Thank you for spending your time with us today.
We would like to hear your opinion on our DICOM Viewer (EV Insite R) as a PSP user.
First of all, could you tell us what brought you to use EV Insite R?

Dr. Yamada
It has been 12 or 13 years since I got to know PSP.
Back then they started considering the use of a new reporting system while I was working at another hospital. I was recommended PSP’s web reporting system. In fact, I heard that the DICOM Viewer of the PACS installed in the hospital was PSP’s for the first time. Afterward, we established a prototype of the first reporting system, which has been customized since then.
Dr. Tanaka
We have also benefitted from PSP’s reporting system after Dr. Yamada moved back to our university hospital and highly recommended us to use it. At this time, being able to paste up to 30 key images on a report was an innovative feature. It really helps us to produce reports with as many key images as we want, which is more efficient to share information with doctors from other departments.
In addition, it came with a teaching-file system, which was really helpful to us.
We could easily save important cases on the teaching-file system to use for presentation or education purpose. Displaying a list of key images is very useful to check later on. Up to now, I have registered about 6000 cases.
Dr. Sato
I have started to use PSP’s product in a different context than yours. Though I only had limited choices within the hospital’s budget, I considered either of two PACS vendors. Since PSP strongly recommended their PACS (EV Insite System) then, I decided to try using it.
Thinking of that now, I am grateful that I didn’t choose another option. I really believe I made the right decision choosing EV Insite System. I have already renewed our hospital’s contract with PSP twice

Which part of EV Insite System do you like the best?

Dr. Yamada
Altogether, it takes much less time to do the interpretation.
I used to do the interpretation until 10 PM every night without EV Insite System.
However, I am now able to complete the interpretation by 5 or 6 PM, although the number of examinations is still same and the number of images has even increased, since progress of modalities made thin slices a common technology.
We often get similar testimonials from other hospitals using EV Insite System as well.
Dr. Tanaka
I totally agree with you.
I was exhausted after daily interpretation, but now I still have energy for research.
As I told you earlier, teaching-file system is very useful to sort out past cases for research or education purpose.
Since then I have never thought of using other PACS since the environment for interpretation has drastically changed.
Dr. Sato
I often come across resident physicians from university at the hospital where I work and they also say this system is user friendly. I think it is because EV Insite System needs fewer steps for us to use functions, compared to other PACS. Radiologists are grateful for being able to perform quickly what they want to do.
In addition, very useful functions have been recently added to EV Insite R such as computed diffusion besides MPR and MIP.
We are glad that we can use these functions from any workstation.
Dr. Tanaka
I believe doctors in each department have changed their mindsets about images since they started using EV Insite R in the hospital.
Of course many doctors still use usual functions, but I find some doctors proactively making the best of various functions.
Dr. Yamada
I believe it is a great advantage for respiratory physicians to be able to create a coronal image very quickly and look into lungs. Unlike us radiologists, many general physicians think it is more efficient to display easily images as a whole.
Dr. Sato
For my hospital, respiratory physicians proactively make use of it for conferences amongst other things.
There is a new teaching-file system which is different from the one that Dr. Tanaka used to work with at that time. I find many people making use of it in the hospital. Even technicians create teaching files about imaging methods to develop their skills.

I sometimes hear that someone finds it difficult to use a variety of functions, what do you think about this?

Dr. Yamada
If they would like to use only simple functions, their viewer could be customized to match to their needs.
If some presets have been prepared in advance, they only have to choose their favorite and customize it as they like.
Dr. Tanaka
It surely has a lot of functions. Even I don’t know some functions although I have been a EV Insite System user for many years. So far I have never felt difficulty as PSP is so supportive and provides adequate advice to my questions and customizes my viewer as needed.
I would like to learn how to use more functions and make the best of it.
Dr. Sato
We will be in trouble if our viewer doesn’t have enough functions, yet we appreciate a variety of functions. I also requested to add functions. PSP takes a real interest in our requests and gives us better proposals.

I know you use EV Insite System for teleradiology as well. What do you think about it?

Dr. Tanaka
PSP helped university doctors to found an NPO. There was hospital in a remote site that would require more than 3 hours each way to get to, but we can now spend the commuting time on interpretation since we started doing the interpretation remotely.
Also, the clinic really appreciates the fact that we can interpret images every day when we could only do it once a week back then. We have received so many interpretation requests from other hospitals, which are not under my hospital group because it is becoming popular among doctors.
Dr. Yamada
The NPO of my university was assisted by PSP, too. As quite a few hospitals have been connected to the same network, staffs are glad to be able to spend more time for their research or personal life. The fact that each hospital can raise urgent requests and have images interpreted very fast, without having to wait for a few days, is highly valued. We would like to perform as many interpretations as needed, but a shortage of doctors in the prefecture makes it impossible. We currently have to limit the number of interpretation requests for each hospital.
Dr. Sato
I don’t deal with teleradiology as my hospital doesn’t have any affiliated hospital or clinic. However, we are connected to clinics in the surrounding area through PSP’s regional cooperation system. Clinics can schedule examinations with my hospital online through the same network. Clinics which have requested examinations can view patients’ images and reports at any time remotely. Since I introduced this system, the number of referred patients has increased by 20% every year.
Clinics strongly appreciate that they can refer to images from the network and not to CDs or DVDs.
In addition, I have an educational website for private doctors to study medical images using teaching files once a month. It aims to enhance doctor’s ability to find diseases on the general image. They look at chest images first, followed by CT images and MRI images, and write simple descriptions.
I believe it is important for private doctors to be able to find diseases on general images.
Dr. Yamada
My University hospital is also connected to hospitals and clinics in the prefecture using EV Insite R. They use the web-based viewer as it is inexpensive and the speed for loading images is very fast. Medical records can also be viewed, but I mainly receive requests from doctors in the region to view images.
I am glad to know that they are now more interested in medical images and would like to refer to reports as well since EV Insite System has improved their workflow

PSP is going to expand their business overseas.
Do you have any advice for doctors overseas?

Dr. Sato
I wonder what kind of viewer they are using…, probably those from famous PACS vendors…
I regret to say that radiologists overseas have never used EV Insite R before.
I guarantee that they will know the merits without explanation once they use it.
I strongly recommend using PSP as your first choice.
Dr. Yamada
EV Insite R has functions to reduce human errors that lead to overlooking lesions in the image. I recommend that they use such functions actively. I believe that they will feel the differences as if their ability had improved and that they will like it.
Dr. Tanaka
One of the good points is easy-to-use functions. Hopefully they will be able to learn how to use them on their own, without struggling looking at operation manuals. They might feel challenged by having to change their PACS viewer at first, but they will be able to make use of EV Insite System much faster than expected. I believe that not only radiologists but also other doctors will be satisfied with such user-friendly functions for conferences or explanations to patients.
Dr. Sato
I hope we can exchange cases and opinions with doctors from other countries in the future. I believe the teaching-file system will be useful for such situations.
I look forward to exchanging cases and studying with doctors from other countries.

Thank you for your participation in this interview today.
I will greatly appreciate your continuous guidance and support for the future.

[Participants]: Interviewer , Dr. Yamada (assumed name) , Dr. Tanaka (assumed name) ,and Dr. Sato (assumed name)

(*1)Please note that their identities are protected under assumed name in accordance with Japanese confidentiality standards.
(*2)Please note that PSP’s reporting system and teaching file system are only released in Japan.
(*3)This round table talk was held in 2015.

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