IBM helps deliver smarter health care with web-based 'Radiology Theatre'

Armonk 13 March 2009IBM is working with Brigham and Women's Hospital of Boston on a research project to create an on-line "Radiology Theatre" where teams of medical experts can simultaneously discuss and review patients' medical test data using a web browser. IBM has created a secure website that allows select medical experts at Brigham and Women's Hospital to "make rounds" on a patient - no matter where the doctors are located. Data such as CT scans, MRIs, EKGs and other medical tests can be posted on the website and analysed by the team. Each medical expert can talk and be seen through live streaming audio/video through their standard web connection, and have the ability to whiteboard over the web page as well as input information to the patient's record.

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A group of doctors can log into a secure website at the same time to review and analyse a patient's recent battery of tests. For instance, a radiologist could use her mouse to circle an area on the CT scan of a lung that needs a closer look. Then using the mouse she could zoom into that scan to enlarge the view for all to see. An expert on lung cancer could use his mouse to show how the spot had changed from the last scan. And then, a pathologist could talk about patient treatments based on spots of that size depending on age and prior health history, paging through clinical data accessible on the site.

The theatre allows all these experts to discuss, tag and share information simultaneously, rather than paging through stacks of papers, calling physicians to discuss scan results and then charting the results. This collaborative consultation brings together the personal data, the experts and the clinical data in one physical, visual theatre.

Dr. Francine Jacobson, thoracic radiologist at Brigham and Women's and assistant professor, Department of Radiology, Harvard Medical School, stated: "The medical community is at a crossroads. We realize the effectiveness of individualized medicine but the increasing volume of data stored in multiple electronic medical record systems makes it progressively harder to correctly select the information required for each patient care episode as well as share that information with other physicians or care providers. We need a better way to record information, organize it, access the stored patient data and then collaborate. We see the Radiology Theatre as an electronic metaphor of how to deal with the explosion of information."

What also stands out in the Radiology Theatre is that the software only requires a standard web browser. There's nothing to download and it's built with open web standards. That means a doctor can be at any location using a laptop, mobile device, or other desktop to collaborate with colleagues and confer on results.

"Our focus in building the Radiology Theatre was to connect existing visual and clinical information so experts at Brigham and Women's Hospital could make faster, better decisions together", stated Rod Smith, vice president, IBM emerging technologies. "Using the browser as a platform, IBM is exploring a new wave of smarter web applications to address the most pressing societal and business issues."

Dr. Jacobson is currently using the Radiology Theatre to review together the visual and non-visual data gathered in the "Risk Factors for Chronic Obstructive Pulmonary Disease (COPD)" project funded by the Flight Attendant Medical Research Institute (FAMRI). Grouped viewing of CT data, pulmonary function tests, second hand smoke exposure, nutrition, and other risk factors provides a novel method for searching for subtle correlations between non-pathologic CT findings and risk factors for COPD.

The Radiology Theatre has the potential for tapping experts from all over the world to consult on cases. Multi-discipline and potentially multi-institutional data could be brought together in the theatre. Using telepresence provides "just-like-being-there" live virtual meetings with sight, sound and interactive web experiences. The theatre has the capability to be used as an educational archive of medical cases for teaching conferences. The theatre can act as an electronic whiteboard of information for experts to comment on or update.

IBM researchers have combined different web components - data mash-ups, high-definition video, audio and graphics - all on the same browser page. Called Blue Spruce, this technology allows multiple users to "cobrowse" or interact with these components in real time and see each others' changes. All of the components are live and all participants can cause change that will be propagated in a secure manner.

Behind the scenes, the Radiology Theatre website is hosted by an IBM secure software server, which provides the conference management, application synchronization and subscription to push services. IBM built the Radiology Theatre using the WebKit Open Source Browser Engine and IBM's Blue Spruce prototype code. Right now the server runs on Linux or the MacOS X operating systems. The browser can be Safari or Internet Explorer. The application uses the following open standards: HTML, JavaScript, CSS, Ajax, XMPP and H.264. Because the application follows OpenAjax metadata specification, the Radiology Theatre can utilize any web widget. The Radiology Theatre was designed to be utilized in a secure environment.

More IBM news can be found in this VMW issue's article IBM World Community Grid to search for cure for childhood cancer.


Source: IBM

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