The Herald, Sharon, PA Published Sunday, Feb. 11, 2001
outlook 2001


High-tech X-rays get around

By Michael Roknick
Herald Business Editor

X-rays and other medical images are going to get a new look at UPMC Horizon.

On the other hand, it’s also a case of Horizon getting a new look at medical images.

Through its affiliation with the University of Pittsburgh Medical Center, Horizon will be the first hospital in the UPMC network to get a new digital imaging system outside of UPMC Presbyterian in Pittsburgh.

Developed by Dr. Paul J. Chang, the system uses computers and super-fast Internet technology to get images on computer screens for doctors and other medical staff to view. His system, called Dynamic Transfer Syntax, replaces film used in medical images with digital technology.

With this system an images ranging from a broken bone X-ray to a CT scan of a brain can be sent almost instantly to medical personnel.

A radiologist by trade, Chang also is an associate professor and director of radiology information division at UPMC. Over the years he’s developed a knack for creating medical computer technology.

This latest creation stands to change the way doctors work and cut down on time patients have to wait to get results back from images.

Currently, doctors, radiologists and others in medicine must view images on film, a concept which dates back nearly 80 years. If a doctor asks a fellow physician to give a second opinion on an image the film must be sent by mail or physically transported to that doctor’s office. That takes money and precious time. In many cases patients or their families are called on to tote the film to various offices, Chang noted.

"Patients shouldn’t have to be used a carriers,’’ he said. "That’s ridiculous. They’re sick enough.’’

Working out of his Pittsburgh office, Chang developed DTS to forgo film and store the image on a computer. With the click of a mouse button that image can be sent by modem to another computer in seconds. Since the image is stored on UPMC’s computer system, with the proper password dozens, even hundreds of doctors can view the image at the same time.

Until recently, moving images with computers was a slow and expensive proposition. Chang’s system has four times the bandwidth of the University of Pittsburgh and Carnegie Mellon University combined. Like lanes on a highway, bandwidth is the measurement of how much information can be driven over a cable. The greater the bandwidth the more information can be sent with greater speed.

Prior technology compressed the information to fit on bandwidths. The problem was it often left images looking fuzzy.

"Using compression is indefensible,’’ Chang asserts. "You can miss finding things like a collapsed lung.’’

By using this extra wide system crisp, clear images are able to be viewed by medical staffs on a personal computer.

DTS can send images through a fast and continuous stream over cable systems to a PC, versus the slower and choppier method. Once the images are received, doctors or radiologists can move the image around or enlarge portions of it to get a better view.

A computer with at least a 17-inch monitor is needed to view the images, along with a mouse and the proper network connection.

"Because this streams the information the PC can literally be a piece of junk,’’ Chang said. "You don’t need a lot of memory.’’

He developed the technology based on medical need rather than the desires of computer enthusiasts.

"I’m not a computer nerd,’’ Chang said. "We’re not trained to be techno-geeks -- we’re trained to be health care providers.’’

He acknowledged it’s going to take time to get certain physicians onboard with DTS.

"Most physicians’ clocks on their VCR’s blink,’’ he joked.

Doctors are going to find having a computer in their office will be a necessity rather than a luxury, Chang said.

"This is inevitable,’’ he said. "Not only is film going away but so is paper. You will not be able to function without a PC and web access.’’

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