HIStalk Interviews Jim Litterer, CEO, Vital Images

Jim Litterer is president and CEO of Vital Images, A Toshiba Medical Systems Group Company, of Minnetonka, MN.

Tell me about yourself and the company.

Vital Images is a company that’s been around for about 25 years. It was founded by Vincent Argiro. For the first 20 years of existence, it focused on advanced visualization and clinical applications. We’ve been broadening the focus of the organization over the past several years because we realized that advanced visualization and 3D imaging capabilities are a great way to communicate to downstream care teams.

We’ve been broadening our solution offerings and have created three divisions within Vital. One is focused on enterprise imaging, our Personalized Viewing Solutions.

In the second, Enterprise Informatics, we deliver a unique interoperability solution where information can be connected across disparate structured content systems to provide the right information to the right person at the right time within the care cycle.

Our third division focuses on image practice management software and an analytics platform. We are able help IDNs visualize the imaging operations across all locations in real time, in conjunction with the ability to drill down to patient-level quality benchmarking. That data is then used to make informed decisions on operations management and capital investments in lockstep with accountable care imperatives within the organization.

Describe what visualization tools do and how they are used.

Visualization tools can range from diagnostic decision-making tools to enterprise viewers to assist the care team. Even patient communication, which is crucial as organizations strive to attain patient engagement.

The personalized viewing platform delivers the ability to adapt to simple examples of clinical review, or drill down to diagnostic view, then further advanced visualization. In essence, the platform adapts to the role of the clinician and disease state of the patient.

Our advanced visualization solution creates quantitative data that can then be stored as discrete data that can be leveraged in broader sets of applications.

From the diagnostic imaging side, we provide patient-centric viewers to imaging specialists — such as radiologists and cardiologists – who use that to make the diagnosis.

Finally, we have viewers beyond diagnosis that help care teams treat patients ongoing. Clinicians use our zero-footprint viewer, VitreaView, to understand the diagnosis and make treatment planning decisions.

What will the next generation of VNAs and enterprise viewers look like?

It’s heading to a place where hospitals are looking for enterprise systems that connect not just imaging information, but discrete data as well. We’ve all heard of PACS 3.0. These solutions are migrating to where you’re accessing locations of information, and then you use viewers and interfaces to create care dashboards for the clinical specialists to more effectively treat patients by being presented with the right information at the right time.

We reviewed the VNA and enterprise viewer market, Based on direct feedback of our customers, we launched second-generation products. For instance, VNA On Demand allows the CIO to incrementally build a VNA based on their architecture.

What is the expectation that images will be shareable in an interoperable world?

Images, multimedia, and other structured content are critical to decision-making and treatment planning. As a support line within a hospital, imaging practices are going through a large amount of change due to the effects of the Affordable Care Act. Hospitals need solutions that help align imaging activities with bundled payment models. Imaging is a key technology to driving cost-effective diagnosis, but in order to get the full value from imaging practices, the information needs to be completely integrated in with the health record.

In the past, it was assumed that you’d have to aggregate information to a central location to use it. We’re creating solutions that can access imaging data and imaging content in their native sources, which allows physicians to access that data through the health record in a patient-centric context.

What are the most pressing issues in medical imaging?

Imaging data is exploding and accounts for the majority of the storage claimed within a health system. This large set of data is also one of the most underutilized in terms of population management and risk stratification.

The largest task at hand is to take that image content that is being successfully used within a radiology department and then extend it across the healthcare enterprise. Imaging investments are large and there is much more we can do to leverage the information for improved patient care outcomes and improved efficiencies to align with the Affordable Care Act payment models.

Who consumes the actual images rather than the interpreted description of what the images are believed to show?

Text-based reports have been the primary focus of delivering imaging results to the treating physicians. We have found that if you provide treating physicians with a zero-footprint, three-dimensional viewer and quantitative results displayed on image itself, this information is used just as much as the text-based report. The old adage, “A picture is worth a thousand words” couldn’t be truer in medical imaging.

As an example, once you’re able to provide simple volumetric viewing tools along with the text information, it’s a much easier way for a surgeon to plan a complex procedure or learn the best way to operate on a specific disease to save OR time, not to mention educating the patient on the procedure.

We’re seeing applications for this imaging data as health systems investigate 3D printing applications. 3D printing is a hot topic and is starting to build momentum in the market today, primarily for treatment planning and for patient education. We are just starting to scratch the surface with this technology. It will be something to pay attention to.

What has been the impact of having the surgeon be able to walk through a representation of the procedure as a practice run before doing it for real?

We’re on the edge of 3D printing becoming a much more broadly used application. We have about 5,000 installations of our advanced digitalization tools around the world. We’re seeing a lot of interest from radiology practices that are looking to offer 3D printing as a value-add to their practice for downstream physicians. We’re certainly seeing it in big hospitals and large academic sites. Many of them have invested in 3D printers to handle this type of workflow.

You released an imaging analytics solution specifically for ACOs. How are their needs different?

We are using Vitality IQ to enable IDNs to visualize the all activities that are happening within their imaging department. Operationally, this solution provides real-time access to frontline management to understand where bottlenecks and idle time are occurring. Strategically, the solution provides aggregated information from EMR, PACS, HIS/RIS, and financial systems to make larger informed decisions on future equipment investments or how to better market to referring physicians based on trending information.

Where do you see the company in five years?

We will be a healthcare informatics company that provides an enterprise service bus for structured data that help HIEs and IDNs integrate in the imaging information through our viewers. We’ll continue to be focused on viewing or imaging-based applications, but we know that these solutions must tie in much beyond a specific department. We’re going to continue to evolve our solutions to help our customers solve the challenges they have within imaging and in the utilization of that information.