Wednesday, August 28, 2013

Introduction to Nephosity

How did Nephosity start?

Nephosity began as a cloud-based medical image viewer for the iPad. From there, we saw the potential to address several other issues along the care continuum and started to build out from there. "Nephos" is Greek for "cloud," since we provide the solution for cloud-based medical imaging.

What is Nephosity’s mission?

We’re a small company trying to do big things. For now, we’re focused on the pain points inherent in medical imaging. Our first product, MobileCT Viewer, a medical image viewer for the iPad, addresses the medical image mobility and patient engagement issue.  Our second product, Jack Imaging, is a platform for medical image viewing, sharing and collaboration.  All you need is access to your medical images and and a HTML5 web browser.  We have also integrated MobileCT Viewer into the platform, so that you can interact with your medical images anywhere, anytime. 

How do Nephosity’s products help ‘fix’ medical imaging?

Here’s how medical images flow through the system today:

After receiving an order from your doctor to get an MRI, you prepare for and undergo a medical scan (CT, MRI, X-Ray, etc.). These images are transferred to a picture archiving communication system (PACS) which are then sent to image viewing and workstations or burned onto CDs in order to be transferred to other hospitals. A radiologist will read your images and send a text-only summary report to your doctor. 

As a patient, there are several things that should bother you about this flow: 
  • information rarely flows directly to you
  • you are dependent upon the imaging center and your provider to deliver your imaging information, and you may not be able to schedule another appointment until you have complete medical records
  • your doctor receives a text-only summary report, meaning they may not have all the information you'd want to know
  • images are transferred via CDs of which ~20% are unreadable due to software incompatibilities, forcing you to get re-imaged and re-exposed to scan radiation
Radiation levels vary by scan type:
  • a chest x-ray exposes you to about 0.1 mSv, about the radiation dose people are exposed to naturally over ~10 days
  • a mammogram exposes a woman to 0.4 mSv, about the radiation dose people are exposed to naturally over ~7 weeks
  • a CT scan of the abdomen (belly) and pelvis exposes you to about 10 mSv and up to 20 mSv if the test is done with and without contrast
  • results from a study conducted by the National Cancer Institute (NCI) suggested that 1 in 270 women and 1 in 600 men undergoing CT heart scans at the age of 40 will develop cancer related to that CT scan
Providers also experience challenges, namely an inefficient workflow, given:
  • image viewers do not talk to one another, creating a manual transfer process
  • images are transferred via CDs of which ~20% are unreadable due to software incompatibilities, delaying appointments and wasting your time
  • siloed PACS

What is a typical use case of your product?

For patients

Say you broke your ankle two years ago and though it’s healed, you’ve been feeling some residual pain recently. You tell your primary care doctor about it when you go for your annual visit and he suggests you follow-up with an orthopedic surgeon to ensure the break healed correctly. He advises you to bring the CD you received two years ago so you do not have to get re-imaged. Now, you either go home and a) find the CD, pop it into your computer and upload the images to then send to providers, or b) realize you’ve lost the CD, get imaged and upload those images immediately to so you can avoid re-imaging your ankle as well as the associated costs and radiation exposure.

For providers

With new patients, it may be challenging to get a hold of their previous medical records. To transfer their images, have your patient either bring in their imaging CDs or upload those images themselves on, then sign on to view, share and collaborate with your patient and/or other providers.

What do you hope to achieve through wider adoption of cloud-based medical imaging?

A few things: use of Jack Imaging will eventually eliminate the need for CDs and thus the associated hassle of lost images, corrupt files, delayed appointments, re-imaging, and so on. In addition to the patient risk associated with re-imaging, duplicate imaging also financially burdens our healthcare system. If we can eliminate the need for duplicate imaging (by keeping better track of our images), we can save billions of dollars in healthcare.

How does Jack help the patient? The provider? The payer?

Jack empowers patients to take control of their medical situation. It enables providers to remotely review their cases and collaborate with other providers. It also allows for greater patient engagement, as physicians can review images alongside the patient in real-time. Jack Imaging finally provides the payer with generous cost savings as a result of reduction in duplicate imaging.

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