When radiologists use a new platform or workstation for the first time, there is often an adjustment period. The radiologist has to take it on a “test drive” of sorts, seeing how certain functions are carried out and learn how to get the most out of the technology.

When the team at McKesson developed its latest mammography solution, however, the company flipped the script completely. Instead of the radiologist adapting to the platform, McKesson thought, shouldn’t the platform adapt to the radiologist?  

McKesson Radiology Mammography Plus™ Version 2.0 is a multi-modality PACS system with a natively embedded breast mammography solution. It supports both 2D and digital breast tomosynthesis (DBT), giving radiologists access to all modalities from a single workstation.

Indra Lalari, McKesson product manager, says the company worked closely with critical advisors and spoke with users of a variety of systems to better understand the problems those in the imaging industry face on a daily basis.

One thing the company noticed, Lalari says, is that some radiologists crave the ability to customize their work environment as much as possible.

“We found that a large number of mammographers want greater flexibility from a user preference perspective,” Lalari says. “So a big highlight of our system is that we added functionality that other vendors don’t have, and we made each of those functions options from a user perspective, because user scenarios were widely different across our base. To accommodate all of them, we figured we would make the user preferences flexible.”

The feedback to this approach has been overwhelmingly positive. She and her team continue to work with customers to address their requests. Often the system is already capable of the request; it is sometimes as simple as a specific setting change.

“I was on a call last week where a customer wanted to be able to include source images,” Lalari says. “We said, ‘You can do that. It’s a user preference. Not everyone wants to do that, but you can.’ That’s a real benefit.”

New features

Besides its fully customizable UI, McKesson is also excited to share a variety of other exciting new features with its customers.

For instance, McKesson Radiology Mammography Plus includes BI-RADS and breast density “at a glance.” BI-RADS “at a glance” is a visual assessment of the BI-RADS assessments found in a patient’s portfolio. It extracts relevant information and provides it both in a numerical manner and in a convenient color-coded fashion.

“It’s a visual assessment in a numerical manner about a patient’s breast history,” Lalari says. “In this era where they have to go through so much more data with DBT, this is a feature that has saved radiologists so much time. This is one feature that is a differentiator of our system. Nobody else is doing it.”

Similarly, breast density “at a glance” extracts the breast density value as the alphabet formation—A, B, and so on—and as the text value, whether it is “extremely dense,” “heterogeneously dense,” or something else. This feature comes along at the perfect time, with breast density notification legislation now in effect in a total of 26 states. 

McKesson Radiology Mammography Plus is also completely web-enabled, so when it’s running, users aren’t limited to just mammography.

“You can have other applications running in your environment,” Lalari says. “You don’t have to have a dedicated technologist workstation just for mammography.”

The platform also offers users an advanced slabbing tool, sector zoom, and historical similar matching, which allows radiologists to easily cycle through relevant historical images.

The importance of education

One of the biggest challenges imaging departments and private practices encounter is dealing with the large data sets related to DBT. Navigating through those data sets can be difficult, and McKesson has tackled that problem by implementing functionality that aids the radiologist with viewing prior images, loading image data, and presenting relevant information from the same workstation.

Storing DBT data can be especially challenging, and the market as a whole has been nervous about saving such large files. Lalari says other vendors have saved space by interpreting data in a proprietary format other than DICOM, but that was more of a Band-Aid than a true solution. 

“They were able to conserve space by doing that, but the challenge was that it wasn’t interoperable,” Lalari says. “So if a patient was to leave a facility where imaging was done at that specialty workstation, they wouldn’t be able to take it to a facility that had, say, a McKesson PACS, or any of those other PACS vendors, and visualize that image data.”

McKesson’s developers recognized that for data to be in the correct format, it can only be compressed so much. So instead of shrinking down files, it was a matter of educating customers about what their requirements are going to be, how they can manage their environment, and what they need to consider when building their network.

“As soon as you inform the customer that every PACS vendor has the same challenges and that if they are going to store industry-standard, interoperable data, it must be DICOM, they got it,” Lalari says.

Big savings

Implementation of McKesson Radiology Mammography Plus can save users significant time and money. For example, the platform is completely embedded. A full-time employee isn’t required just to manager the routing manager; since it is a central repository, there’s no one behind the scenes deleting and uploading studies to keep the system running. Also, it provides work environments with a paperless workflow.

“You’re not able to read reports in a many of these systems, so you’ll see big stacks of paper at a radiologist’s desk,” Lalari says. “In our system, everything is part of the workflow and you can tap into that report when you need it.”

Also, since a majority of its customers already have a McKesson PACS system, McKesson developed functionality that represents the company’s standard interface.

“These radiologists already know how to use our system and they’re seeing the same interface, so you’re saving the customer’s time,” Lalari says.

And again, since the solution is fully customizable, they can change that interface at any time.

McKesson at SIIM 2016

Lalari is scheduled to take part in a SIIM 2016 vendor panel at 4:15 pm. on June 30. Along with representatives from other vendors, she will share insight about the challenges facing radiologists who practice DBT and some of the many solutions available to them.