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PPT Template for Diagnostic Imaging

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Peter R.G. Bak, Ph.D. Project Director, Diagnostic Imaging and Laboratory Architecture Canada Health Infoway 15 February, 2006 Disclosures Peter R.G. Bak is a ... – PowerPoint PPT presentation

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Title: PPT Template for Diagnostic Imaging


1
What is Canada doing about Lossy Compression?
Peter R.G. Bak, Ph.D. Project Director,
Diagnostic Imaging and Laboratory
Architecture Canada Health Infoway 15 February,
2006
2
Disclosures
  • Peter R.G. Bak is a consultant working for Canada
    Health Infoway

3
Lossy Compression in Canada
  • Canadian Association of Radiologists (CAR) have
    endorsed the use of lossy compression in
    principle
  • CAR intends to fully endorse lossy compression as
    a standard of practice by end of 2006
  • Confirm that lossy compression does not impact
    visual quality through clinical evaluation
  • Develop practice/ratio guidelines to assist
    radiologists/health authorities with
    implementation

4
Context The Motivation for Compression
  • Canada has initiated the deployment of a
    pan-Canadian interoperable Electronic Health
    Record solution (EHRs)
  • Canada Health Infoway (Infoway) is an
    independent, not for profit corporation
    responsible for developing the architecture of
    the EHRs
  • A core component of a patients health record is
    the diagnostic imaging result medical images,
    radiology reports and evidence documents
  • Canada is moving aggressively towards a fully
    filmless medical imaging environment we want to
    print less than 2 of our exams

5
Context The Motivation for Compression
  • Canada performs about 35,000,000 exams annually
  • This equates to about 3.5PB of storage annually
  • We have an aging population expect an increase
    in exam volume and CT utilization
  • Canadian healthcare facilities are widely
    dispersed across a large geography
  • Over 540 facilities (lt100 beds) in rural Canada
  • Network connectivity is limited most rural
    areas have 1mbps connectivity
  • Canadian Radiologists and Specialists are
    centered in the larger metropolitan cities
  • The challenge is getting images from rural
    facilities to metropolitan centres in a timely
    manner

6
Context The Motivation for Compression
  • Storage Costs
  • Storage costs are coming down but the storage
    volume is going up
  • We expect consumption increase will offset price
    decrease
  • Storage costs are significant (50M) but not
    significant enough to drive change!
  • Storage Total Cost of Ownership is far more
    significantenough to drive change!
  • Infoway is completing an economic assessment that
    indicates significant cost savingsyet to be
    completed and published!
  • Network Costs
  • Increasing bandwidth to rural areas is practical
    up to 5mbps (more or less)
  • Increasing bandwidth to rural areas at rates of
    100mbps is not going to happen in the foreseeable
    future
  • Compression will have a positive impact on
    quality of care and cost

7
Challenging the Status Quo
  • Lossy compression does NOT degrade image quality
    and can be used safely in daily practice!

8
The Canadian Approach to Driving Change
  • Commissioned 2 independent reviews of the
    literature
  • To assess the degree of research conducted in the
    evaluation of lossy compression
  • To determine whether a consensus of opinion
    exists among those who have evaluated the effect
    of lossy compression on diagnostic image quality
  • Conclusion
  • Lossy compression is a clinically acceptable
    option for the compression of medical images
  • The extent of allowable lossy compression ratio
    is dependent on the modality of the image and the
    nature of the imaged pathology and anatomy

9
The Canadian Approach to Driving Change
  • Commissioned 2 independent legal reviews
  • To assess the legal risk of adopting lossy
    compression
  • Conclusion
  • If the professional body adopts lossy compression
    as a standard of practice, and
  • If institutions deem the use of lossy compression
    provides economic and practical operational
    benefits as well as contributes to better quality
    care,
  • Then the exposure to legal risk is no greater
    than with current practice.
  • The key presumption, however, is that the use of
    lossy compression does not impact the visual
    quality of an image

10
The Canadian Approach to Driving Change
  • Commissioned 1 regulatory review
  • To assess regulatory constraints in Canada, USA,
    EU and Australia
  • Conclusion
  • No statements preventing or endorsing the use of
    irreversible compression
  • Commissioned an economic analysis
  • To assess the financial benefit to Canada in
    using lossy compression
  • Conclusion
  • Potential storage cost savings of C100 million
    annually

11
The Canadian Approach to Driving Change
  • Commissioned clinical evaluation
  • To assess the impact of lossy compression on
    visual quality
  • To develop guidelines for use of lossy
    compression within Canada
  • In Progresscompletion targeted for end 2006

12
The Canadian Approach to Driving Change
  • Evaluation Project Scope
  • Evaluate the impact of JPEG and JPEG 2000 lossy
    compression at safe compression ratios
  • Large matrix images 251
  • Small matrix images 101
  • Evaluation Project Protocol
  • Diagnostic accuracy with ROC analysis
  • Original Revealed First Choice Just Noticeable
    Difference
  • 27 different sessions, with 3 reviewers for each
  • 81 radiologists from all across Canada
  • Sample size for each session will be 60 to 80
    images.
  • 5 modalities CR/DR, CT, US, MR, NM
  • 7 radiological areas Angio, Body, Breast, Chest,
    MSK, Neuro, Pediatrics)

13
The Canadian Approach to Driving Change
  • Solicited Regional Health Authority
    Administrations
  • To declare the use of lossy compression a matter
    of public policy and resource allocation
  • In Progress
  • Fraser Health Authority (largest HA in Canada)
    has made such a declaration
  • In discussion with Provincial Health Ministries

14
Conclusion
  • We expect CAR to formally endorse lossy
    compression as a standard of practice by year end
  • We expect most Provincial health ministries to
    declare the use of lossy compression as a matter
    of public policy and resource allocation by end
    of 2007
  • We will declare DICOM JPEG, JPEG2000 and JPIP as
    pan-Canadian standards
  • Canada has a Standards Collaboration Process for
    declaring standards for the pan-Canadian EHR
  • We will implement a reference system to serve as
  • An open source test harness
  • A standards compliance tool

15
Questions?
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