The same new technology that's made data available to any computer via the Internet is being harnessed to bring complex radiology images to inexpensive computers wherever a physician needs to view the results.
If the claims made by a new breed of developers hold up, the technology could turn today's average PC into a radiology workstation good enough for a physician to review digitized X-rays and other scans. That could save tens of thousands of dollars per station.
And the new scheme of communicating information to these PCs could eliminate the expense and bother of continually updating versions of software in scattered places.
The systems to transmit, display and manipulate images were demonstrated by several companies at the Radiological Society of North America exhibition last week in Chicago.
They all take advantage of the fact that the average desktop computer purchased these days is anything but average.
Because of advances in computing power, program memory, data-storage capacity and screen resolution, an investment of $2,000 can buy performance that previously could be found only in $50,000 workstations developed especially for computerized radiology images, said Pete Killcommons, M.D., president of MedWeb.
The San Francisco-based supplier of computer-image networks for radiology practices unveiled a system that plugs into a World Wide Web browser and greatly enhances it, supplying the same sophisticated features to a PC that were under the hood of a $50,000 model, Killcommons said.
Those so-called "plug-ins," installed on every PC in a network, receive transmissions from a high-powered computer called a server. That machine is loaded with the capacity to take electronic images from a radiology department and use protocols developed for the World Wide Web to dispatch files created in the standard computer language for complex diagnostic images called DICOM.
Normally those transmissions could take an unacceptable length of time to receive over standard telephone lines, but the system addresses that problem in two ways, Killcommons said.
First, it compresses the computer file to about one-twentieth of its original size for the trip to the destination browser, which automatically uncompresses it once it's received.
In addition, the file is sent in progressive waves of detail, allowing a physician to begin working with the image while the rest of the details fill in.
MedWeb is offering an unlimited number of "plug-ins" to run the system on PCs with the purchase of the server, which sells for $50,000-about the cost of one self-contained radiology workstation.
The same Internet-derived technologies, compression of files and progressively detailed image resolution offered by MedWeb are employed in a system marketed by an Israel-based company called Algotec Systems.
But Algotec's version relies on a new computer language, called Java, that allows not just files but also the programs to run them to be sent at the same time.
As a result, nothing needs to be installed or plugged into PCs receiving the information, said Yossi Reichman, vice president of operations. A computer server linked to digital data sources is the housing and engine for all transmissions and computer instructions.
Reichman said the company has tested the system at North York General Hospital in Toronto, and it expects to have the necessary clearance from the U.S. Food and Drug Administration by an April 1997 target date for general release of the product.
Making a server the location of all essential computer programming not only simplifies the task of setting up workstations for physician users but also eliminates the need to go out to all those sites and bring them up to date whenever enhancements are made to computer software, said Reichman.
When changes are made in the programs at the server level, the latest version automatically goes to any PC on the system from then on, he said.
The MedWeb system doesn't distribute programs directly with the image transmission, but the server detects an older version of the plug-in and alerts the user to click on a button to download the newest version, Killcommons said.
The potential of such Web-style transmission systems could be further enhanced by the fuller use of the Java programming language, said John LaLonde, who's directing an initiative at GE Medical Systems to bring together in one place all the multiple sources and forms of radiology information on a patient.
Currently a radiologist using an electronic imaging workstation has dozens of digital images on a single patient encounter, each with rich information that can be manipulated in a number of ways to get a better grasp of what the image reveals, LaLonde said.
But the radiologist ends up printing out a static film image of a half-dozen looks that he decides will be of greatest benefit to a referring physician. Then a printout of a radiology report is attached and the whole package is mailed out, he said.
The doctor could use the prevailing Internet-style protocols to send images, but they're the equivalent of an electronic photo-still static and incapable of carrying the full information of a DICOM image.
GE Medical is working on a system that can use the capabilities of the Java language to give physicians the same type of file that the radiologist sees, and also to attach text, voice messages and other types of patient data to the same transmission, LaLonde said.