EasyGrab R1Image based in-OR radiology consultation

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Medical Image Management 2.0Get a firm grip on image based medical documentation

In today’s healthcare performance, accuracy and security are ever growing demands.

The complexity of the medical environment accelerates and the workload grows continuously - by the day. Common methodology as well as daily routines are evolving and being adjusted to new science and technology all the time.

Growing demands on the healthcare provider runs parallel, driven by a more educated, healthier population with higher demands and expectations in life!

The only way to handle this challenge is to ensure streamlined processes in all aspects of the healthcare process. Distributed Medical have put a lot of effort into streamlining the imaging management process, making sure you can adjust to the image related workflow your clinic has today - and in the future!

That is our contribution to the future healthcare environment. Please allow us to introduce - Medical image management 2.0

Image management is a collective term describing the handling of all types of images in your professional environment.

Today’s healthcare environment is cluttered with image producing equipment. Endoscopic units, x-ray equipment, camera units in the OR-lighting or perhaps on the head of the surgeon, ultrasound appliances of various kinds (external as well as in vitro) and so on. Most of these units are used for medical guidance - as an extended eye of the physician.

However, still very few clinics have well established routines for storing images to create a complete and objective report of the examination. This is often not by lack of need or by ignorance but rather due to the fact that there is no structured or automated way of doing so. This is where image management systems makes a difference!

Distributed Medical offers numerous solutions for collecting, storing, editing and sharing medical images in automated, workflow optimized, secure and clinically relevant ways.

Our products are based on the computer network infrastructure already in place in most healthcare environments in combination with tailor made software. This combination makes our products powerful - the ability to move images and video around instantly - over the network - is the one feature that makes it future proof, scalable and a solution that you can grow and evolve with. A software tailor made for medical image professionals makes it suitable for the job!

We would also like to mention that medical image management is our core business. In fact our only business! In fact image distribution is so close to our hearths we included it in the very name of the company...

That is your insurance of our commitment!

Image management

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Image management systems are often based on a few basic feature categories.

Image recordingŸImage reviewŸImage storageŸ

EasyGrab is a medical image solution for capturing, combining (restructuring) and presenting medical images in an automated and workflow optimized fashion. EasyGrab is compatible with most imaging modalities on the market such as single an bi-plane x-ray labs, mobile C-arms, ultrasound and IVUS modalities, guiding systems for endoscopy or intravascular treatment tools, vital data monitors and similar devices.

One of the main features of EasyGrab is the ability to capture images from two or more image sources and combine them together into one single, resulting image (still or dynamic). This can be valuable in complex imaging scenarios (hybrid ORs, angio labs etc.) where multiple image sources present vital information at the same time. In those cases it might be difficult for the operating

The medical image puzzle

physician to take in all of that data at the same time. A combined image is typically easier to interpret and the physician does not have to mentally overlay images from various image sources to get the full picture.

Another way of capturing images with EasyGrab is to activate periodic capture. This feature automatically captures a set of images each n seconds.

An example can be an FFR (pressure measurement graph) captured from an FFR device being overlaid onto the radiology image, resulting in a combined image which is very useful during the treatment as well as for documentation. We reefer to this piece of the puzzle as - to record images.

EasyGrab supports DICOM storage for the resulting images and utilizes MPPS to acquire study data from the main modality. Hence no preparation is needed as long as the main modality has a active study based on a worklist scheduling. EasyGrab can be activated at any moment, if needed, and will seamlessly attach to the ongoing study. This

represents two pieces - to distribute and store images.

EasyGrab does not feature it’s own local workstation software as another DICOM viewer seldom is needed. Any standard PACS workstation can be used to review and edit the captured image material. This piece corresponds to - review images.

The whole solutions stands on a solid, industry fit security model to ensure both staff and patient security, integrity and safety at all times - much of which is regulated by law.

Each of these pieces have received great attention and consideration because we feel that nothing but the full picture is good enough.

This is why we can claim, with great confidence, that EasyGrab is one of few, fully laid out complex imaging environment puzzles!

Please do compare us!

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Reviewimages

Streamline, streamline, streamline!A complete image documentation from your procedure adds a new dimension to your medical documentation. It helps ensure patient security, safety and objectiveness. Often this comes at a cost of extra workload, new preparations, training and added steps to the routine.

We’ve put a lot of effort into making the EasyGrab system as easy as possible to adopt to and integrate in the every day workflow. By using MPPS patient data is automatically retrieved by the system from the ongoing study. By using predefined image combinations with clear text labels on the touch panel interface (such as ‘FFR overlay on frontal x-ray’, etc.) the system becomes intuitive and easy to use. By automatically and instantly sending each resulting image captured to a DICOM facility of choice (PACS or QC station) no extra steps need be taken to assure full image integrity.

Visual feedback of patient data, study data, each captured image and more are constantly presented on the touch panel interface used to maneuver the system.

All of these features together makes up for a product that seamlessly integrates into your existing imaging environment - yet adds a new dimension to your documentation.

Resulting imagesA resulting image is the “the result of combining multiple other images or parts of images into one”.

Minimal invasive workflow

When the system is setup you define a number of resulting images and label them accordingly. Examples of such resulting images could be the frontal x-ray image with parts of the FFR measuring system image overlaid at the bottom of the image (refer to example 1). Anywhere from 1 to 32 different resulting images can be defined in the system and each can be defined as a still image or a dynamic sequence. If a dynamic sequence is defined the total number of images in the sequence as well as the frame rate must also be set.

An example of when a predefined dynamic sequence could be valuable is during insertion (the ‘inflation moment’) of intra vascular heart valves. For such a moment a dynamic sequence of 100 images at the rate of 10 per second can be stored to ensure proper documentation for a full 10 seconds during which the new heart valve fixates. Full attention can be kept with the patient rather that on the documentation. In the event of problems this 10 second dynamic sequence can also be of great value when determining the course of action to take in pursuits of damage control.

Resulting images can have many forms and shapes and can be combined from two or more images source. Common examples are two images placed side-by-side (refer to example 2 and 3) or a more classic picture-in-picture combination where a small version of one image is placed in a corner on top of the second picture.

Examples of common image sources used with EasyGrab are single/bi-plane x-ray labs, ultrasound and IVUS modalities, vitals signs of different kinds (such as FFR), endoscopy cameras and various guiding systems.

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Example 2 - The resulting images might be a side-by-side combination of images that ‘belogs together’ to ensure that a specific moment during the exam is properly documented. Above an x-ray image and it’s corresponding FFR measurement.

Example 1 - A resulting image derived from two image sources. In the above example the frontal x-ray image and part of the FFR device image is combined into one, resulting image by overlaying the FFR graphs onto the x-ray image.

Example 3 - A resulting image in a top-and-bottom combination of images that ‘belogs together’ to ensure that a specific moment during the exam is properly documented. Above an x-ray- and corresponding IVUS image.

Creativity and imagination is the limitVirtually any kind of combination of images or parts of images can be created with the system and endless possibilities and situations can be accommodated with this multi purpose imaging tool.

Common environments for EasyGrab includes (but are not limited to) PCI labs, hybrid ORs, neuro surgeon suits, etc.

A new level of visualizationTake a moment to envision your very own EasyGrab setup!

To further understand and visualize a conceptual EasyGrab setup have a look at the diagram below.

The EasyGrab appliance (which can be a touch panel, desktop or rack mount appliance) marked 1 goes in the OR or examination room. It connects image (video) input from the imaging modality at hand. There is a video input line card

available for just about every type of video signal. The EasyGrab appliance also connects to your network for commun-ication with the other modalities for MPPS and the PACS for storage.

The existing PACS workstations, marked with a 2 typically located in the radiology department is your primary review tool for the images created with Easygrab.

The resulting image captured with EasyGrab are stored along with other images created by other modalities in the ongoing study. The PACS (marked 3 ) can be replaced with a QC Station for local review and diagnostics if that better suits your particular setup and needs.The system is tested with most major PACS solutions in the market (incl. but not limited to Sectra, GE, Agfa, Visus, Lexmark etc.).

Conceptual overview

Data center

DICOM based PACS for centralstorage of all radiology images 100Mbit Ethernet

network switch

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Conventional PACS Viewer from PACS vendor.

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Radiology department

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Example EasyGrab setup

Mobile C-arm

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Ultrasound or IVUS

EasyGrabTrolley mounted on

touch panel platform

Endoscopiccamera

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image signal

Digital or analogueimage signal

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Whether you prefer rack mount, desktop or panel PC packaging - the choice is now yours! The choice of platform usually depends on the need for mobility etc. Regardless of which model of the platform you choose it is fully CE-MDD classified and meets all general requirements for clinical use.

All hi-tech products has some important specifications. Here are ours!

Vendor independent in relation to image ŸsourcesAccepts signals from comp. video (CVB), ŸS-video (Y/C ), comp. video, VGA, SDI, HD-SDI, 3G-SDI, DVI and HDMI inputsImage input supports SD (768x576 pixels) Ÿor HD (up to 1920x1080 pixels)The image input can be captured at full Ÿ

Technical specifications

Rackmount Desktop Panel

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resolution 1920x1080 at 60 fps. but limitation in the modality or equipment may apply

Ÿstorage Diagnostic quality video encoding to Ÿensure artifact free image quality (h.264 transfer syntax)Touch panel user interface with foot Ÿpedal or mechanical button for capture as an accessory

Local image buffer built in for temporary

Full CE-MDD Class 1 compliance Ÿ(hardware and software)Full DICOM and MPPS complianceŸSetups available in desktop, rack mount Ÿhousing to meet comply with different installation scenariosPower consumption 95 - 400 w (dep. on Ÿmodel)Physical dimensions W:450 - 650 mm. ŸH:220 - 450 mm. D: 120 - 600 mm. (dep.

Device

To best accommodate all different needs EasyGrab is being offered in a choice of touch based panel, desktop or rack mount housing.

With the desktop and rack mount unit a separate touch panel for interaction and visual feedback from the system is needed. This panel can be any touch capable monitor of your choice with a minimum resolution of 1920x1080.

With our touch based panel housing a mobile, trolley mounted setup is possible to create if desired. With the touch based panel housing a limitation of two image sources apply.

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