Advocates of 3-D imaging say that despite such challenges they see significant value in the technology and believe it is poised to become a standard part of patient care. They cited three factors: declining costs, the availability of more user-friendly image-conversion software, and growing interest in the technology among physicians outside of the radiology suite.
“In the last five years, all of the companies have developed (3-D) software that sits on a server,” says ECRI's Launders. “You can set up an entire hospital for $200,000 plus an annual licensing fee.”
The newer software, Launders added, can be downloaded onto a PC and is much more intuitive than older software. It allows cardiologists, surgeons and other doctors who may have a need for more detailed scans of their patients' imaging studies to simply call up an image from a picture archiving and communication system or a disk and automatically convert it into a 3-D view. Once the image is constructed, the software allows the user to rotate the view, change the contrast and even take away bone and other structure to get a more precise view of the area of interest.
Such ease of use is prompting nonradiology specialists and surgeons to use virtual images to get more accurate views of their patients' diseases and conditions and plan for subsequent treatments and surgeries. “Radiologists control this technology at the moment, but I see it as—once the genie is out of the bottle and you see how easy it is—a whole lot of providers will use it,” Launders said.
Letting the genie out of the bottle is precisely what one medical software provider is hoping to accomplish. Earlier this month, Redmond, Wash.-based FiatLux Imaging took a calculated step aimed at making 3-D imaging a ubiquitous tool. The company made its 3-D-image conversion software, FiatLux Visualize, available for free download by any healthcare professional. The software can use MRI or multislice CT data to construct 3-D images.
“What we're trying to do is make 3-D imaging a big pie and drive adoption,” said Tom Sanko, vice president of sales and marketing at FiatLux. “We're artificially constrained right now. Most of the solutions out there are marketed to radiologists, but there are millions of healthcare providers who could use this technology.”
Sanko said his company's hope is to get surgeons, orthopedists and other specialists as frequent users of its 3-D technology. The company plans to make money by creating add-on products that it sells to physicians, Sanko said. He declined to reveal what those products will be.
For Sanko and other advocates, the future of 3-D imaging won't rest on better reimbursement, but on the ability of the technology to become cost-effective and improve workflow and clinical outcomes.
“It has to fit into a physician's current workflow,” Sanko said. “If they have to spend a lot of time training on it, or if they have to make a lot of changes, it won't work.”
But Sanko acknowledged that getting away from the reimbursement question could be tough. “When we were trying to sell the original version of this software, we got a lot of questions from doctors: What's the reimbursement on this? But if that's what you're looking for, this is probably not the right technology.”
Fishman concurred, saying his hospital long ago embraced the use of virtual imaging technology for reasons other than reimbursement.
“Johns Hopkins does more than 200 3-D images a week. A patient would never go to surgery without it. It's become part of workflow and what the surgeons expect.”
The University of North Carolina has a similar philosophy, Fielding said. She noted that while reimbursement for 3-D image processing is minuscule or nonexistent for most types of radiology procedures, her hospital is using the technology for a growing number of purposes, particularly surgical.
“We use it routinely for ultrasounds and most of our vascular work and liver transplants and resections,” Fielding said. “I do think in many places that we use it the patients get better care, and the surgeon can be more confident about where he or she goes.”
A version of this story initially appeared in this week's edition of Modern Healthcare magazine.
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