SUMMERSIDE, PEI – It always surprises people when they find out that a team of software engineers in Canada’s smallest province is winning large-scale contracts around the world for their advanced healthcare systems. The Carestream Health group, in Summerside, PEI, has emerged as a leading developer of Radiology Information Systems (RIS). Earlier this year, it was recognized for its success, winning an award for ‘fastest market penetration’ from high-tech market researcher Frost & Sullivan (www.frost.com). Recently, the group snagged as customers all of the health trusts in Scotland, and it’s now supplying the RIS for the leading-edge Cedars-Sinai Medical Center, in Los Angeles, Calif. – one of the top acute-care hospitals in the United States. Overall, it now has a base of 600 organizations that are using its RIS worldwide, including 20 sites in North America. The crew in PEI provides ongoing service and support, and conducts leading-edge R&D from the island, working hand-in-glove with the company’s PACS team in Israel and archive developers in France and Rochester, N.Y. For its part, Carestream Health is based in Rochester, where it was spun-off from Kodak.

In May 2007, Carestream was purchased by Toronto-based Onex Corp., which is headed by high-profile Canadian entrepreneur Gerry Schwartz. As worldwide director of RIS research & development David Perry points out, geography is no longer a barrier. Using high-powered telecommunications networks, along with remote control software and simulations, much of the support work can be done from a distance. What’s critical, of course, is the brainpower needed to create the cutting-edge applications. Carestream seems to have attracted that talent, growing from an original core of seven people in the year 2000 to over 55 today. Many of them, notes Perry, are Maritimers who have worked far from home and are eager to return, often for quality of life reasons. “We’ve got people who’ve worked in Silicon Valley, as well as in Ontario and in Western Canada, and they’re coming back with new ideas and skills,” comments Perry. The Carestream Health centre, moreover, has developed its own home-grown expertise. And it uses a software development methodology known as the ‘agile’ system, which allows it to respond quickly to the ongoing needs of current customers, even as it develops new versions of its RIS software. Recently, the company won its first RIS customer in Canada – an independent imaging clinic in Pierrefonds, Quebec, on the island of Montreal. Perry points out that the RIS marketplace – until recently regarded as a mature sector with slow growth – is currently booming, thanks to two important factors. First, new intelligence is now being built into RIS. That’s causing customers in hospitals and health corporations to upgrade, so they can take advantage of these new features.

“There’s a big replacement effort going on in hospitals right now,” comments Perry, explaining that the new generation of RIS have interfaces to scores of hospital systems, such as PACS, laboratory information systems and scheduling systems. He notes that in many hospitals, radiologists have to physically get up and log into different computers to access PACS, let alone lab or other components of the hospital information system. Having the ability to tap into various hospital systems, from a single workstation, is a big time-saver, and can have a dramatic impact on the productivity of radiologists.

“Some hospitals have told us that this feature alone is worth the investment in a new RIS,” said Perry. Carestream Health is currently working on Version 11 of its RIS, which will be ready for market in the fall of 2009. It’s being built on the Oracle database using Microsoft’s .Net framework. Perry explains that .Net is allowing the team to answer the market’s demands for web-based applications, while still including features that aren’t typically found in web-based systems, such as voice-recognition and biometric security.

A second driver of the growing RIS market can be found in independent imaging clinics. These clinics operate outside the walls of hospitals, but typically conduct a huge number of diagnostic exams – about 50 percent of the total number of medical images in Canada. Until recently, they haven’t bothered with PACS or RIS, which have been too expensive for them. However, the prices of imaging systems and PACS have dropped in recent years. Moreover, Carestream Health intends to grab a portion of that market with its Version 11 RIS, which will be available as a hosted application, also known as an ASP. For example, the turnkey cost for a centre doing up to 15,000 exams per year will be approximately $80,000 – software and hardware included. There will be no need for investment in storage or networking infrastructure, as Carestream Health will be able to handle that from a data centre. This should eliminate most maintenance headaches for clinics.

“A lot of clinics simply haven’t had the infrastructure or the support to handle PACS and RIS,” commented Sean Booth, manager of RIS research and development for Carestream Health. “It’s often the doctor’s nephew taking care of the computers at these centres,” he quipped, adding that in these scenarios, there’s no way the radiologists wanted to start supporting advanced hardware and software applications. A hosted environment, however, removes both the barriers of cost and support. “They’ll have no big capital expense up-front,” said Booth.