There's another example, too. In orthopedics, we're seeing strong adoption of our iPad app, which enables the user to pull up image-based surgical plans right in the OR.

When you add in offline syncing capabilities, you create the ability to work on surgical planning anywhere. With a cloud solution for orthopedics, there can be multiple users in disparate locations who are involved in the surgical planning process. Users can template orthopedic cases and give a remote colleague the ability to instantly see that new or changed surgical plan. It can even work without an Internet connection-you just sync the images and plans to the cloud when a connection becomes available. So it's really untethering the clinicians involved in orthopedic care.


DMN: About 80 percent of data in healthcare is still unstructured, and some argue that a lot of that has to do with how many multimedia images are out there. With a push toward consumer-centric organization on the way, how will PACS help make that unstructured data more accessible and mineable?

JW: All the buzz out there is over HIPAA and HITECH, and the concerns and risks of exposing patient healthcare information (PHI). So what we're seeing is that IT folks are responding in fear-they're putting fences and walls up because they're so afraid of exposing PHI. This trend can be a hurdle to leveraging data stores.

However, government regulations are maturing, as I think they should. The providers need to share information with other providers to achieve a patient-centric model and flow of information. Specifically, we're seeing access being granted to relevant parties, whether they're clinicians or patients, on a granular level. Data mining these clinical repositories can provide many immediate benefits such as closed-loop learning systems, where physicians can leverage their quality and outcomes data to improve their current decision-making process.

Beyond the clinical application, too, we see opportunities to leverage that data to help drive down the cost of care, particularly in terms of inventory controls and logistics.

DMN: Would you cite the core challenges and biggest opportunities you see with orthopedic PACS going forward?

JW: Sure. On the challenge side we've already touched on the risks of consolidation. If the consolidation trends inadvertently force niche technologies out of the system, then the clinical and financial benefits of targeted solutions will be lost.

Another challenge is the impact that earlier digital templating technologies have had on the psychology of orthopedic surgeons. Several inferior templating solutions were rolled out to the orthopedic community around a decade ago and were not sufficiently accurate. So, unfortunately, this produced an attitude that digital templating in general is not trustworthy. Yet if you look at our current technology, we have many, many surgeons around the country who have extremely accurate results and have grown to trust it so much that they've completely changed the way they do business.

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