonymization requirements for DICOM tags;
2. To understand whether a 3D rendering of head anatomy scan (e.g. MR) can identify a person;
3. To understand the difference between de-identified and original head scans for the identification purposes, and for the purposes of automatic post-processing.
4. To learn to share MR head data using automatic online de-identification tools based on pipelines in XNAT (open source research image sharing database);
CONTENT ORGANIZATION
1. 3D head visualizations based on high resolution MR scan vs. photographs for identification purposes.
2. Obscuring facial features: registering the image into atlas space combined with anatomical surface obscuring
3. Sharing data using the open source research database engine (XNAT) with DICOM anonymization and face obscuring pipeline
4. Comparison of original and face-obscured MR head renderings.
5. Outcomes of post-processing tools (gain field correction, skull stripping, registration) on original and face-obscured MR images
SUMMARY
The exhibit will review the de-identification technique that consists of DICOM anonymization and obscuring of face anatomy. The emphasis will be made on learning the impact of face obscuring algorithm on visual change in a 3D rendering appearance, and of examining the outcomes of post-processing tools used on obscured images.

TEDxToronto 2012 Talk - Dr. Joseph Cafazzo

Dr. Cafazzo is a biomedical engineer who has spent his entire career in a hospital setting. By observing healthcare delivery from the inside, he works on ways to keep people out of hospital by creating technologies that allow for self-care at home. At the same time, Joe and his team are the biggest critics of poorly designed health technologies and their ineffectiveness. He surrounds himself with whip-smart, and passionate engineers and designers who are creating technologies that are spirited, modern, people-focused, and hopefully, suck less.

Computer Magazine November 2012 - The move toward electronic health records

Check out Computer Magazine November 2012 for a whole series on the move toward electronic health records. Selected articles are also available Bericht publicerenfor free at the computer magazine website.

Use of Mobile Devices in Healthcare institutions

Amcom Software surveyed nearly 300 healthcare organizations to better understand how healthcare facilities are addressing questions about the use of mobile devices and to see how far along hospitals are in devising their strategies. This white paper report titles "The Role of Mobility Strategies in Healthcare" examines the top three topics and discusses solution ideas.

Cycle while you work

A new product to increase activity during a busy working day. You can actually buy this!

World Usability Day 2012 - Workshops

Besides the Apple presentation in the previous blog, other presentations were given by people from different companies and consultants on their approach to user centered design. This gave a lot of differnt insights.

After lunch the workshops were planned.

My first one was by the University Twente about participatory design. They developed a tool to facilitate this process by a game. The aim of this game is to include users in exploration and establishment of requirements of products, software or environments which are to be used in complex, activity flow oriented situations.
The case during the workshop was to develop a weight loss app for an insurance company. It was really fun to do and it stimulated the process of discussing by providing a flexible envrironment to start with with predefined roles. The parcipatory workflow design game will be available soon in the UCD Toolbox

The second worshop was about the UCD toolbox itself by Tristan Weevers. The UCD toolbox is to find, learn and apply methods for UCD. Determining the right method from the over twohundred available methods is extremely difficult and the knowledge about these methods is not centrally available but spread over a large amount of sources. The UCD toolbox provides a filter, compare and get info sequence to facilitate this selection process. The filtering process is based on what you are creating, what the goal is and how much resources you have. Based on this a basic comparison is provided of the most usefull tools. After selection of one of the choices more information is provided about the methods including indepth information and possible tweaks. It's not online yet completely but we were able to work with the prototype which really looked great. This will allow easy communication with different stakeholders about usability. Keep an eye on www.ucdtoolbox.com to see when it comes available.

World Usability Day 2012 - Apple design

Visit the conference home page here.

Design in general is discussed in this session by Apple. However, many of these ideas for products can and should also apply to medical devices to ensure adoption and make them more user friendly.

The revival of apple was really started with the iPod which became a more wellknown brand than Apple itself. Now they sold 380 million iPods in 11 year.
1. How to design a good product
I=I2 innovation is iteration on iteration.
Design should not be about the product but about the experience.
I=A2 Innovation is an application.
People want the application not the product itself.

Target your audience! Make the devices not for the 'nerds' but for the regular users. Addressing the right people is really important. Apple design for the 12 o'clock flashers (people that have devices in their home with the clock flashing at 12 o'clock). In Apple the software teams include people from all kind of different people like musicians, etc to make sure what is developed makes sence to 12 o'clock flashers.

Bond with your user!
I=U2 innovation is what a user wants. Don't ask the user but look at what they do. Observe the user to see what they want.

It's not the feature set that counts but it's all about the user experience!

The lock down of IT in organizations causes a second layer of communication where users use devices and tools that are public. Organizations need to allow BYOD because if they don't they will lose their best people because they want to have the possiblities available. Apple allows organisations to block certain capabilities of their devices in the organizational network, e.g. disable the icloud ability.

The next step in augmented reality

Published at ISMAR conference 2012. This video shows first steps towards a Superman-like X-ray vision where a brain-computer interface (BCI) device and a gaze-tracker are used to allow the user controlling the augmented reality (AR) visualization. A BCI device is integrated into two medical AR systems. To assess the potential of this technology first feedback from medical doctors is gathered. While in this pilot study not the full range of available signals but only electromyographic signals are used, the medical doctors provided very positive feedback on the use of BCI for medical AR.