With advancements in technology continuing to shape the future of health care, McGovern Medical School and Memorial Hermann Hospital have collaborated to create the Center for Advanced Imaging Processing (CAIP) and bring a higher level of image processing into clinical workflow.

The vision for CAIP began with Roy F. Riascos, MD, professor of diagnostic and interventional imaging, and an increase in processing advanced imaging into clinical workflow. With technology rapidly changing the industry, Riascos said there needed to be a big investment in advanced imaging in order to remain at the forefront of technology and health care.

“One of the biggest areas in health care that utilizes new technologies is imaging,” Riascos said. “It’s usually very difficult to integrate these technologies because of cost, but there are definitely clear pathways on how to start impacting patient care by using them.”

So in 2017, Riascos and his team began devising a plan to implement some of the new technologies. The team focused on creating a system of post processing which would cover Memorial Hermann Hospital system wide and cross over boundaries of not only specialties but also regions within the system. Post processing is using software to enhance information that is coming out of the equipment, for instance, taking a flat CT scan image and creating a 3D version of that.

“Two years ago, we went to the Innovation Council for the Memorial Hermann System, and our pilot was approved,” Riascos said. “We were going to utilize the technology that we already had to post process, but what we needed to increase was the utilization. Memorial Hermann was completely inundated with physicians wanting to include software in their practices, but it takes a lot of time to deploy any software in a big system like this.”

The Center for Advanced Imaging Processing works as a middleman between physicians and technicians who are trained to do post processing work. Working together as a team, the physicians and technicians tremendously increase the utilization of the software. This process allows experts to not only make qualitative interpretations of scans, but quantitative as well.

“When seeing something with just the eye, you could make a lot of mistakes, Riascos said. “Once you have the quanitification markers, you actually have proof of it. This reduces mistakes tremendously. It’s precise medicine.”

One of the issues the project faced is that the Memorial Hermann system features 13 hospitals and 32 centers around the greater Houston area. Hiring new technicians to implement the technology across such a widespread base would not be feasible, so instead, Riascos and his team decided a centralized location for the technology would work best.

“If you centralize the technology, the coverage is increased dramatically, and you can lower costs,” Riascos said. “You are also able to get post processing expertise, and are able to standardize the results you get. This allows the treatment of one patient to be reproduced throughout the entire system, which allows the Hermann concept to happen and grow with service labs.”

Fortunately, for Riascos and his team, the Memorial Hermann system houses one of the largest networks in the world, which provided the infrastructure to create a centralized system. So with one of the biggest hurdles out of the way, the team set its sights on strategizing and creating a virtualized version of all of the software available to the physicians, while also deciding which software to include. Memorial Hermann has close to 120 pieces of imaging equipment throughout the system with software available from each of the four big vendors, Siemens, Cannon, Phillips, and GE.

“We had conversations with all four of the big vendors and discussed how we would like to deploy all their applications in the same ecosystem,” Riascos said. “This was an awkward request due to the fact they’ve never been in a place where they’ve all sat on the same platform. We further discussed the importance of having a cook-off to ensure we can utilize all the greatest and lastest and make our own comparison in their technology for our patient’s needs when it comes to post processing. They allowed us to have the top technology, support, training, and to always have the latest interaction with their software.”

Once the center had the first vendor on board, Riascos and his team moved forward in conjunction with the IT department at Memorial Hermann to develop a server that could deploy the software throughout the entire system.

“The end result is breathtaking,” Riascos said. “Right now we’re at the top with our technology. Maybe you can go somewhere else, and they have access to the software, but they are accessing it from a box they have. We can access it in any computer in the system with the most optimized speed. These are super computers.”

Moving forward, the center hopes to add the remaining three vendors into the system and continue to add and train CT and MRI technologists to help the system grow organically. The center is also in the process of creating a Picture Archiving System to allow outside images, which are very data heavy, to be saved into the system.

“It’s visionary for Memorial Hermann to work with us to create something like this,” Riascos said. “If centers like these do not exist, it would be almost impossible to have access to this technology. This will put Memorial Hermann and UTHealth at the forefront of the deployment of these technologies in the world. This is just the beginning.”