- By Miriam Friedmann
Image management in radiology: interview with three experts on current developments and innovations
Efficient image data management plays an important role in radiology, hospitals and other medical specialties where image data is generated and managed. At the end of the year 2024, we asked three experts from the field where they currently see challenges, how modern technologies such as the cloud can help to overcome them and what they would like to see from politicians in order to drive forward the digitzation of the healthcare sector.
The Head of MIT: Dr. Henning Janßen
Dr. Henning Janßen is Head of Medical and Information Technology at the Klinikum Bremerhaven-Reinkenheide.
Klinikum Bremerhaven-Reinkenheide gGmbH is the municipal hospital for Bremerhaven and the region. As a maximum care hospital, it has 813 beds, 16 clinics, two institutes and a medical care center. Around 25,000 inpatients and around 3,000 day clinic patients are treated there every year. In addition, approx. 20,000 outpatients and approx. 31,000 emergencies are treated each year. With around 2,500 employees, it is the largest hospital in the Lower Weser region.
1. What challenges or bottlenecks did you encounter in your day-to-day work before you opted for a cloud solution?
Dr. Henning Janßen: “We previously relied on local solutions, which meant that we had to make cost-intensive replacement purchases for the storage systems every three to five years. We were also highly dependent on our PACS manufacturer for long-term archiving and we wanted to eliminate this. In addition, the processes associated with the transmission of digital radiological images to further practitioners or patients were quite complex due to CD/DVD creation, cab transport or the use of local portal solutions.”
2. Was there a particular moment or situation that made you realize that a change was inevitable?
Dr. Henning Janßen: “Unfortunately, our PACS manufacturer presented us with major challenges a few years ago. We had to contend with considerable service problems, as local support was no longer offered in Germany. This made us realize that we had to set up our image data management independently of our PACS. Our focus was therefore on migrating our long-term archive away from the PACS and into the cloud.”
3. When you look back on your decision to use a cloud solution, how would you rate it today? What positive changes have you noticed?
Dr. Henning Janßen: “Of course, we also had initial investment costs for this solution and the running costs are not insignificant either. However, we can now map our data growth more easily and no longer have to invest in new storage systems. We have also decided to share digital X-ray images of our patients in future using QR codes instead of CDs. This is a very important point for us, where the advantages of this cloud solution will come into their own. In addition, importing third-party images via the importer software is already working very well for us.”
4. In your opinion, what needs to happen at a political level to ensure that digital innovations are used even more in radiology and hospitals?
Dr. Henning Janßen: “In my view, image transmission needs to be standardized throughout Germany. At the moment, every hospital is building its own solution. Every hospital currently has to connect to countless different radiology networks - a lot of money is spent on transporting data. In my view, image transmission should be supported nationwide by the telematics infrastructure and be uniform and standardized. One example of lengthy decision-making processes in Germany is the ePA. I find it increasingly frustrating that we are in such a bad position compared to other countries. Another example is the much-discussed patient portals. Here, too, a standardized nationwide solution would make many things easier and significantly minimize the costs and effort involved in connecting the various portals.”
5. How do you think radiologists, clinics and SaaS providers can work more closely together to meet the challenges of digital imaging and promote future-oriented healthcare?
Dr. Henning Janßen: “We want practical and uniform principles from politicians. Then manufacturers and operators can follow suit.”
Unfortunately, our PACS manufacturer presented us with major challenges a few years ago. We had to contend with considerable service problems as local support was no longer offered in Germany. This made us realize that we had to set up our image data management independently of our PACS.
Dr. Henning Janßen, Bremerhaven-Reinkenheide Hospital
The radiologist: Dr. Peter Pickel
Dr. Peter Pickel is a specialist in diagnostic radiology at Rhinish Radiology Cologne-Suelz.
The Rhinish Radiology has two locations - the original location in Bernrather Street in Cologne-Suelz and a second location in Cologne-Porz in cooperation with the Medical Care Center there. The practice has been managed by Dr. Pickel since 2016 and together with his partners Dr. Becken and Dr. Kasemian since 2023. In addition to magnetic resonance imaging and computed tomography, the practice's range of services also includes digital mammography and high-resolution sonography.
1. What challenges or bottlenecks did you encounter in your day-to-day work before you opted for a cloud solution?
Dr. Peter Pickel: “Before using the cloud, the provision of image series was sometimes significantly delayed. As a result, workflows sometimes got stuck regardless of the patient. My employees need the preliminary examinations to be able to carry out new examinations properly. If these are delayed, this is not a problem for knee examinations. However, they are absolutely essential for abdominal examinations.”
2. Was there a particular moment or situation that made you realize that a change was inevitable?
Dr. Peter Pickel: “It had been clear to me for some time that cloud solutions were the best option for us. However, we had to wait a little before we could start implementing our concepts because the legal framework was not yet in place. We looked at various cloud solutions early on and found them to be useful, especially when working with different locations and wanting to access images. Therefore, once cloud use was legally permitted, we were able to move quickly into implementation.”
3. When you look back on your decision to use a cloud solution, how would you rate it today? What positive changes have you noticed?
Dr. Peter Pickel: “All processes that have to do with image data have been extremely accelerated. Retrieving and transmitting images is much more convenient than before. Data transport is no longer dependent on individual lines, which saves us having to send data several times from one location to another.”
4. In your opinion, what needs to happen at a political level to ensure that digital innovations are used even more in radiology and hospitals?
Dr. Peter Pickel: “In Germany, we are lagging behind when it comes to digitalization, especially compared to Denmark, Finland or Norway. I would like to see us manage to streamline the paths to more digitalization, without neglecting security, of course. At the moment, however, I'm very happy that we can use cloud-based software - that's the be-all and end-all for me, because we're much more flexible, for example if individual workstations break down. We can then switch to another workstation much more quickly without having to carry out any installations.”
5. How do you think radiologists, clinics and SaaS providers can work more closely together to meet the challenges of digital imaging and promote future-oriented healthcare?
Dr. Peter Pickel: “That can't really be summed up in one sentence. There are many areas that could be improved if the systems understood each other better. The cloud is an important step in this direction. We need more standards and standardization in data communication so that processes work faster and data exchange improves. I like to compare this to the charging cable for cell phones, which now finally fits all devices. If I think of a specific example from my practice, I would like to see the downloading of image data from QR codes work better, for example. This already works very well with your system, but unfortunately not with many others. This would be very important for hospitals in particular, for example for preparing for operations.”
It had been clear to me for some time that cloud solutions were the best option for us. However, we had to wait a while before we could start implementing our concepts because the legal framework was not yet in place.
Dr. Peter Pickel, Rhinish Radiology Cologne-Suelz
The SaaS service provider: Andreas Dobler
Andreas Dobler, is Managing Director of Telepaxx Medical Data, a leading SaaS provider for the management of medical image data in the cloud.
Telepaxx Medical Data GmbH operates the largest cloud-based archive for diagnostic image data in Europe and manages over 25 billion image data for customers in the healthcare sector. The company works with several hundred hospitals and general practitioners in Germany.
1. What challenges do you currently perceive in discussions with hospitals and radiology practices?
Andreas Dobler: “A major issue that we encounter time and again is the extended security requirements stipulated by KRITIS and the NIS-2 directive. Many existing image data management systems cannot fully cover these requirements, which leads to uncertainty. In addition, business continuity concepts are a crucial point. Hospitals and practices are increasingly asking themselves: How do I ensure that I can continue to access image data even if my network is unusable due to a cyber threat? This is not only a technical challenge, but also a strategic one.”
2. What feedback have you received from your customers since they switched to cloud solutions and what positive changes have you observed?
Andreas Dobler: “The feedback has been consistently positive. Many customers report a smooth transition, which is mainly due to the well-thought-out planning and the unchanged continued use of already established interfaces, such as the H7 DICOM integration. One clear advantage of cloud solutions is the improved availability and speed of the data. Their elasticity and flexibility are also rated positively: Users have access to their image data anytime and anywhere. Many clinics also appreciate the fact that cloud solutions relieve the burden on IT departments. This allows the IT teams to concentrate on specific specialist knowledge and strategic projects rather than on day-to-day IT tasks.”
3. In which areas do you still see potential for innovation or improvement in the field of digital image data management, and how does Telepaxx plan to drive this forward?
Andreas Dobler: “Up to now, cloud data has primarily been archived or shared, which often leads to isolated solutions. We see great potential here to integrate more functionalities, such as diagnostic viewing or greater interoperability between systems. Particularly with regard to electronic patient records, the benefits could be significantly increased if data is made available seamlessly between different platforms. Telepaxx plans to address this potential in a targeted manner. We are developing solutions that not only store data, but also actively make it available in diagnostic workflows. Our goal is to make data more usable and interoperable.”
4. How do you see the role of politics? What do you think needs to happen so that digital innovations can be implemented faster and more effectively?
Andreas Dobler: “Political requirements play a central role, but also bring challenges. One example is GEMATIK's telematics platform, which still does not allow image data to be shared across the board. Another exemplary point for innovation is the remuneration of AI solutions. In Germany, these are often not supported financially, which makes it difficult to use them in practice. It would be important for technologies that demonstrably improve care to be reimbursed by payers.”
5. How do you think radiologists, clinics and SaaS providers can work more closely together to meet the challenges of digital imaging and promote future-oriented healthcare?
Andreas Dobler: “The basis for successful collaboration is the consistent use of standards. SaaS providers can play a key role here by providing platforms that facilitate standards-based exchange between radiologists, clinics and other stakeholders. Centralized data provision would be a further step forward. A cross-institutional medical identity would be very helpful for this. It is important that collaboration is promoted through clear regulations and interoperability standards. Radiologists, clinics and providers should work together on solutions that not only address the current challenges, but also create a standards-based, resilient foundation for the healthcare of the future.”
Many clinics appreciate the fact that IT departments are relieved by cloud solutions. This allows IT teams to focus on specific expertise and strategic projects rather than on day-to-day IT tasks.
Andreas Dobler, Telepaxx Medical Data
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