Business Impact Article - Posted 10/12/2007

Views: 450

Rate This Evidence:

Vital Images

Vital Images Solution Costs Less than Traditional Medical Tests, Helps Save More Lives

Susan Sartor liked to go for walks on weekends. She liked to work out at the gym. She thought she was leading a perfectly ordinary life. And she was. Until the day she collapsed on the floor of her mother’s kitchen.

Paramedics rushed Sartor to Abbott Northwestern Hospital in Minneapolis. Doctors labored to slow a heart that was beating, as one doctor later described it, “way too fast.” Eventually they were successful. But that left them with a mystery they needed to solve immediately: what had caused the fainting spell and racing heart—and what could they do to prevent a fatal reoccurrence?

Traditionally, the next step might have been a cardiac catheterization, in which doctors make an incision in the patient’s leg, snake a catheter into an artery and up the patient’s body into the heart, squirt radioactive dye into the heart and surrounding arteries, and take x-ray pictures to attempt to identify the problem. The procedure is as invasive as it sounds—and not always successful. One out of every 200 patients who undergoes the procedure dies as a result.

Whatever the doctors were to do, they’d have to do it quickly and effectively if Sartor were to take another of those weekend walks.

The challenge facing Sartor and her doctors faces six million cardiac patients throughout the United States every year, and millions more around the world. For the typical patient arriving in an emergency room with chest pains, it takes 20 hours to arrive at a diagnosis, when every second can mean the difference between life and death. It also takes U.S.$25,000 per patient, a tab that runs to tens of billions of dollars for the U.S. healthcare system each year.

Until now. Among the many high-tech tools that are changing medicine today is an advanced imaging solution from a company called Vital Images, based in Minnetonka, Minnesota, that gives doctors the equivalent of Superman’s x-ray vision: without exploratory surgeries or catheters, doctors now can see a patient’s internal organs—not just the heart, but the brain, stomach, lungs, and virtually any other internal body part—with unprecedented clarity. Unlike shadowy x-ray films or two-dimensional color sonograms, the Vital Images solution uses color and shading to produce truly three-dimensional pictures that can give a patient’s entire medical team—and not just a radiologist trained to look at such pictures—an instant understanding of the patient’s condition.

The solution’s built-in intelligence shows only the organs that the doctors want to examine, eliminating confusing, overlapping images of adjacent organs that can obscure relevant detail. They can see tumors, polyps, or other abnormalities too small to be easily captured with previous systems. Doctors can see the extent and type of blockage in an artery, enabling them to decide if a patient needs emergency surgery—or merely a prescription for Lipitor. And the images even go beyond three-dimensions to portray images in four dimensions, including the dimension of time: For example, doctors can observe the beating of the heart.

Dr. John Lessor, Minneapolis Heart Institute, Abbott Northwestern Hospital, credits the Vital Images software with helping to save the life of a patient “because it allowed us to see the critical information that we could not see with her invasive angiogram and echocardiogram.”

“By doing a cardiac CT [computed tomography] scan and putting that data into the Vital Images software, we were actually able to see parts of her body in motion,” recalls Lessor. “We could make the diagnosis and send her to surgery immediately. She survived as a result.”

This technology is truly revolutionizing medical practice. It’s allowing things to be seen that have never been seen before. Dr. Robert Schwartz Minneapolis Heart Institute, Abbott Northwestern Hospital

To accomplish this feat, the Vital Images solution uses images from standard CT, magnetic resonance imaging (MRI), and positron emission tomography (PET) scanners, but in a new way, using built-in software intelligence that assembles thousands of separate, two-dimensional images to create the three-dimensional image; interprets the result and adds color and shading to make the images more meaningful and immediately understandable, and quickly displays the result so doctors can get to the business of saving lives.

The Vital Images solution also builds on a range of technology innovations of the past few years. For example, today’s high-powered scanners can take thousands of images in seconds; a decade ago, scanners required a minute or more to take just a few hundred images. Graphics hardware built for computer games can be used to help present medical images more quickly and effectively. And 64-bit computing has increased the power of popularly priced computer systems, enabling them to process the vast amounts of information—up to a terabyte or more—that the solution uses.

“Without these advances in hardware and software, we wouldn’t have the immense throughput we need for these three-dimensional images,” says Schwartz. “And imaging solutions like this wouldn’t be possible.”

Michael Meissner, Vice President of Engineering, Vital Images, also credits the Microsoft® software on which the Vital Images solution is built. The solution runs on standard Windows®-based computers, was built quickly and cost-effectively with Microsoft development tools, and takes advantage of the latest Microsoft .NET technologies to present images and communicate with other computers (see "Under the Hood" below).

“IT departments at hospitals and medical centers love it when we come in and say that they can run this solution on the Windows computers they already have,” says Meissner. “In the past, powerful imaging solutions have required expensive, proprietary hardware and software. No one wants to deal with that any more. Because this solution is built on Microsoft technologies, they don’t have to.”

The combination of Windows-based technologies and the availability of high-bandwidth Internet connections also enables the Vital Images solution to work over tremendous distances. As a result, doctors can view patient images from home, saving the precious time it might otherwise take for them to get to the hospital on short notice. Specialists in distant cities can be consulted on complicated cases, adding insight to which a patient’s doctors might not otherwise have access.
 
For example, a 20-bed hospital in rural Wisconsin uses the Vital Images solution to send images over the Internet in seconds to a large Minneapolis hospital when the local doctors want a consultation.

“Given the vast numbers of patients subjected to invasive tests each year, the potential savings to the healthcare system from a solution like this is huge,” says Jay D. Miller, President and Chief Executive Officer, Vital Images. “We’re talking about the potential to save tens of billions of dollars.”

One of the lives that the Vital Images solution has already helped to save is Susan Sartor’s.

 “Vital Images gave us the answer to Susan’s condition pretty much immediately,” recalls Schwartz, one of her doctors. “It told us exactly where the problem was. Susan had an extremely rare heart defect, an artery that came off in the wrong direction.”

“We avoided an invasive angiogram and defibrillator that she didn’t need, made the right diagnosis, and got her into surgery,” continues Lessor, who was also part of Sartor’s medical team. “That’s the reason she’s alive today.

And Susan is far from the only one who’s benefited from this solution. Vital Images’ solution is one of the most important clinical tools we have.”

Under the Hood
Vital Images built its solution using a range of state-of-the-art Microsoft technologies. The Microsoft .NET Framework 3.0—the latest version of the Windows component that provides a programming model and runtime for Web services, Web applications, and smart-client applications—contributed several key technologies. Windows Presentation Foundation, for example, made it easy for Vital Images developers to create the highly visual presentation of information that is the core benefit of the solution. Windows Communication Foundation enabled the rapid communication of the vast amounts of information that make up the images.

In addition, development work on the solution was expedited by the use of Microsoft Visual Studio® 2005, which streamlined and automated much of the development process, and Microsoft Office SharePoint® Portal Server 2003, which enabled Vital Images developers to collaborate more quickly and easily.

To manage the massive databases required for the solution, Vital Images turned to Microsoft SQL Server™ 2005 database software on the computer servers that build the images, and to SQL Server Express Edition on the personal computers that run the images locally for doctors and other healthcare professionals.

Learn more about Vital Images at:
www.vitalimages.com

Learn more about Microsoft resources for ISVs at:
www.microsoft.com/isv