High-Speed Data Networks Austin radiologists are upgrading to enhance their practice

by David Orenstein freelance writer

A venture is underway in Austin that exemplifies the potential of computers and networking. It doesn’t come from Dell or the University of Texas. Instead, it is the brainchild of a radiology practice and it could change the way it practices medicine in important ways.

Austin Radiological Association is linking its 14 centers with a high-speed data network that will allow it to shuttle around 200,000 medical images a year with simple mouse clicks.

“It’s not a project, but a process of re-engineering the way we practice radiology,” says John Relic, the assocation’s CEO. Instead of putting digital images on film so they can be driven across town to the proper subspecialist for interpretation, ARA will be able to transmit them instantly and electronically. This is true for new images and for archived images, which will be stored in ARA’s huge Picture Archiving and Communications System database. Every radiologist in the association’s 14 centers will have access to this comprehensive database. Without this kind of network, it would be available only at a single location.

ARA expects to save $500,000 a year in courier costs alone. Other financial savings include eliminating film and gaining an estimated 20 percent in productivity will produce a positive return on ARA’s $7 million investment in 27 to 36 months, Mr Relic says. If all goes well, the network could make the practice not only more efficient, but also more profitable.

The network itself must be very high speed because medical images contain an enormous amount of data. A standard chest X-ray is a 64- to 80-million bit image. For comparison, the fastest dial-up modem line transmits data at only 56,000 bits per second. But over the next three years, 11 of ARA’s sites will be linked to the PACS with connections called “OC-3c” lines that provide a rate of 155 million bits per second (mbps). A site in San Marcos will connect via a 44 mbps line called a “DS3.” Two others will use a 1.5 mpbs line called a “T1.” Time Warner Telecom is providing the lines, while Internet hardware giant Cisco Systems is providing the switches and routers that will direct data traffic on the network.

Although such a high-speed network is expensive, radiologists do not have the luxury of compressing image data the way most people on the Web do. Compression reduces the size of an image file by a factor of 16 by casting aside subtle details that a casual observer would never notice were missing. But radiologists are hardly casual observers. A 2000 study in the Journal of the American College of Cardiology found that when medical images are compressed into a typical Web image format called JPEG, the error rate with the images is 30 percent higher than with uncompressed images.

Beyond its pure speed and convenience, the network offers ARA’s radiologists another advantage: the chance to work with medical images in their original digital form. This is important because digital images can be electronically enhanced and manipulated in ways that can aid interpretation. In the future, Mr Relic notes, radiologists will be able to use digital medical images to construct realistic, 3D computer models of body parts and tissues that can aid in diagnosis and treatment. This isn’t possible with an image on film.

Ultimately, the key word here is “possible.” When technology is implemented smartly, it creates new possibilities. In any medical specialty, that can translate into better care and better profits, often at the same time.

David Orenstein is a technology and business writer in Silicon Valley. E-mail him at davealli@earthlink.net.