March 2004 Newsbytes

Raymond D. Aller, MD;
Hal Weiner;
Michael Weilert, MD

Visualization technology offers new take on tumors

The National Institutes of Health Clinical Center, in January, installed a cutting-edge three-dimensional spatial visualization system designed to allow users to view and identify tumors more accurately than conventional flat-screen display technology. The system, called Perspecta, was developed by Actuality Systems Inc., Burlington, Mass.

Using special software, the system projects images, such as computed tomography or magnetic resonance imaging scans, into a global display to create 360-degree spatial images. Each image is likened to a sculpture versus a photograph and occupies a volume of space similar to a hologram.

"It’s something you can walk around and appreciate the spatial relationship better because rather than clicking on a mouse, rotating a 3D model that sits on your 2D monitor, you actually just move your head. You can see how the relationships differ between devices and targets, and tumors and treatments, and therapy zones," says Brad Wood, senior clinical investigator for the NIH Clinical Center.

In a study performed by the U.S. Navy, spatial displays were found to provide users with a better understanding of trajectory, velocity, path, and proximity than flat-screen displays.

"That is, people can make decisions with more accuracy and much greater speed in a spatial display than on flat-screen displays or using those 3D virtual reality goggles," says Gregg Favalora, Actuality Systems’ founder and chief technology officer. The company is building Perspecta systems for universities and medical research sites in the United States and Japan.

Favalora says he expects Perspecta to be used widely in catheterization labs and surgical planning suites. The system, however, has potential for other medical uses. "Eventually, the other places we see it having real application is in nuclear medicine, specifically in radiation treatment, which is one of the most complex 3D problems," says Actuality CEO Cameron Lewis.

The spatial imagery created by Perspecta can also be used in biology and microbiology. "You can look at individual cells created by confocal microscopes or examine the molecular scale at individual atoms from standard PDB [protein data bank] data," says Favalora. "It’s amazing."

The NIH Clinical Center has thus far been using Perspecta to view medical data sets, says Wood, but its longer term goal is to develop interactive four-dimensional displays of data sets before, during, and after interventions, procedures, or image-guided therapy.

Government trying to can assorted varieties of spam

CAN-SPAM is an acronym for Controlling the Assault of Non-Solicited Pornography and Marketing Act of 2003, a new federal law that took effect Jan. 1.

If you think the law (available at www.spamlaws.com/federal/108s877.html) will reduce the amount of junk e-mail you receive, think again. Critics of the bill say we’re about to get more junk e-mail than ever. But how bad can it get? According to Brightmail, a leading anti-spam software vendor, almost 3 trillion spam messages were sent last year, and that number is expected to increase significantly. More than 56 percent of all e-mail is spam, the company reports.

The new law prohibits using fake addresses and names to mislead e-mail recipients, deceptive subject headings, and ignoring recipients’ opt-out requests. Companies, however, can still send commercial e-mail if it is labeled as an advertisement or solicitation, provides the recipient with an opt-out option, and includes a postal address.

The provisions of the bill require you to manually opt-out of every spam e-mail message you receive. Consequently, you are forced to view a company’s advertisement to access the opt-out process.

An element of the new law includes penalty payments for spammers, but no one yet knows how quickly or aggressively the government will pursue offenders. The federal law also overrides major provisions of state anti-spam laws, including a California law that would have prohibited unsolicited commercial e-mail. And it directs the Federal Trade Commission to recommend a plan and timetable for establishing a nationwide marketing do-not-e-mail registry.

Will the law be effective? We’ll have to wait and see. According to section 10 of the law, "Not later than 24 months after the date of the enactment of this Act, the Commission, in consultation with the Department of Justice and other appropriate agencies, shall submit a report to the Congress that provides a detailed analysis of the effectiveness and enforcement of the provisions of this Act and the need (if any) for the Congress to modify such provisions." -Hal Weiner

New workbook focuses on clinical decision support

A new Web-based tool, the Clinical Decision Support Implementers’ Workbook, is now available from the Healthcare Information and Management Systems Society.

The workbook (available at www. himss.org/cdsworkbook) is designed to help health care information technology professionals and organizations capitalize on electronic health record systems by implementing clinical decision support solutions. The workbook was written by the decision support workgroup of the HIMSS patient safety task force.

"The workbook is a detailed road map for using clinical decision support to enhance a variety of key outcomes, such as health care safety, quality, and cost effectiveness," says Jerome A. Osheroff, MD, chair of the workgroup and a coauthor of the workbook. "With expertise from CDS pioneers, we developed step-by-step guidelines for those who are responsible for developing, deploying, and evaluating CDS interventions in their organizations to help them best deliver health care."

The workbook makes extensive use of tables and sample worksheets to help implementers of clinical decision support strategies identify appropriate stakeholders in their organizations, develop goals and objectives, select appropriate interventions to achieve those goals, validate and implement the interventions, and monitor and improve their effects.

Bayer Diagnostics licenses Axeda’s DRM software

Bayer Diagnostics recently licensed Axeda Systems’ device relationship management system for the proactive, remote servicing of its Advia Centaur immunoassay system and other laboratory instruments.

The DRM system lets instrument manufacturers monitor, manage, and service intelligent devices deployed at remote customer sites anywhere in the world. Instrument data are transmitted securely via the Internet from remote equipment to service representatives, alerting the latter if a device is operating outside preset performance standards.

The system leverages patent-pending Firewall-Friendly communications technology and network security within medical facilities.

Bayer Diagnostics

Axeda Systems

Missouri to use indexing software for surveillance

Health Language Inc. and the state of Missouri have announced that HLI’s Language Engine software technology will be used to implement concept-based indexing of patient data gathered across Missouri for disease and terrorism activity pattern surveillance.

State officials will collect patient encounter data from emergency rooms and other sites located throughout the state. All data are pooled for statistical analysis. Officials will then use Language Engine software to convert the raw data into information tagged by medical concept.

Health Language Inc.

Dr. Aller is director of bioterrorism preparedness and response for Los Angeles County Public Health Acute Communicable Diseases. He can be reached at raller@ladhs.org. Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at hal@weinerconsulting.com. Dr. Weilert is director of laboratories, Community Hospitals of Central California, Fresno. He can be reached at mweilertmd@communitymedical.org.