Bochum, 17 January 2012 – Number of customers: up. Revenue: up. Strategy: successfully implemented. Outlook for 2012: very positive. That is the VISUS fiscal year 2011 in a nutshell. “In Germany, we saw strong demand from all customer categories – hospitals, single practices, practice groups and screening units. We not only grew our customer base but we also extended and expanded cooperation with existing customers. The technical platform used by Teleradiology Network Ruhr plays a major role in our future-oriented growth strategy. Is has been in full operation since 1 January 2012 and is now regularly being used by the 35 members of the network. We were also able to increase both, revenue and number of new installations outside of Germany – despite the international financial crisis. Our partners throughout Europe and the OEM business for OR management solutions contributed immensely to this success“, summarizes Jörg Holstein, Managing Director at VISUS.

In demand: image management outside radiology
In Germany the demand from radiology environments remains strong. But particularly last year’s MEDICA has shown a clear trend towards image management outside radiology – termed PACS II. “In addition to PACS migrations, several large dentistry departments at university hospitals were equipped with our solutions. Thanks to our product philosophy – JiveX for radiology, full image management, mammography screening and teleradiology – we are positioned excellently and benefit from this trend“, says Guido Bötticher, Sales Director Germany. “Our customers confirm that our solutions are scalable, that they are easy to manage and that we offer good service.“ 

In 2012, VISUS will continue to grow its business in Germany. “But what is most important to us is that we continue to provide first-class service“, Bötticher emphasizes. This is the foundation for future PACS II installations and for further expanding market leadership in mammography screening. Another major objective is the implementation of new solutions such as 3D Volume Rendering, vessel tracking and image data registration with requantification.

International contender: PACS II
Internationally as well PACS II is playing an increasingly important role. Particularly in countries with high PACS coverage the focus is on image management outside radiology. Case in point: Maasstad Hospital in Rotterdam. “The 600-bed facility is fully digitized and paperless. JiveX is being used in all departments as Enterprise PACS. It is linked to more than 160 imaging devices and to the radiology PACS of a third party vendor. More than 200 000 examinations per year are being managed and archived with the help of JiveX and even legacy paper files are scanned and transferred to our product”, says Peter Rosiepen, Vice President International Sales and Business Development.

 
Integration in comprehensive image management solutions requires DICOM capabilities of medical technology devices, for example electrocardiograms (ECGs). “Our JiveX ECG Modality Gateway obviously meets an urgent need of hospitals and manufacturers. It ensures smooth integration and storage of vital data and offers specialized measurement and analysis tools”, explains Rosiepen. 

As far as the European strategy is concerned, in 2012 VISUS will focus on its successful JiveX Enterprise and on central archiving solutions. Moreover, Austria and Switzerland will be launching mammography screening programmes this year.

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Bochum, 28 September 2011 - radprax Group, an association of medical care centers and radiology, nuclear medicine and radiation therapy practices, encompasses 45 specialist physicians and 250 highly qualified medical-technical staff at 14 sites in the German cities of Wuppertal, Solingen, Hilden, Düsseldorf, Münster, Arnsberg and Meschede. "From the very beginning it has been our aim to establish one of the most modern practice groups in Germany. Consequently, at all sites we offer state-of-the-art equipment as well as the best diagnostic procedures and therapies", says co-managing director Dr Heiner Steffens.

Since in addition to the medical technology equipment it is the IT infrastructure that contributes significantly to top quality patient care, radprax Group updated its current information system: as of 1 July 2011 the team uses JiveX, the PACS solution by VISUS. "The system was integrated into the iSOFT RIS and linked to the hospital information systems by systema and Agfa HealthCare that are being used by three of our hospitals partners", explains Marek Stefanides, Director of IT at radprax Group. The complexity of the project did not faze VISUS and Stefanides is highly pleased with the outcome: "Everything was on schedule and on 1 July eleven of our sites started working with JiveX. Installation went smoothly and in cooperation with VISUS we were able to master all challenges along the way such as training our staff and parallel implementation in the different practices." The practices now use a real multi-site PACS in which user profiles, image data, image status, etc. are continuously synchronized. "In order to enable seamless access to older images we migrated about 68.5 terabyte of legacy data from the old PACS", adds Dr Alexander Klemm, PACS project manager at radprax.

Moreover, radprax introduced another innovation: the PACS was not purchased but is operated by VISUS and radprax uses the so-called application service for PACS (ASP). "The radiologists pay a monthly fee based on the data volume. This pay-per-use model includes service and maintenance. The advantages are obvious: no investment and no tied-up capital but full flexibility and payment that reflects usage", explains Guido Bötticher, Head of Sales Germany of the Bochum-based IT service provider VISUS. The eleven sites that are currently linked to the PACS generate approximately 200.000 examinations with a total data volume of one terabyte per year. Silent Cubes by Fast LTA take care of the Group's long-term archiving needs.

"The new PACS complies with all data protection requirements. Together with the centralized structure it offers many advantages for both physicians and patients. Due to the system's multi-client capabilities earlier images can always be integrated into the diagnostic process - independent of location - which avoids unnecessary second examinations. Radiologists and radiation therapists exchange information on previous examinations and radiation therapy sessions and can easily set up a tele-conference to discuss complex cases", says Dr Steffens underlining the benefits of the software update. 

Bochum, 18 May 2011 - As one of the first PACS providers the Bochum image management expert VISUS integrates the three-dimensional visualization solution into the workflow of its system. For example, in JiveX users can generate 3D volume rendering (VR) images in any number. "The 3D representation allows to visualizing complex information, such as the size and position relationship with complicated fractures," says Dr. Marc Kämmerer from the product management of VISUS.

Another new feature in JiveX is the registration for which images of different modalities across studies may be mathematically compared and displayed parallelly at the same place. "This ensures that for finding the doctor gets presented the comparative examinations on the same anatomical site," says Dr. Kämmerer. With the additionally selectable combination with requantization different layer thicknesses are adjusted or geometric inequalities compensated - through a recalculation of the images.

In addition, highly specialized clinical applications such as vascular analysis with segmentation, measurement and reporting are integrated in the JiveX finding surface. This now allows a detailed vascular analysis with the creation of 3D views as part of the diagnosis directly on any PACS workstation.

All functions are embedded directly in JiveX, so that the user can compare tomograms and volume representations across studies and modalities. These can automatically be synchronized. The doctor, for example, may access via cursor positions in different section planes and sees in parallel the position in the volume - or vice versa. The usefulness of the study is increased by overall studies synchronization. This makes it possible to compare previous images in 2D and 3D with current images and to retrace, for example, the courses of diseases more accurate.

VISUS JiveX not only offers the functionalities in a system they can also be defined individually as workflows in form of hanging protocols. By incorporating them into JiveX the hospital can make available the clinical applications to any doctor on his workplace. This eliminates the time-consuming walk to a specific workstation. Workflows can thereby be made more efficient. 

Bochum, 30 March 2011 - Modern image management has to acquire, communicate and archive image data as well as videos, no matter whether in the DICOM or Non-DICOM format. Besides radiology this includes also the endoscopy, sonography, cardiology, and wound documentation. Here data originate in the PDF or JPEG format.

This comprehensive management platform for all picture-related processes in the hospital is made available with JiveX by VISUS. Basis is the consistent use of the DICOM standard and the IHE profiles. The archiving according to X-ray order for the radiological image data and a logical separation of the picture areas, software-supported by JiveX, are as guaranteed as the licensing according to the Medical Device Directive for the overall system.

The Catholic Hospital Union (KHV) Weser-Egge, a group of four acute care hospitals in Höxter, Bad Driburg, Steinheim and Brakel, has gradually built up this image management platform during a 18-month routine phase. "We wanted to create a central image management which really integrates all image-giving systems. Besides, a central infrastructure and uniform communication ways should be set up. We hope to gain the grouping of investments and an easy integrating of new systems from this DICOM platform", says the head of IT Thorsten Krian.

Till this day, beside the radiological departments of four houses, are integrated an external X-ray practice, a medical care center and a nuclear-medical practice. Also the cardiology and the internal medicine communicate and archive their images in the central picture management system. Besides, the endoscopes are integrated via Frame-Grabber (Analog Modality Gateway). The radiation therapy is integrated by the module JiveX DICOM-RT. In addition, the image management platform offers a clinic-wide DICOM-Worklist, also for the functional departments beyond the radiology.

"By the new strategy many advantages arise for us", is Krian contented. "We can integrate all modalities, even if they are not DICOM-capable. All data, no matter from what system, is stored in one place. We work on a data bank and have to administer only one system." And regardless from which sources the image originally comes, VISUS offers a uniform system-covering Viewer. Thus the image management platform becomes the central access point to all image data in the clinical workflow. It is integrated via a call interface into the KIS and creates a quick access to all information in an operating surface for the users. "Now after the good experiences so far we go on with the integration of the image-giving departments and connect the sonography as well as the ECG", Krian looks into the close future.

VISUS, international provider of comprehensive image management solutions, is expanding its commitment in Northern and Eastern Europe. Since August, Timo Aarnio supports the team Sales Management Nordic & Baltic. "With this step, we intend to expand our good market position in the region and ensure an optimal support of partners and projects," said Peter Rosiepen Vice President International Sales at VISUS. Aarnio will support the partners from the office in Veikkola, west of Helsinki, and minister the more than 180 installations in Finland, Sweden, Norway, Denmark, Estonia, Latvia and Lithuania. Aarnio can draw upon over 20 years experience in the field of radiology. After many years with OneMed, the distributor of VISUS in Northern Europe, and after a brief interlude with a provider of healthcare IT he came to the company in Bochum. "We appreciate in particular his expert knowledge and his excellent contacts which he has especially to the greater hospitals," said Rosiepen.

The Vice President International Sales sees Russia as the future market. To establish the PACS solution JiveX there, the distributor European Medical Distribution, who has been active for VISUS for over two years, opened an office in Moscow. "Hospital information systems are already established in Russia, the interest in PACS, however, is currently very high," describes Rosiepen the market in the giant country. "Especially in demand are effective solutions, such as DICOM Mail for fast and secure data exchange as hospitals struggle with particular problems in the network infrastructure." Currently, JiveX runs the certification as a medical product by the responsible Russian Ministry. First potential projects are emerging in hospitals in Krasnoyarsk and St. Petersburg. "With EMD, we see good opportunities, to introduce and establish our image management solution in the growing market of Russia on a long term basis," Rosiepen is sure of.

The electrocardiogram (ECG) is one of the most common examinations in medicine. Thanks to modern data compressing it is possible to reproduce the cardiac streams digitally on a monitor and to assess findings. For an optimal workflow the ECG devices will receive information from a patient information system (eg, HIS) and save the final examinations in a clinic-wide available image management system (PACS). With JiveX ECG based on the communication standard DICOM VISUS integrates ECG devices from the leading manufacturers in the market. The exchange with the hospital information system (HIS) will be established via HL7 interfaces.

Fast and effective finding

Doctors have easy-to-use measurement functions available. In unclear waveforms he can blow up the curve at the push of a button, or select a different display on the screen. Also a comparison with preliminary examinations at the same workplace is not a problem. For example the last image of the lung or a cardiac catheterization film may support the evaluation. In addition to saving time, the diagnostic reliability is increased. All results can be documented in the form of a summary report revision-proof and be stored.

Flexible archiving, fast access

Archiving of the images and reports is flexible, it is adapted to meet the individual needs of the house. Thus, the data can be stored on CD or DVD in a single media archive, or stored in network structures in the Storage Area Network (SAN). The newest opportunity offers PACS Storage Service (SSP), in which the data are stored in an external archive. The payment depends on the usage.

Essential support in the practice

In the Augusta-Hospital Bochum, the system is in use for over a year. Dr. Olaf Hagen, head of the Medical and Geriatric Clinic sees substantial benefits for his work: "All the ECGs are provided at any time together with other images, findings and other information. In findings I am able to make electronic measurements and increase the measurement distances easily. Finally, we now have better opportunities in demonstrating the ECG. In a conference it was almost impossible to show the small strip of paper with the ECG trace to the colleagues - at least so that they recognize something."

Today hospitals can realize essential improvements in the clinical procedures by the association of medicine technology and IT. VISUS sees the fusion of both components as an essential key for the process optimization in the hospital. The strategic enhancements of the Enterprise PACS JiveX are orientated towards it.

The Bochum IT service provider is also presenting this at this year's MEDICA. With the integration of DICOM ECG, endoscopy, cardiology, sonography and radiotherapy in its PACS - clinic-wide and also cross-site - the road leads further in the direction of a comprehensive image management. On the basis of the DICOM standard picture and video data, bio-signals as well as documents are integrated smoothly. In detail the data transfer between modalities and IT, the structured finding, the documentation and archiving, the control of working processes as well as the quality assurance and consistency are guaranteed.

The user spectrum of JiveX reaches from PACS departmental solutions for different professional disciplines to the cross-departmental Enterprise PACS with teleradiology up to the complex cross-site network solution with data processing operations.

VISUS' comprehensive offer is extended by JiveX ASP/SSP, the PACS managed services with external archiving. It guarantees audit-proof, highly available long-term archiving in the data center with round-the-clock access. Besides, VISUS makes available everything to its customer from the software to services incl. full service up to the IT infrastructure with archive, servers as well as finding workstations and monitors. The user pays an individual, monthly basic charge according to equipment and scope of the solution, in addition a demand-oriented monthly user fee in dependancy on the agreed services as well as availability and performance guarantees. The advantages for the user are obvious: reasonable operation, payment purely after use, no investments and capital commitment, planable costs, no additional expenditures for migration, administration, servicing.

VISUS introduces a new version of its Enterprise PACS JiveX. With the system the Bochum IT service provider offers a series of functional and strategical enlargements to its users. By the integration of the ECG and the radiotherapy in the clinic-wide picture management for example other possibilities for efficiency increase and workflow optimization present themselves to the hospitals. The integrated picture and findings distribution with Web 2.0 technologies simplifies and accelerates, in addition, the work routines. The new version is rounded off by enlarged possibilities for the hanging protocols as well as a quicker loading speed.

Integration of ECG

The integration of ECGs is another, logical step for the implementation of a clinic-wide digital picture management system. With the JiveX ECG Modality Gateway DICOM capable ECG devices are connected to the PACS and integrated into the paperless working process. The JiveX ECG Workflow Module offers hanging protocols with automatically arranged ECG sheets, various examination functions (measurements, magnifying glass), as well as the possibility of a 1:1 paper print and the representation together with other admissions of the patient. The findings text is captured audit-proof in JiveX and therewith is available automatically within PACS. 

Integration of the Radiotherapy 

A clinic-wide picture management assumes among other things the logical support of the picture-giving devices beyond the radiology. The DICOM RT Module guarantees the storage and representation of planning data from the radiotherapy. Users have the possibility to load and process the picture data underlying to the radiotherapy planning, the planned radiotherapy dose data as well as the significant body regions or organ contours. In addition, it is possible to compare the different intensity of the irradiation of a region, e.g., to the target volume. 

Quick Picture Access

JiveX Review Web 2.0 allows the easy and quick access to pictures and findings via a web browser. All picture data are prepared for this automatically on the basis of standards and can be worked on interactively. The special JiveX streaming procedure transfers only the indicated picture information which is calculated on the web server. 

Coupling with the Telephone System

Via JiveX CallManager the PACS is connected directly with the telephone system. With incoming telephone calls the caller is identified and then the finding doctor receives a selection of the last examinations of the caller which he can access very quickly. Outgoing telephone calls are supported by a preselection in the electronic phone book according to the referring doctor of the study in process. The teamwork of information from the telephone system and the JiveX PACS manages the situational adjusted workflow. This saves time for the radiologist and he can work more stress-free.

The international activities are increasingly important for the IT service provider VISUS in Bochum. Today, the company may refer to more than 200 installations outside Germany. These are implemented by regional companies and local partners. Their care was also focused on during the Arab Health in Dubai and the European X-Ray Congress (ECR) in Vienna. "We would like to offer to our partners a drop-in center at which they can welcome their customers and present to them the solutions," explains Peter Rosiepen, with VISUS responsible for international sales and business development.

At the joint stand of the German Healthcare Export Group (GHE) VISUS presented itself to the Arab audience. "Here, by the good preparation of VISUS Middle East, we had some interesting and also concrete contacts," said Rosiepen. In addition, the company used the event to introduce four reseller won anew for the Arab region. At the same time new test installations in medical centers in Saudi Arabia, Kuwait, Qatar and in Oman were announced. "The digitization of hospitals in the region is only at the beginning. A big market with strong financial resources will open. I think that for us IT providers arise real chances in the times of the financial crisis, because by the use of modern IT solutions optimization potential and hence savings can be achieved, "Rosiepen looks confidently into the future.

The international sales manager was also extremely content with the ECR. "Particularly with prospective customers from the central European countries, the coming growth market, there were good discussions. Here we are represented locally by strong partners and the VISUS Central Eastern Europe which are pushing tangible projects. A major issue is the mammography screening, which is under construction in some countries in Central Europe and will run digitally. Also tele-radiological networks are asked for, like those VISUS has already realized in Germany, Finland and the U.S.

VISUS business has expanded and continues to expand

CEO Joerg Holstein is very satisfied when looking back on a successful year 2008 for his company VISUS. "Overall we have 100 new customers for our PACS solutions, 60 of them from Germany. It also reflects our development: Germany remains the main market but internationalization is taking on an increasingly important role."

Innovative Solutions to Convince New Customers

In the domestic market the digitization of the houses of Sana Southwest, the Clinical Center Landshut as well as the equipment of the Army Central Hospital Koblenz belongs to the outstanding projects. "The success in the market not only emphasize the great confidence in VISUS, they also demonstrate that our solutions actually help solve their problems," says Guido Boetticher, since October 1, 2008 as Sales Director responsible for Germany.

In this connection he singles out three solutions. With the function DICOM e-mail, users can build up an independent DICOM network over several locations. This creates a highly efficient image communication over secured data lines for non-time-critical applications such as image transfer to referring doctors and aftertreatment hospitals. In the context of a comprehensive PACS, VISUS focuses on the special solutions for endoscopy and cardiology. Both are consistently based on the DICOM standard and can easily be integrated into existing Networks. With JiveX Cardiology angiography and ECG recordings can be integrated, JiveX Endoscopy suits the purpose of DICOM video acquisition as well as image and video documentation. With both solutions the idea of a fully digital electronic patient record moves a significant step closer.

Well Established for Challenges

In future, the hospitals will even more be busy with two challenges: the amount of data will continue to grow and the information has to be made available in even higher security standards. To cope with this, VISUS, together with Telekom's subsidiary T-Systems, expands the services of external archiving (Storage Service Providing, SSP). "We guarantee the communication and data transfer for the hospital, archiving is done in the computer center of T-Systems. The solution combines installation, services and maintenance of the necessary systems. The service allows for flexible customer's payment depending on the usage. They pay per study or data unit (e.g. gigabytes) or simply a fixed price for each year of archiving. They do not have to invest in their own hard- or software", Holstein explains the model.

For 2009, Peter Rosiepen, since October 1, 2008 responsible for International Sales and Business Development, expects a long-growing international business". Emphasis will surely be on the US market but also the Middle East is developing well. In the Eastern European countries we will become more active by new partnerships."