1. Zero Footprint Viewer Atul Setlur
Senior Product Manager, Enterprise Imaging
Thanks for joining us today. We’re pleased to have time to share an update on our strategies and solutions as we head into RSNA Today we’ll cover:
An overview of what’s happening broadly here at GE Healthcare IT
A review of our enterprise imaging approach
And a preview of what we’ll be showcasing at RSNA this year in just two weeks
So, let’s dive in. As we set the stage, it’s no secret that healthcare systems, providers and patients across the globe are facing new and unprecedented challenges. Healthcare systems face exceptional economic, technological and clinical performance pressures. And caregivers and patients are struggle with escalating chronic conditions, rising costs and increasingly complex care needs.
Mountains of disconnected data and inefficient processes are contributing to inconsistent outcomes. Pay-for-performance reimbursement models are emerging. More informed providers and newly empowered patients are calling for significant change.
As the healthcare landscape transforms, many providers believe that in three years, the majority of their income will come from value-based payments, shifting risk from payer to provider. Meanwhile, a global labor gap is stretching providers to provide high quality care for more patients in less time. These shifts present increasingly complex clinical, operational and financial challenges.

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3. GE Healthcare IT Solution Portfolio
Integrated Care Solutions
Enterprise Imaging
Care Delivery Management
Population Health Management
Financial Management
Workforce Management
System-wide
Ambulatory Care
Revenue & Risk Mgt
Visualization
Workflow
Collaboration
Archiving
Ambulatory EMR
Clinical Quality Reporting
Data Control
Healthcare Analytics
Care Coordination & Management
Wellness & Patient Engagement
Revenue Cycle Mgt
Financial Risk Mgt
EDI
Practice Mgt
Time & Attendance
Staffing & Scheduling
Patient Classification
HR & Payroll
Care Areas
High Acuity
Maternal-Infant
Cardiology
Radiology
Pathology
Profit Analytics
Activity-Based Costing
Contract Modeling
Utilization Management
Enhance diagnostic speed & confidence
Make care pathways more productive
Lower cost of treating chronic disease
Improve health system profitability
Optimize workforce productivity

4. Healthcare is evolving to a collaborative care model
Hospital centric
Current Hospital-centric Model
Collaborative Care Model
Fee for service
Collaborative care
Patient data consolidation
Solutions
Open & interoperable
Outcome driven
Patient centric
Patients
Episodic
Departments
Closed system
Data silos
First, let’s take a look at the current state of healthcare. I’m sure I am not sharing anything that you are not already living in your health system. And it’s no secret that healthcare systems, providers and patients are facing new and unprecedented challenges.
With the dramatic increase of chronic diseases and aging populations, and the costs associated with these, medicine is rapidly evolving from a hospital-centric model to patient-centric and outcome-driven ways of delivering healthcare.
Additionally, mountains of disconnected data and inefficient processes are contributing to inconsistent outcomes, while pay-for-performance reimbursement models are emerging. It’s clear that more informed providers and newly empowered patients are calling for significant change.
In fact, as the healthcare landscape transforms, many providers believe that the majority of their income will come from value-based payments, shifting risk from payers to providers.
Meanwhile, a global labor gap is stretching providers to provide high quality care for more patients in less time. All of this is requiring big changes in how organizations are paid, operate, implement IT and share patient data. For example,
Where we once had a fee for service and episodic treatments, we are now seeing outome driven, patient centric care
Where we once had departments operating in isolation, the complexity of pathologies requires collaboration across specialties
Where IT systems were once working as stand alone closed systems, a new wave of IT solutions are open and interoperable
And finally where patient data was once spread across silos of information across multiple departments, we need now access to consolidate patient data to enable informed decisions.
Fee-for-Service
Outcome Driven

5. Imaging is now an enterprise-level priority
Community
Collaboration suite
Radiologist
Best of breed tools
Department
Integrated solution
Enterprise
Standards-based platform
To accomplish this, imaging data needs to seamlessly flow across departmental silos. But as imaging moves beyond radiology systems, to different departments, through the entire enterprise, and even out into the community, the needs and requirements become increasingly more complex.
Think for a moment about how things have already evolved. Organizations used to have the radiologist in the basement using a stand-alone PACS. Now we’re in a world where care is truly collaborative, systems are integrated, departments are interacting within and outside their hospital walls – across regions and in sometimes countries.
A stand alone PACS, a disconnected image archive, and workflow tools that only serve one care pathway just don’t address today – and tomorrow’s – needs.
Clients today need a truly enterprise approach with enterprise-level software that is not a stand alone product but a sophisticated suite of solutions. True Enterprise Imaging requires new tools, new approaches, new workflows and an experienced partner to help make it a reality.
But if done properly, an Enterprise Imaging strategy can help an organization to:
…help to ensure wider access to data and accelerate the exchange and access of images
…deliver advanced clinical tools that allow for streamlined patient diagnosis
…generate workflow efficiencies and productivity enhancements
…and enhance quality and patient centric care
Coordinated care demands moving from stand-alone silos of data to integrated, user friendly workflows

6. Visualization: Display images from multiple specialties on a common viewer with analytics
Centricity Universal Viewer: A unified, web-based viewer
Streamline workflow with intelligent productivity tools
Reduce swivel between workstations
Read multiple modalities on the same workstation
AW Advanced Visualization solutions
Streamline post-processing and synergize imaging techniques
across CT, MRI, PET, SPECT and interventional
Collaborative 2D, 3D and 4D visualization and analysis
So let’s take a look at each of the products that make up our Centricity Solutions for Enterprise Imaging.
Everything really begins with visualization.
Universal Viewer is where imaging comes together and allows our clients to consolidate workstations. Universal Viewer helps to connect advanced visualization, provide extensive breast imaging tools, image-enable EMR systems, and unlock patient history from silos. It’s all delivered in an easy-to-use, web-based, and unified reading desktop.
Again, this all goes back to helping to improve clinical efficiency. As mentioned earlier, radiologists can spend up to 19% of each day going to between multiple systems and multiple workstations to obtain all the information needed finalize a case. (1)
By consolidating tools into a single workstation and pulling images from different care areas, customer can save real time, helping to improve report turnaround time and increase the number of studies that can be read in a day. Plus, think about the potential cost and space saving possibilities of consolidation into one workstation.
Because of our history in delivering advanced visualization tools, and, in partnership with our imaging modalities, we can deliver very specific and specialized AW tools – again all on the same workstation. This can really help to improve productivity and efficiency.
(1) Source: Radiologists’ Burden of Inefficiency Using Conventional Imaging Workstations, Dr. Bruce Hillman and Dr. Bhavik Pandya, Journal of the American College of Radiology. November 2013;
Centricity Universal Viewer
Increase clinical productivity
“I want to consolidate workstations.”
Help save up to 19% of radiologist’s time1
Your needs...
1Source: Radiologists’ Burden of Inefficiency Using Conventional Imaging Workstations, Dr. Bruce Hillman and Dr. Bhavik Pandya, Journal of the American College of Radiology. November 2013;

7. Centricity Universal Viewer
Enhances patient care and collaboration while reducing total cost of ownership with a common platform
Centricity Universal Viewer
Radiologist
Viewing
Breast
Imaging
Advanced Visualization
Home
Reading
Cardiologist Viewing
Clinician
Viewing
Helps to streamline workflow with enhanced usability and Intelligent productivity tools, including smart reading protocols, native MIP/MPR & PET-CT
Screening and diagnostic workflows
Read Tomo on the same workstation
Supports multi-modality reading as part of hanging protocols
Embedded applications powered by AW help to reduce swivel between workstations, enables access to post-processed images
High system performance with bandwidth-adjusting streaming technology
Access via web helps to reduce IT involvement
Brings cardiology together with multiple imaging disciplines together in a common viewer and a single patient jacket
Clinicians can view any image anywhere1 on a device of their choice, within or outside the hospital with little burden for IT.
From sales deck: DOC
Radiologists do not have easy access to priors
Could end up using 3 or more viewers in Radiology
Limited to access advanced viz solutions in specific locations
Do not have at home access to imaging studies
1Where internet access is available

8. Archiving: Consolidate images from multiple systems for rapid retrieval and display
Centricity Clinical Archive2 solution is a standards-based, multi-ology, multi-site VNA
Store clinical content from DICOM & non-DICOM systems
Deliver a single patient jacket
Interface directly within an EMR
Deliver proven scalability for large enterprises
Provide location agnostic ‘multi-ology’ information access
2Centricity Clinical Archive solution includes the following product components: Centricity Enterprise Archive, Universal Viewer ZFP, Caradigm™ eHIE, Centricity Clinical Gateway, NextGate MatchMetrix EMPI, and PACSGEAR PacsSCAN.™
Last, we move to archiving. Centricity Clinical Archive, our vendor neutral archive (VNA) solution serves not only as the foundation for enterprise imaging but is also the foundation for a coordinated care network. Plus it helps to eliminate the need to buy storage for every department, every year.
At RSNA we unveiled our newest release of Centricity Clinical Archive 6.0 – with anticipated availability in the first half of It delivers several new and enhanced capabilities, including:
A full XDS architecture that allows external systems to access patient records in a standards-compliant manner. This is important because we believe that to be a true VNA, it must be standard-based, not based on a vendor’s proprietary software. XDS is a standard that crosses systems, is widely deployed across the world, and we believe, represents the future.
We’ve also offered new capabilities for storage, management and deletion of images for more efficient and cost-effective information lifecycle management. Just think as you store images from many departments there are very different requirements for how long you need to store those, etc. You have to have efficient rules-based ways to mange that efficiently and in an automated manner.
Last, we’ve also introduced a mobile image capture application that allows for ad hoc image acquisition and immediate storage in the VNA, and was jointly developed with University Pittsburgh Medical Center (UPMC). (1) This is really exciting and represents a brand new way to get clinical content into the VNA. Again, as you’re looking to expand your enterprise imaging approach departments you have to have ways to get dermatology, the ER, plastics, all involved. This is one innovative way to do that.
We know there are lots of small vendors in the VNA market these days. It seems a new one pops up every day. But we’ve been in the space for a very long time. And we’re proud of the fact that Centricity Clinical Archive was ranked the #1 Global Vendor Neutral Archive in the IHS 2012 Medical Enterprise Data Storage Report. (2)
In 2013 they changed the rules a bit to base it on revenue, but in 2013 we were again #1 in image volume. (3) If you want a partner who offers a truly scalable VNA – the number of images is much more important than how much the vendor is charging you. And we’ve consistently been #1 in managing the largest imaging volume in the world. That’s true scalability.
(1) UPMC is a collaboration partner of GEHC and as a result, has a financial interest in the development and commercialization of certain GEHC next generation imaging products.  
(2) Source: 2012 IHS Medical Enterprise Data Storage Report
(3) Source: 2013 IHS Medical Enterprise Data Storage Report
Centricity Universal Viewer
Contain costs
“I want to stop buying storage for every department, every year.”
Helps reduce cost to archive images by up to 20%1
Your needs...
1 Source: We Calculate a 74% Reduction, But It’s Hard To Compare Apples To Apples by Andrew Reichman, August 25, 2011; Note: UPMC is a collaboration partner of GE Healthcare and as a result has a financial interest in the development and commercialization of certain GE Healthcare next generation imaging products.

9. Help enhance clinician access…

10. What has changed in the past 10 years?
Increased usage of Mobile devices in Healthcare
51% of surveyed physicians using tablets access EHRs
54% physicians use iPad® tablets
Only 18% of tablet users were “very satisfied” with the quality of apps
Four big players for Web Browsers. In the US, Chrome ~ 10pts higher Safari 5pts 10%
Takeaways:
Four main Web Browsers in use on the Desktop
IE 11 has 24% market share
IE 8 has 17% market share
Source:

11. Primary Care Physician needs
Default access to report and key images
Providing referral physicians with information they need to deliver patient results.
Access within and outside facility
Cross reference lines
Designed with the needs of the Clinician
Default display of report and key images
Internal and external access
Targeting large # of users with limited training
Simple guide to application functions
Help access images and view results: Default display of cross reference lines, series navigator
Same UI, icons and tools for UV Web and ZFP
Targeting large # of users with limited training
Information overlays guide to functions

12. Surgery & Emergency Department needs
Enabling access to images before and during surgery
Volume Rendering
Emergency department requires technology accessible at patient’s bedside
Surgery
3D Volume rendering
Extending timeout for OR
Emergency Department
Immediate access to images
Collaboration - Access to Exam Notes in PACS
Display of images on specific monitor
ER – Radiologist Discrepancy Communication

13. Cardiology
EKG and Echo
Providing Cardiologists with imaging and accompanying EKG waveforms
Optionally launch MUSE™ Cardiology Information System application externally
Designed with the needs of the Clinician
Mobile and remote access to images
Mobile access to images

14. Help enhance care coordination

15. Complexity of Care Delivery models increasing
Oncology Community
Chronic Disease
Management
Cardiologist
Patient / Guardian
Internist, GP
Surgeon
Neurology Community
Trauma Center
Affiliated Hospitals
Oncology
Telemedicine
Neurology
It’s time to transform Imaging…to integrated, user-friendly workflows
Consolidate DICOM + Visible light and other Clinical Content across the enterprise
Increase imaging access across the enterprise
Leverage interoperability to implement enterprise imaging

16. Clinical photographs (Visible light)
California’s Kaiser Permanente organization now has more images coming into its system from outside radiology than it does in the imaging department.1
Pressure Ulcers
Burn Assessments
Wound Dressing Instruction
Wound Care
ER Abuse documentation
Retinal Fundus
Ophthalmology
Liver Stain
Pathology
Melanoma, Rashes, Acne & Mole Tracking
Tele-dermatology
Dermatology
Scope Pictures
ENT & GI Lab:
Motor Skills & Cognitive Ability Video
Neurology
Motor Skills Ability and Range of Motion Video
Treatment Progression
Physician Occupational Therapy
Reduce integration cost
Secure access to clinical content
Launch specialized external applications
Timeline provides easy navigation to patient history and comparison selection
1- Source:

17. Patient centric view of all clinical content in the vendor-neutral archive (VNA)
Patient Timeline – Matrix view
Access to patient’s DICOM, Clinical Photographs and other Clinical Content e.g., CDA
Optimized to quickly navigate large amount of patient data e.g documents
Consolidating image access across disparate health systems
Build patient centric view of all clinical content for the patient
Single viewer integration from the EMR
Linked documents
Historical slider/timeline
Flagging
Default filters

18. Increase access to patient’s imaging
Access related imaging performed at other affiliate Hospitals.
These affiliates have their own PACS systems
MERCY
GENERAL
HILLTOP
The needs
Simply put we have a region of hospitals
Each have unique instances of RIS and PACS
They wish to have access to a global patient jacket to improve patient care / provider productivity for all physicians and rads

19. Enabling multi-disciplinary Oncology care
Collaboration via virtual Tumor Boards
Display of Pathology ROI and accompanying Radiology Images
Launch specialized viewing applications where needed
Pathology ROI
Designed with the needs of the Clinician
Key Images

20. Telehealth programs for stroke care
Neurologists are in short supply, so many hospitals are turning to virtual stroke networks staffed by specialists from a variety of hospital bases who interpret scans and diagnose strokes.1
Hospitals in Cleveland and Houston are dispatching special ambulances rigged up as mobile stroke centers modeled on a successful program in Germany.
On-call neurologists view CT scans and evaluate patients through a secure encrypted network and two-way video screens.
Through a national Target Stroke program, hospitals are working with first responders and emergency medical services, to notify them about possible victims before they arrive. A single call can activate stroke teams which can fast-track CT scans for the patient’s arrival. Hospitals in Cleveland and Houston are dispatching special ambulances rigged up as mobile stroke centers modeled on a successful program in Germany.
On-call neurologists view CT scans and evaluate patients through a secure encrypted network and two-way video screens.
1- Source:

21. Help contain costs
manage total cost of care

22. Simplifying image distribution
Zero Footprint
No admin rights required
No software install
Low memory requirements with Server side rendering for 3D
Low bandwidth support
Broad web browser & device support
Clinicians can quite simply view any image anywhere1 on a device of their choice, within or outside the hospital.
IHE-XDS registry and consumer (multi-format, multi-ology)
EMR interoperability
Single viewer for DICOM, Clinical Photographs and other Clinical content
1Where internet access is available

23. Access patients imaging history from the EMR
Reduce operational complexities
Make Images accessible via EMR
Single EMR interface
Secure inbound interface
Outbound interfaces, e.g. Ortho templating
Centralized management of users
Enterprise Active Directory & SSO support
Role based access control
Audit viewing of patient data
Access patients imaging history from the EMR
Image enable the EMR and or standalone access
Broad web browser support
Support for low bandwidth environments

24. A robust, standards based solution
Path
Derma
Rad/Card GI
Scopes
Optho
Non-standard sources
DICOM & XDS
Connectivity components
(messages & devices)
XDS Registry
Vendor Neutral Archive
With XDS/XDSi Repository

25. Case Study: Huron Regional Medical Center
Challenges
Solution
Outcomes
Stay competitive- keep care local
Balance high-end technology with costs
Quick and easy access to images from EHR
Integrated to launch directly out of the EHR
Broad access to images within and outside the facility
Images viewable through modern web browsers
Reformats on the fly
Intuitive user interface
Improve relationships with referring physicians
Faster patient care
Reduce burden of installing & maintaining software
Help improve market presence
Improve relationships with referring physicians
Help improve care coordination
Faster patient care
Help contain costs
Reduce burden of installing & maintaining software
The zero-footprint viewer is very intuitive. The tools are very basic, but they’re the tools you need. They’re easy to learn.
– Chad Moser, RT and PACS Administrator
Source: Huron Regional Medical Center case study; January 2015
Results may vary and do not constitute a representation, warranty or performance guarantee

26. Large Hospital Operator Scenario
Background
Consolidated Radiology and Cardiology imaging from all Hospitals on the VNA
Petabytes of imaging data from GE Healthcare PACS and other vendor PACS.
Redundant data centers w. replicated data
ZFP use
Enable access to imaging on the VNA
Redundant and high performing infrastructure accessible from all facilities
Focusing on ZFP – I would like to share how ZFP product is in use

27. Addressing Enterprise Imaging challenges
Remote access to Referring Physicians
Improve market presence
Tools to meet needs of Specialists e.g., Cardiology, Orthopedics
Patient centric view of Imaging
Improve care coordination
Cross enterprise display of data
Summarizing the challenges
Single point of access imaging across the enterprise
Support of latest Web Browsers and platforms for image viewing
Mobile access to imaging results
Interoperable solutions
Contain costs
Consolidate images access across multiple systems

28. Centricity Universal Viewer Zero Footprint
Clinician access
Any image anywhere1 on a device of their choice
Care coordination
Patient centric with broad tool set
Cost containment
Simplify image distribution with robust interoperability & ease of deployment
IHE-XDS registry and consumer (multi-format, multi-ology)
EMR interoperability
Clinicians can view any image anywhere1 on a device of their choice, within or outside the hospital with little burden for IT.
1Where internet access is available

29. Thank you! Questions?