Introduction

Visualization of the human anatomy

KJAYA Medical provides medical imaging and workflow solutions using the cloud. These series of slides introduces the medical imaging industry as it pertains to KJAYA Medical, and our ambitious vision and mission. So, we begin first with the question: what is medical imaging?

Medical Imaging is the creation of images of the human body for diagnostic purposes (scans). Americans spend $100B on 500M medical scans every year for these purposes. Insurance reimbursements provide financial support towards the cost of these scans.

Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiology practices use an array of imaging technologies such as X-ray radiography, ultrasound, computed tomography (CT), nuclear medicine, positron emission tomography (PET) and magnetic resonance imaging (MRI) to obtain images of the internal organ.

When a patient visits his/her primary care physician or specialist, the doctor orders a imaging procedure when further information about the patient's morphology is needed. A diagnostic imaging scan is performed at an imaging center or hospital, and presented to a radiologist, who then interprets the images for the purpose of diagnosing and treating diseases. The radiologist creates a report of the finding, and the radiologist sends the result to the patient's doctor who ordered the scan. The doctor subsequently incorporates the findings in the prognosis of the patient's condition.

Radiology images enables the detection of diseases occurring within ones body, and early detection of a serious illness can ensure longevity. Visualization is the key.

KAYA Medical develops and distributes VoXcell Cloud, an FDA cleared visualization solution that delivers and stores diagnostic-quality images. The specialized cloud for medical imaging is uniquely based on gaming technology and artificial intelligence.

Medical Image Storage

The Advent of PACS and its Shortcomings

Have you ever wondered where medical scans are stored? Well, in the past, medical scans were stored on films.  As you can imagine, this became a burden to healthcare providers.

So, the concept of Picture Archiving and Communication Systems (PACS) was introduced and became widespead in the 1990s. PACS today is a digital system comprises of servers, workstations, and software hosted on-site at the premises of a healthcare provider.
 
Ultimately, the cost of supporting the electronic storage and distribution of medical scans is borne by healthcare providers.  The Affordable Care Act is adding to the burden; providers need to cope with reduced reimbursement, yet make medical scans accessible electronically, while improving patient care.

Cabinets that were previously filled with hard copy films are now filled with servers with IT personnel managing them. Furthermore, access to the patients imaging record was time consuming, and many films were lost. Hardware would also fail and software needs upgrading, adding further burden to healthcare providers to manage them with their PACS vendors, but KJAYA Medical has a solution.

VoXcell® Cloud

Platform for Consolidation

Other software systems are also used in conjunction with PACS, and increasingly need to be interoperable with PACS, including RIS, Image Sharing, Archival, Post Processing, and Computer Aided Diagnosis:

. RIS or Radiology Information System software supports workflow, such as appointments, patient registration, work-lists and reporting

. Image Sharing allows communicating outside of the hospital premises or to remote physicians, specialists or referring physicians, or teleradiologists.  This has now been mandated by legislation (ACA and HITECH).  Most PACS systems are proprietary and historically could not link to one another, so Image Sharing requires additional IT investment

. Storage and Archival - Exponential growth in the volume of data means that storage requirements continue to rise. Furthermore, US law requires healthcare providers to keep medical records for seven years.  As such, PACS are often augmented with an offsite Archival system, generally at lower cost and slower access/higher latency.

. Vendor Neutral Archive concept was introduced to ensure operability with various PACS system, whereby the format and interface of the image archive is non vendor specific and follows established standard

. High Availability - PACS can become overloaded with simultaneous user requests, so that high availability solutions need to be in place for peak demand.

. Redundancy - PACS operation is mission critical and that redundant solutions need to be in place for coping with catastrophic failures, or even outages of the IT components. Failures could include power failure or hardware malfunction, or a more serious catastrophe such as a fire, flood or others.

. 3D Post Processing and Computer Aided Diagnosis (CAD) are other PACS add-on solutions required for certain routine procedures such as cardiac analysis and mammography. These applications rely on having the complete exam set available, are computationally intensive, and require specialized workstations.

. Dictatation software using Voice Recognition has become the standard for accepting voice input from a radiologist for report generation

. Computer Networks - Growth of scan data places ever increasing burdens on software and network efficiency in storing, retrieving or manipulating images.  Provider premises are generally connected through Local Area Network connections at typical speeds of 1 Gbps, and many are considering expensive upgrades to 10 Gbps to enable moving medical scans.  Physicians need powerful PCs or expensive custom workstations to manipulate the data on existing medical imaging systems when utilizing an onsite PACS system.

Conclusion: With the range of services and products available in the market to address the above requirements, managing medical scans is increasingly burdensome and costly to healthcare providers, but KJAYA Medical has a solution. KJAYA has built a specialized cloud for medical imaging uniquely based on gaming technology and artificial intelligence to consolidate the above requirements.

The VoXcell® Cloud platform provides KJAYA's team and 3rd Party developers with the immense processing power for developing demanding medical imaging application, Internet bandwidth, and redundancy and high availability of customer's data through multiple geographical location hosting. The new paradigm of combining access and storage so that the entire medical applications can solely reside on the cloud, removes the need to transmit raw scans to end user and enables front end application to run on any device. Neural network and genetic algorithms that are basis of artificial intelligence can be used to run on powerful gaming hardware to enhance analytics and intelligence of the clinical application. This is the foundation that our platform is built upon.

Healthcare provider benefits from a simple and powerful PACS, RIS, Image Sharing, Archive, 3D post processing, CAD, high availability and redundancy system: 
. Reduced image management costs to cope with reimbursement reductions
. Accelerated image management performance
. Improved producivity through efficient workflow
. Facilitation of a worldwide medical imaging information exchange
. Availability of diagnostic viewing and interpreation anytime, anywhere
. Improved patient care and safety
. Ability of diagnostic viewing and interpretation of anytime, anywhere
. Enhance accountability to payers and patients
. Improvement of availability of medical images and results to patients

Technology

Cloud Supercomputing Imaging

The premise of KJAYA's intellectual property is that intelligent visualizations are streamed on-demand, allowing medical images that are so large, to reside and accessible over the cloud. Since medical imaging exams are very data intensive, transmitting the entire scan at once to user reduces access to the information. Because of the power of our platform, complex visualizations of the exam are possible anywhere they are needed.

This means that the clinical application needs to be solely executed on the cloud, i.e. not rely on dedicated workstations power to display the images. To power such a demanding medical application would require immense processing capability. The power comes from vector processors. A cost effective vector processor is available on off-the-shelf video gaming hardware, now commonly referred to as Graphics Processing Unit (GPU).

Neural network and genetic algorithms that basis of artificial intelligence run faster on powerful gaming hardware. This augmented with the centralized collection of data to act on, enhance analytics and intelligence of the clinical application being developed.

The above describes the foundation that our cloud supercomputing platform for medical imaging is built upon.

Using this new platform, KJAYA's team has built a complete radiology software suite that completely replaces an onsite system, and provides a consolidated infrastructure for a full spectrum of applications to satisfy the medical imaging needs of healthcare providers.

Our software is also extensible, either KJAYA's team or 3rd Party developers can contribute to development of future medical applications by the software primitives and hardware platform provided by KJAYA.

VoXcell® Cloud

Medical Imaging and Workflow Solutions

VoXcell Cloud is a platform technology that provides a consolidated solution with PACS, RIS, 3D, Image Share, Archive, Report and Billing capabilities. There is no hardware needed, no capital cost, and everything is accessible over the web.

We offer our solution on an affordable, subscription basis. A single payment per study uploaded, and no other charges. Images are kept at multiple geographical disparate centers for 7 years for instant accessibility, high availability and redundancy. We also offer our software on a trial basis, and even our free trial supports powerful, clinically relevant functions.

While many other offers simply host an application designed for on site use in a remote data center, we have utilized true cloud computing architecture. This means that we can scale to a user’s volume instantly, we can achieve incredibly high availability and redundancy, and low cost per study due to the economy of scale we can leverage. Software upgrades are simple to deploy, and there is zero downtime to the users.

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