RealTime’s DI network can support hospitals in the event of an outage

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RealTime Medical (RTM), a Mississauga, Ontario-based company providing radiology collaboration services for hospitals across Canada, is now offering a business continuity solution to ensure uninterrupted diagnostic imaging operations during a ransomware attack or any other unexpected downtimes. 

The idea for the company’s business continuity solution took shape when several of its regular customers experienced a cyberattack that took down their PACS. 

“Because they were existing clients of our teleradiology service, they were already connected to our cloud instance and could use our infrastructure to continue to provide diagnostic imaging services,” said Maynard.

That meant that any hospital connected to RTM for teleradiology support also had a ready-made backup if their own infrastructure was compromised.

“We saw the ability to assist our hospital-based radiology colleagues in a ransomware attack as a natural extension of our radiology collaboration service,” said Ian Maynard, CEO and co-founder of RTM. “We have your back under normal circumstances. We help to improve worklife balance, cover holidays and address the typical issues of not having enough radiologists, but now we also have you protected in an emergency situation.” 

“In today’s environment,” said Maynard, “it’s important to have a plan in place for the unfortunate occurrence of either a cyberattack or other unexpected downtime.” 

With RTM’s subscription-based business continuity solution in place a hospital hit by a ransomware attack can continue to image patients, provide reports to referring physicians, archive images and minimize the impact on patient care. The company’s turnkey infrastructure includes a cloud-based PACS, voice recognition and much more.

“Of course, if it’s a complete internet outage and there’s no way to connect to the outside world, there’s nothing we can do about that, but for other modes of failure, our backup service has you covered,” said Maynard. 

Ian Maynard, CEO & Co-Founder RealTime Medical Inc.

In the absence of backup from RTM during a ransomware attack, hospital radiologists would normally have to read exams at the modality workstations. That would be especially disruptive for radiologists working from home on weekend and overnight shifts because they would have to drive to the hospital. 

“That’s a terrible waste of time and a huge inconvenience with an obvious impact on reporting timelines which could be extremely detrimental to patient care, especially in the case of time-sensitive diagnoses such as stroke, or pulmonary embolism,” said Maynard. 

With limited archiving capacity on the modality workstations and no access to a hospital’s PACS, images would also be lost, preventing physicians from being able to track a patient’s condition over time.

“That really jeopardizes a hospital’s ability to provide continuity of care because even if you can get a current exam read, six months from now when the patient re-presents, you won’t be able to review prior exams to do a comparison and see, for example, if a tumour has grown or regressed. 

“One of our clients took upwards of 13 months to rebuild their PACS database,” recalled Maynard. “That would be a huge disruption for a diagnostic imaging department. Fortunately, they didn’t incur that impact because they were able to use our infrastructure.” 

Hackers know how disruptive a ransomware attack can be and count on hospitals not being able to tolerate that kind of impact. 

RTM stores exams and reports in a highly secure public cloud protected by an army of security engineers and is able to transfer them back to a hospital’s PACS once it’s rebuilt. 

Maynard advises hospitals not to wait until after a ransomware attack or other disruption of service to subscribe to its business continuity solution. 

Getting connected to the service is very straightforward. Working with the hospital’s IT department,

“a hospital would either download the secure gateway to our cloud infrastructure or we would do a direct VPN to your site,” he explained. “That establishes a DICOM node on the hospital’s network to which exams can be sent directly from the modalities.” 

Using RTM’s backup infrastructure and its automated critical results reporting system, referring physicians have secure access to reports at bedside on their mobile devices. The company’s portfolio of software tools also includes what it calls context-aware dynamic workload balancing. 

Traditional worklists distribute exams based on a radiologist’s specialty and the amount of time it takes to read a case.

“But what happens if you get stuck on a more complex case?” asked Maynard. “With a typical worklist, the next stat case is going to have to wait until whenever you can get to it. There may be a timer or a reminder that you’re running beyond your target service level agreement but there’s nothing you can do about it. That’s sub-optimal. You don’t want a patient being adversely affected because you happen to be doing your best for another patient.”

“Systems should be smart enough to understand, monitor, see what’s happening and dynamically rebalance these cases,” said Maynard. “We don’t want cases sitting on a worklist that are delayed any more than necessary because that has a direct impact on patient outcomes and patient lives.” 

RTM’s dynamic workload balancing software will reassign an exam to another onsite radiologist with the required specialty in such a situation, or direct the exam to one of RTM’s 25 radiologists if the hospital’s onsite radiology group also wishes to take advantage of RealTime’s radiology collaboration service on an as-required basis. 

RealTime Medical’s software portfolio also includes an AI-powered KnowledgeEnable tool that serves up relevant research from peer-reviewed radiology journals. A keynote speaker at a conference Maynard attended estimated that radiologists would have to spend 120 hours per week to stay current in their specialty because of the number of new findings published every day. 

“That means the gap between what the patient thinks you know and the latest information you could apply is turning into a gaping chasm. He felt strongly that we should do all we could to help radiologists close that gap.” 

With support from the National Research Council’s Industrial Research Assistance Program, RTM developed AIKnowledgeEnable to help radiologists make better informed decisions for their patients by curating the most relevant research from multiple, trusted, peer-reviewed medical data sources. The system then compounds this benefit with the collective intelligence of your physician peers in an easily accessible interface available at the time of diagnosis.

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