In 2011 ASZ signed a seven-year, multi-million-euro contract for Carestream Vue Cloud Services, becoming the first hospital in Belgium to choose this unique “Software-as-a-Service” (SaaS) model. The comprehensive deal includes a new generation onsite Carestream Vue PACS with native reporting and speech recognition; cloud archive for all radiology studies delivered from the Carestream regional data centre plus a 40 TB legacy archive which will also be accessible from the Vue Cloud Portal on the internet.
The 600-bed ASZ is a large hospital group in Belgium operating across three sites located in Aalst, Wetteren and Geraardsbergen, managing more than 320,000 studies annually. The deal also included PACS services for a related hospital in Oudenaarde.
Dr. Eddy Van Hedent, Head of Radiology, and Geert Brantegem, CEO, Medical Board, explain here the rationale for this decision and the benefits provided by the new services.

Dr Eddy Van Hedent, Head of Radiology, ASZ, Aalst
We’ve three locations connected with the same PACS. We wanted a total solution for the future but also for the integration of all our imaging modalities. And at the moment we made our decision we found that Carestream gave us the best solution, also compared to the price. This solution gave us confidence for the future. First of all we have four years’ storage in the hospital at two different locations and all the rest is in the Cloud.
We needed easy access on portable system like Ipads; we wanted to work at home just as we work in the hospital, I mean, completely in the same conditions. And I can tell you it works fantastic.

Geert Brantegem, CEO, Medical Board, ASZ, Aalst
We wanted the kind of system where we had a price for each image we put on the PACS, so ‘fee for service’. Carestream gave us a price for each medical examination that was coming from the modalities and going onto the PACS. It was very easy to do a prospective budget and to know what will be my cost next year, because with the older vendor, every year we had surprises. One of the reasons to finally go for Carestream, they gave us the best value for money and even today I’m very convinced that we made the right decision.
Our radiologists are very happy with the software, it’s reliable and we feel quite happy with it.

Dr Eddy Van Hedent
For us hanging protocols are very, very important to compare images and, with the hanging protocols which we developed together with the people from Carestream, our comparison of images is done so fast, you don’t have to drag and drop, it’s all automatically displayed on the screens.
For the maintenance of the system, it’s best that you can do outsourcing. If you have few problems you can have a small IT service in your department.

Nico Van Weyenbergh, Chief Nurse
Now we have a solution that gives us more possibilities on the PACS for reporting, working with the images, and connecting to other modalities. The connection with all the modalities is available, we don’t have any problems any more to connect with the PACS, and we have only one vendor.

Dr Eddy Van Hedent
Everybody in our hospital has access to Vue Motion. Vue Motion is integrated into the EPR system in the hospital, so referring clinicians can start Vue Motion very easily without having to log in again, so for them it’s an automated link within
the EPR system.

Geert Brantegem
Each month I get a report, a simple Excel file and from each modality I know how many examinations they did on that modality. It’s so easy for us that we can tell you for each modality how many links we made to our PACS system and this is perfect.

Dr Eddy Van Hedent
Voice reporting is very important. First of all you have the speed, there are almost no errors; after you have read it you sign it and a few minutes later it’s in the electronic reporting. So it’s very fast, it’s very good and we do it ourselves.

Geert Brantegem
I think we were the first hospital here in Belgium where they did a complete roll out of the system. For the first two or three months there were two Carestream engineers who were constantly here in the hospital and they solved the major problems and now I think everybody knows where each button is, what they can do with the system and they feel happy with it and I feel happy because I have transparency. I have good information and I think we also have value for money.

Nico Van Weyenbergh
I can log in at home and I can see problems at home and sometimes I can solve them at home, so it’s easier to work. We have a good and close relationship with Carestream. We can contact them immediately by Helpdesk and very quickly we have one of the managers or one of the technicians on the phone to solve our problems.

Dr Eddy Van Hedent
So now it’s all linked on one systems and we have very, very few problems. Turning back is impossible you know. After this achievement it’s impossible, impossible to go back.

Enterprise imaging (EI) seeks to optimize the quality and value of medical imaging for healthcare enterprises. Although definitions of the term still tend to vary, there is widespread agreement that it means more than simply implementing a new technology.

Components of enterprise imaging
For Barbara Mullarky, a radiology products marketing veteran, enterprise imaging has four basic components: visualization, workflow, collaboration and archiving.
Visualization allows images from a multitude of specialties to be displayed on a single viewer, along with intelligent tools for efficient reading and reporting. The workflow component provides configurable, patient-centric movement of images and other, associated data. Collaboration enables radiologists, cardiologists and other medical specialists to share images and data with providers in and outside a care network.
The key archiving approach consists of vendor neutral archives (VNAs), which consolidate images from multiple systems and specialties for rapid retrieval and display, along with intelligent image and content management. Individual diagnostic imaging applications plug in to the VNA, with an enterprise worklist application consolidating workflow into a single view and determining the best display application to be launched from the VNA for interpretation.

Heralding a new healthcare culture
Experts seem to broadly concur with the above framework. Some, however, also see enterprise imaging as being the symbol of a wholly new healthcare culture. For example, in comments to UBM Medica, Paul Chang, MD, from the University of Chicago School of Medicine, says that a robust enterprise imaging strategy means reinventing and aligning radiology to a new, patient-centric approach for healthcare delivery. Chang believes that EI has the potential