Croatian PACS firm Vamstec goes global

Croatia may not be the first country you’d think of as a hotbed of PACS entrepreneurship, but that’s exactly where Vamstec has set up shop. Based in Zagreb, Vamstec has spent a decade developing a range of digital image management and telemedicine products, and is now looking for a piece of the global PACS market.

Vamstec’s primary products for radiology are Issa and Pharos. Issa is a patient-focused medical information archiving system designed to organize a wide variety of data types, including patient demographics, medical examination findings, notes, and medical images, according to the firm.

Pharos is a remote image data communication system that enables interactive and store-and-forward telemedicine consultations, even over standard phone lines, according to the company. Pharos can also support ISDN, Internet, or any other TCP/IP-based communications.

In the interactive mode, two users can simultaneously display, manipulate, and annotate images, according to Adil Dzubur, Vamstec’s owner and general manager.

"For example, if I’m changing an image in Zagreb, and I’m connected with you, you will see those changes as I make them," Dzubur said. "Through an integrated chat function, I can also explain what I’m trying to show."

These "whiteboard" discussions are automatically stored as documents, and an event log allows for easy retrieval of all documents created in interactive communication, Dzubur said. Pharos can support all types of medical images, he said.

The company has set its sights on becoming a player in the U.S. marketplace, thanks to a distributor relationship with nGenius Telemedicine of San Antonio. Food and Drug Administration 510(k) clearances for Issa and Pharos were secured in February. A stand-alone system, including storage, acquisition, a viewer, and the Pharos telecommunication module, would cost between $15,000 and $17,000, Dzubur said.

When Vamstec was founded in 1990, the firm initially focused on developing Sform, an image processing and analysis software package for histopathology and cytology applications. In 1994, one of Vamstec’s customers, the University of Zagreb, expressed interest in sending and receiving pathology images over phone lines. A year later, the telepathology service was used to transmit images between Zagreb and a hospital in Dubrovnik, which was in a region then under occupation by Serbian forces.

Vamstec broadened its focus to include radiology images in 1996 by capturing, storing, and transmitting CT images within and between several hospitals in Croatia. In 1998, the Croatian Ministry of Health elected to deploy Vamstec’s system to set up a national teleradiology network.

In use for over two years, the network includes 33 workstations linked to imaging modalities -- primarily CT and MR scanners -- at 27 hospitals in 18 cities, Dzubur said. Two workstations were located in the referral site: the neurosurgery clinic under the direction of Josip Paladino at the Clinical Hospital Center REBRO of Zagreb. Although the initial implementation was focused on teleradiology, many hospitals have also added PACS capability, as well as the ability to integrate patient demographic information, images, and reports by implementing Issa, Dzubur said.

At a separate installation, Vamstec has set up a network between five cardiac cath labs in Croatia and a hospital in Zurich, Switzerland. As part of this network, Clinical Hospital Centers Split, in the town of Split, is exchanging live cardiac cath imaging data over standard phone lines with the department of cardiosurgery at Nova Hospital in Zagreb. Another site, Hospital for Cardiology and Cardiosurgery Magdalena, is exchanging store-and-forward images with a Swiss cardiology center in Zurich.

At this year’s RSNA conference, Vamstec introduced version 2.11 of Pharos. The new release includes an ASP purchasing option, as well as support for ICQ messaging programs, Dzubur said. Users can now use Microsoft's Internet Explorer Web browser to access the hospital server, allowing for images and patient information to be available remotely.

By Erik L. Ridley staff writer
December 6, 2000

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