A straw poll for radiologists without PACS

Posted by Martin P in Project matters      4 comments

Dec
4

Every now and again, I’ll take a look at the site traffic & while the hit counter hasn’t reached the point where I’m tempted to drop in Google adwords (and by golly would resist when it does!), there’s a steady stream of interest and even (gasp) some returning visitors. So here is a request for help.

While we have our own ideas of why PACS – despite being a no-brainer, hasn’t infiltrated every corner of the globe, we’d like to know what other people think. We’ve put together a VERY short survey 1-2 minutes only. It would be a great help if you could spare the time to fill it in, and there’s no sneaky stuff.

The survey is here, for Radiologists and institutions without a PACS.

Database Replication

Posted by Martin P in Development      3 comments

Dec
3

There are few systems in a healthcare environment which are more critical than PACS. Availability of PACS must be maintained through thick and thin. That much is given. But PACS are complex animals. Many PACS users would be acquainted with the complexities of a reporting workstation or even a browser-based reviewing interface, but just as complex are the interactions that go on at the server-side, to deliver the services required. Between external interfaces (DICOM, HL7 and perhaps even CCOW), worklist generation, storage management and web delivery (to name just some), there can be up to a dozen specific processes processes needed to form a complete package.

Far and away the most important of those processes is the database server. The database lies at the center of all of those other processes and is one of only two (the other being the physical network) which, if unavailable, renders all others at best impotent.

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Open Source – Amateurs?

Posted by Martin P in Open Source      No comments

Dec
3

I just came across this article on the Society for Imaging Informatics site. After getting about halfway I had to go off, drum my fingers & count to ten before resuming. On re-reading, it isn’t all bad but there are a couple of sections I very much disagree with:

Q: If one builds mission-critical systems on OS, there is no one to call if PACS goes down in the middle of the night?

A: This argument assumes that the decision makers at the medical center:

a) Took a suicidal leap of faith and changed products without support; or

b) That the market will not evolve solutions like Levanta – LinuxCare Data Center Automation (formerly LinuxCare) to support the OS products that are given away (http://www.levanta.com).

Obviously, neither of these events is likely. It may take some time before OS projects replace FDA approved clinical systems in private sector U.S. medical centers. However, the U.S. Veterans Administration Hospital System already uses OS clinically [Conn]. Similarly, other countries are using OS in mission critical health care [Uribe].

This section certainly gives the impression that the Open Source software market needs to ‘evolve’ to provide enterprise-level support. Uh… Mr. President. That’s not entirely accurate. The Open Source business model based on support and services is not only well established (think Red hat, MySQL, OpenOffice amongst others) but is the key differentiator between OSS and proprietary.

Q: If everyone starts giving away software, won’t commercial vendors go out of business?

A: To believe this you have to think one or more of the following:

a) A group of experienced professionals with years of experience cannot beat a bunch of (by definition) unpaid amateurs;

b) That current customers are so dissatisfied with their commercial product and/or its service that they would risk the exposures of Q4 to go it alone; or

c) That said professionals cannot out-innovate the amateur team.

To be blunt, if any of the above is true, perhaps the company so indicted should go out of business. This concern also forgets past history, such as the fact that the current commercial PACS vendors almost universally based their early products on the OS Central Test Node code released by Mallinckrodt at the 1993 RSNA. Or that IHE members benefit from the OS Mesa test libraries today.

Now, where to start. “a bunch of (by definition) unpaid amateurs”. It’s spectacularly disappointing that someone who clearly is supportive of OSS should get this wrong. If one were to take the OS software cited earlier in the article as success stories, there is much qualitative and quantitative evidence to suggest that by far the majority of contributing developers are paid for their contributions, by companies who then go on to monetize (by providing services) the software. A large part of the remainder consist of professional developers who ‘exhibit their wares’ by contributing to OSS projects, hoping to get further employment. That sounds like a powerful mix to me, and not (by definition) unpaid amateurs.

It is probably true that many OS projects have less R&D resources than proprietary equivalents, there are many OSS products which are as good if not better than the proprietary competitors (apache, Linux server, Firefox, PHP , Gimp, Eclipse …………….)

RSNA 2007

Posted by Martin P in PACS General      No comments

Dec
3

Living on the ‘other’ side of the pond, and running this on a shoestring, I didn’t get to RSNA this year so thanks to the customary completeness of Aunt Minnie (even if they did delete one of my forum posts!) and of course the irreverence of Dr Dalai for keeping us all informed. Now I can get back to work.