The US army constitutes the largest single care provider in the world and is aiming at implementing a network system through PACS in all its six hundred military hospitals in order to view, transport, archive and print medical images. The US Ministry of Defence selected Applicare Medical Imaging, a Dutch software company founded in 1987 and now forming part of an IBM consortium, to provide the workstations technology software for this huge project. Applicare's RadWorks visualisation package is the first one running under Windows NT. This is exactly the environment the Pentagon has chosen to standardise in all of its medical facilities. The multinational competitors still having to deal with their Unix past, the immediate availability of Applicare's technology formed a decisive factor for their final selection, according to the Automatisering Gids and de Volkskrant.
The military prepared their initial request for proposals very thoroughly, as Ruud Kroon, Applicare's managing director explains. The document comprised more than 350 pages and was often revised during the tender process. Two new approaches struck at once: the solutions had to be commercially off the shelf (COTS) with a minimum of customisation whereas the demands in terms of functionality and performance outstripped all the disposable applications. The Pentagon was willing to take in account a certain degree of development and growth but the participants clearly had to outline what was present and what not as well as how and when the missing links would be provided.
Apparently, the highlights in Applicare's RadWorks medical imaging package respond harmoniously to that need. In the image acquisition, there are modules for film digitising, frame grabbing, document scanning and graphics file import, windows clipboard input and input from Twain 32 supporting devices, allowing almost any monochrome and color image to be imported into RadWorks and through this into the Dicom environment. The viewing capabilities include cut- and scoutlines display, an auto windowing tool, magnifying glasses, post processing filters and various additions to measurement and annotation tools. On the fly printing is done through a graphical layout pool and a virtual filmsheet.
All media supported by Windows NT can be used for archiving data which are written in the Dicom 3.0 part 10 format. In the near future, an index tool will facilitate the building of a large index of patients or studies. A combination of RadWorks with Microsoft's free NetMeeting transforms the system into a telemedicine workstation with videoconferencing and whiteboarding possibilities. Wavelet and Dicom JPEG compression enable the transport of a few images at once. In this way, teleradiology proves its efficiency in emergency situations. RadWorks viewing and teleradiology had already been used in an independent Beta test, conducted by the US Navy, and were installed at various Navy bases, the National Naval Medical Centre at Bethesda and on aircraft carries for ship to shore communication.
Finally, the proposed integrated IBM solution comprising Applicare's software package, went successfully through a series of grueling tests by the military team. Therefore, managing director Ruud Kroon expects Applicare to receive offers from civil US hospitals as well and is fully aware of the fact that his development staff will have to be doubled to cope with the enormous workload the project has in store. On the other hand, everybody is now starting to court Applicare Medical Imaging so that its turnover is bound to increase at rapid pace to unknown heights. Perhaps even the sky might not be the limit for this bold and beautiful dwarf who came out of the Zeister woods to conquer the Pentagon. Read more about this remarkable event at the Applicare Medical Imaging web site.