Spotlight ON TECHNOLOGY & TECHNIQUE

Digiversal, a Clearinghouse for Images

By Leslie Goldberg, Associate Editor

"Ophthalmology is a very heavily image- and drawingdriven specialty," says Ian Lane, OD, executive vice president of technology for Kowa. Trouble is, "each instrument has its own management system, and looking at each type of image individually is very time consuming."

In order to make image management more efficient for ophthalmologists, Kowa created a universal image and data management system called Digiversal. All image formats can be stored, regardless of their platform.

With the Digiversal software system, doctors only need to be concerned with one centralized piece of imaging software. This software also interfaces with medical records. "We have taken a universal approach to this software and work with the majority of ophthalmologic EMR systems on the market," says Dr. Lane. "Because this field is so image intensive, we feel it is more important to organize and manage images as a first step to moving to EMR. You can then move to an EMR system and back into image management. This means doctors can get all of their image files organized and then choose an EMR system."

Image Characteristics

All images managed by Digiversal are DICOM-compliant, Kowa says, and are only compressed to the extent that compression does not interfere with compliance. The system currently interfaces with other non-Kowa instruments and processes slit-lamp, retinal and OCT images.

Users are not required to purchase any other piece of hardware to use the Digiversal software. It can be acquired as a stand-alone package whether you are using Kowa instruments or not.

Digiversal allows simultaneous access to multiple data sources.

Key Capabilities

The Digiversal platform comes with a series of annotation tools. While the original picture is always pristine, doctors are able to mark on top of a copy of the image. Users can make measurements such as cup-to-disc ratio or measure the distance of a lesion from the macula.

The software also comes with image-processing capabilities, including a filtering system that allows viewing of the original image and three other filters at the same time (red, green, blue). When viewing filtered images next to one another, the images are linked so that users view the same section of the multiple images at once.

An emboss feature provides a 3D-relief image of the retina so that users can see elevation and depression more clearly. The software also has an inverse feature to help see the macula more clearly.

The system captures still images as well as live video with accurate color reproduction, clarity and contrast. "The beauty of the video is you can freeze a frame in the video and mark it up," says Dr. Lane. "You can save only one or two frames from the video so you don't have extraneous information and you are not taking up storage."

The system keeps images at the minimum size requirement for medicolegal purposes and won't save them at a lower resolution.

The software is icon-driven and most of the training is centered on technicians. Kowa teaches the techs the basics of image management and how to set the system up. The doctor is taught from a diagnostic and prognostic standpoint.

The Digiversal system allows doctors to search either through a patient's records by diagnosis or a series of diagnoses, or by type of image capture. Users can search by slit-lamp only or visual fields only or look at all central images for glaucoma.

With chronic conditions, where you may have hundreds of images on file, there are many options for reviewing and comparing disparate data over time to gauge the disease's course. It is possible to call up images from up to five instruments at a time.

Licensing fees are charged by the number of locations and stations using the software. The system has a Flex option for multiple locations where all images are stored on one central database. OM

For more information on Digiversal, visit www.kowa-usa.com or call (800) 966-5692.