by Christopher Crosbie MPH, MS and AWS Partner Network (APN) Solutions Architect
As a Healthcare and Life Science-focused Partner Solutions Architect, I have an opportunity to meet with a variety of APN partners who are using cloud computing to enhance the healthcare and life science industries. I also gain insight into the way our APN partners and customers make use of cloud technologies in the health tech field by attending key industry events.
For more than 100 years, Radiological Society of North America (RSNA) has hosted an annual meeting to bring together an international community of radiologists, medical physicists and other medical professionals. This conference presents the latest developments and upcoming innovations in the technically advanced field of radiology imaging. It’s a great place to first learn about upcoming enhancements to the healthcare industry.
Massive file sizes and long retention rates have made the cloud an attractive storage option for radiology IT. The shift away from traditional storage systems has been subtle in the industry thus far, but it’s certainly not new. Radiology vendors have seen the benefits experienced by industry leaders such as Philips Healthcare, who have already embraced and succeeded in the cloud.
Nevertheless, this year’s RSNA conference seemed to be a turning point for the cloud storage option in radiology equipment—for the first time, the cloud seemed to be a ubiquitous storage solution option throughout the innovations and developments presented at the conference sessions. Now that “cloud-ready” storage equipment is reaching clinical users, the industry is beginning to see cloud-native applications built on top of imaging data that unlock information in ways not previously anticipated or even thought possible.
One of the leaders and most innovative companies unlocking the potential of cloud-stored imaging data is AWS Partner Network (APN) Advanced Technology Partner and AWS Healthcare Competency Partner Calgary Scientific with their ResolutionMD application. This technology is built on top of the PureWeb software platform that provides advanced web, mobility and cloud enablement solutions for industries looking for secure access to their data or graphics-intensive applications while continuing to use their existing systems.
When Calgary Scientific demonstrates its products at conferences like RSNA, the presentation starts with a very high-powered server directly connected to the conference environment. The presenter then switches from the local server and does the same demo using AWS and asks the audience, “Did you notice a difference?” The answer is always a resounding, “No.” With no degradation in user experience, the discussion turns to the benefits that cloud and AWS offers clinical users.
I wanted to learn more about ResolutionMD and how Calgary Scientific was able to migrate this highly compute-intensive, complex and yet responsive application over to AWS, so I sat down with Dan Pigat, VP Products—Cloud and Collaboration, Calgary Scientific. However, my line of questioning on complex system migration was quickly cut short when Dan chuckled at my premise and informed me that their migration to the cloud was simple: “It just worked.” So Dan and I began to discuss the impact of cloud capabilities on end users in the many industries Calgary Scientific serves.
About the PureWeb software platform
To understand the success of Calgary Scientific’s ResolutionMD, it’s important to know the history of PureWeb, the software underlying the ResolutionMD technology. Dan took me through a quick crash course.
The PureWeb SDK came into existence soon after the launches of AWS (March 2006) and the Apple iPhone (June 2007). “In a way, these three technologies have grown up together,” Dan said. “Our focus was on adapting existing 2D and 3D applications to run on the cloud and then access them on any web browser or mobile device, connecting these two worlds.”
The initial target for this software was the medical industry—a sector with the most rigorous demands for access, visually rich data, privacy, security and scalability. The ResolutionMD product was developed on top of PureWeb to provide clinical grade medical imaging to the mobile world. Clinicians can use it on web and mobile devices to access the same quality medical imaging that historically was only available on expensive equipment in hospital and laboratory settings. ResolutionMD is FDA-cleared and gaining fast acceptance in the industry, with Calgary Scientific having established more than 50 partnerships with companies like Siemens, Fuji and McKesson due to ResolutionMD’s seamless connectivity into existing Picture Archiving and Communication Systems (PACS).
The PureWeb software platform has recently been expanding into new industries such as design, manufacturing and energy. Despite the vast differences between these industries and their underlying technological needs, “their trajectory with cloud adoption is surprisingly similar,” Dan tells me. He sees a lot of parallels in their use of the cloud’s capabilities.
Moving from expert opinion to interactions
The role of a radiologist is often stereotyped as a solitary one—an expert sitting in a dark hospital basement reviewing images on specialized monitors who then creates reports for physicians. While this representation may be an exaggeration, radiology does diverge from other medical specialties in that it depends entirely on visual perception. Communication of the diagnostic interpretation is, therefore, a critical component of the radiologist’s expertise. Failure to communicate their findings accurately is the
fourth most frequent allegation against radiologists in medical malpractice claims.
“With today’s technology, we can connect everyone to the same tools and data plus provide better ways to communicate,” Dan said. Radiology does not need to be a secluded art. By leveraging cloud technology through applications like ResolutionMD, physicians can use their iPads, Android phones or any web browser from wherever they happen to be to review images alongside radiologists in real time. “This collaboration generates better interpretations and diagnosis,” said Dan. The same images can even be shared with patients on their own devices. This access, in conjunction with an expert clinical team, enables patients to be direct participants in the management of their own care.
This democratization of the data is not limited to the field of radiology. Dan goes on to explain that he is seeing similar excitement and potential from the manufacturing and construction industries. Colleagues on distant ends of a project can use the cloud and PureWeb to access Computer Aided Design (CAD) files in the same way images are now available in healthcare. CAD drawings have evolved from being one expert’s view on a project into a conversation between designers and those on the manufacturing floor or job site about how to best adapt designs into the real world.
Dan is reminded of a conversation he once had with a construction customer who was frustrated with the number of times the acronym, V.I.F. (a shorthand for Verify In Field), showed up on CAD drawings. “He was excited that cloud technologies morphed those V.I.F.s into a collaborative discussion in which all the stakeholders could contribute to finding the best possible project design,” he said.
Unlocking the data
The story of cloud and imaging may have started with a need to simply “put the data away.” With more capable CT and MRI scanners producing ever-larger files, data storage can be a daunting challenge. Many hospitals reach a saturation point where they need to move data to the cloud simply to meet requirements, such as retaining Medicare managed care program provider records for 10 years.
This essential requirement of storing the data cheaply and securely is being met with cloud services such as Amazon Simple Storage Service (S3) and Amazon Glacier. Not only are these more cost effective options, but applications like ResolutionMD can open and enable full diagnostic reads of these studies directly from the cloud. The data is no longer locked away in offsite locations or on backup tape; cloud storage keeps this data accessible and available.
Dan’s excitement over what PureWeb customers are doing with this newfound ability is apparent as he lists applications that range from monitoring cancer tumor growth to tracking changes in oil and gas reservoirs. “We’ve only just started to uncover the myriad of opportunities available with these technologies,” he said.
Focus on the humans
As I asked Dan for some closing thoughts, he reminded me to focus on the end user and to try not to solely get wrapped up in the cool details of the technology itself. This resonated with me, as I’m admittedly a technologist who finds himself quickly enthralled by the underlying workings of the technology innovations that AWS drives.
However, Dan also had very good reason to present this reminder. He took me back to the early days of the cloud and PureWeb, when access over a network was slower than their dedicated systems. Dan says that many of the technologists at the time were disappointed by this and somewhat dismissed the cloud as an alternative. The clinical users, on the other hand, absolutely loved the technology. Even though interaction was slower on a mobile device, that time was nominal compared to alternatives such as driving thirty minutes to the hospital to respond to a page, which can cause a critical difference in care.
As the technologies have matured, Dan believes we’ve actually crossed a tipping point where large files rendered by powerful remote GPU’s can actually outperform local rendering on lower spec PC’s. But it’s still about people and giving them better access to the tools they need to do their jobs.
The result of this progress can be measured with examples like ResolutionMD, which provides significantly faster image access compared to standard of care image viewers. While this is possible due to advances in Amazon EC2 GPU instance types and web standards, we need to look at the actual impact on patients. Dan references a study done by a major healthcare institution which verified that the use of ResolutionMD on mobile devices resulted in an average 11 minute reduction in time to diagnosis for critical groups of patients (such as stroke victims where time equates to brain loss). With results like that, the impact of cloud and mobile technologies in healthcare becomes very apparent.
Speaking with innovative APN partners like Dan of Calgary Scientific makes me anxious for the exciting shift that is taking place with AWS and our APN partners across all industries. If recent innovations in radiation imaging technology are any indication, the future for both imaging and healthcare technology is extremely bright.