NeST Group

Headquarters: VA, USA Engineering

Customized
Solutions
Solutions
Provider
Established: 1991
.
Employees: 4000+

Revenue: US$ 200M Appropriate Enduring

Technologies Partnerships
Industry Focus
Healthcare Industrial Automation
• Radiology • Equipment & Process Automation
• Hospital Wide Systems • Host/Device Connectivity
• Image Processing • SEMI E95 GUI Development
• Laboratory Instruments • Enterprise-wide SCADA

200+
500+
Engineers
Engineers
1000+ software professionals
CMMI L5 Quality Practices
Concept to Product execution
capability

Embedded & Communication Automotive

• Wireless & Multimedia • Automotive Networks
• Networking • Navigation Systems
• POS Terminals • User Interfaces
• Security
• VLSI

200+ 100+
Engineers Engineers
Quality Culture

Next targets (2009):

CMMI-Dev,
Automotive SPICE

ISO 27001
CMMI V1.1 ISO 9001:2000
CMM Level 5 Level 5
CMM Level 3
ISO 9001:1994

1997 1998 2000 2003 2003 2007

• ISO 27001 - Improve Information Security

• CMMi L5 - Continuous Process Improvement
• ISO - Systematic Quality Management

Nest obtained Automotive SPICE™ Organizational

Maturity Level 5 certification on April 2009
Quality Culture

North America Europe Asia

• GE • Alstom • Toshiba
• Brooks Automation • GE • Hitachi
• Lambda • ICOS • JVC
• Microvision • Sectra • NTT Electronics
• Areva • Mitsubishi
• AM Networks • Fujitsu
• Anadigics • Baltimore Japan
• MedWeb • Kanematsu Semi

Operates multiple Offshore Development Centers(ODC) for customers from diverse geographies
To become a synonym for high quality healthcare solutions globally
Integrated Healthcare
Medical Domain
Medical Imaging

Domain
Productisation
Expertise
Productisation Services
Standards
Image Processing
Modalities

Research & Consultancy

Prototyping

Medical Imaging Research Emerging Technologies

DICOM
DICOM conformance ensures that
every medical imaging facility is a
potential customer, because your
equipment can work with any
workflow or electronic health record
systems.

Focus

Service
Gateways
Classes

Viewers Middleware

C A S E S T U D Y

DICOM
CASESTUDY – DICOM WORKSTATION

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IMAGE PROCESSING
Volume Rendering
Ray Casting
Empty Space Skipping
Early Ray Termination
MIP

Reconstruction
 Iterative
 OSEM
 SART
 Analytic
 FBP
 FDK

Rigid Registration
 Mutual Information
 Segmentation

C A S E S T U D Y

AUTOMATIC AUTOMATIC
MIP CONE BEAM
REG. TOOL CARDIAC
CASESTUDY – MIP PACKAGE OF NeMIAS

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CASESTUDY – CONE BOREM

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DICOM – CASESTUDY – AUTOMATICE REGISTRATION

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DICOM – CASESTUDY – AUTOMATIC CARDIAC

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MODALITY MACHINE SOFTWARE
Subsystems
Clinical Data
Applications
Platform Acquisition
Algorithms Imaging

Modality

US

NM

MRI

XR

CT
MEDICAL IMAGING RESEARCH GROUP

Objective

 To pursue the latest trends in medical imaging

 Research and Analysis wing

Team
 Led by a team of highly skilled specialists ( PhD holders & post
graduates)
 Group of 50 image processing experts well versed in
o DirectX 9.0
o OpenGL
o Shader 2.0
o Matlab, IDL
MEDICAL IMAGING RESEARCH GROUP
Activities
 Research in latest imaging techniques
 Collaborating with leading medical institutions in India & abroad
 Prototyping of new product ideas
 Extended R&D support for OEMs
 Paper publication in leading journals

Research Journal
Approach Club
Seminar
Published Programmes
Papers

Research
Research Culture Conference
Presentations
Partners

C A S E S T U D Y

MICRO SPECKLE
MOLECULAR
FLOW REDUCTION
CASESTUDY – MICRO FLOW IMAGING

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CASESTUDY – MOLECULAR IMAGE ENHANCEMENT

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DICOM – CASESTUDY – SPECKLE REDUCTION

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PRODUCTISATION & PRODUCTS
R&D Proto-Typing Productisation Manufacturing Product Sustenance

•Productisation Services
•Full Product Life cycle development
•Concept to product
•Fast Prototyping
•Multiple quality gates
•Stabilization testing

•Products
•Develop reusable IP on promising ideas
•Package IP as full fledged products

C A S E S T U D Y

MEDICAL
BRAINASSIST STRESSECHO iMAS IMAGE PACS
VIEWER
CASESTUDY – BRAINASSIT

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CASESTUDY – STRESS ECHO

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CASESTUDY – IMAS

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CASESTUDY – MEDICAL IMAGE VIEWER

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CASESTUDY - PACS
Healthcare with a difference
Integrates patient radiology and clinical information workflows
that traditionally have been manual- or film-based
Complete electronic health records are now made possible by
offering an integrated image and information management system
Helps to reduce the potential for errors and strengthen the ability
to provide optimal care while reducing operating costs

Ushers in a new age of patient care by realizing the vision of a

filmless and paperless hospital.
Revolutionizes patient care by giving healthcare professionals a
quick and efficient access to patient information.

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PACS FEATURES
Multimodality Support (Ultrasound, CT, Digital X-ray, MRI)
HL7 and DICOM compliant
HIS /RIS integration
3D Image viewer with MPR, MIP and cut view
Web based image viewing and reporting
Mobile Interface
Measurement support
Multi monitor display
Hanging protocol support
Report Generation with images
Auto data backup for redundancy
Role based login privileges for high security
Creating workbenches with key images of patient studies
Conversion of DlCOM to non DICOM images and vice versa
Image processing tools (Window level/width , zoom/ pan/ rotate, pseudo coloring)
CONSULTANCY

Emerging Technologies
GPU-based Cluster Computing Thin client Multi-Core/Multi- Intel SSE
programming •Desktop PCs as clusters technology Thread • Streaming SIMD
tools •Windows Cluster Nodes •Next big technology • POSIX Extensions Instruction
•Windows HPC Server Threads/OpenMP/Intel set
•Direct X /Direct 3D •Server based
2008 rendering/processing TBB • 128 bit
(Microsoft )
•Cluster Server 2003 • RapidMind Multi-Core operations/instructions
•CUDA (from Nvida ) •Only in experimental
•8-Node HPC Bundle stages Dev Platform • Non temporal storing
•Open GL /GLSL & data prefetching
(DELL)
•RapidMind
•IBM Cell

C A S E S T U D Y

AFDM HIGH SPEED

CONE BEAM
FILTER
CASESTUDY – AFDM REGISTRATION

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CASESTUDY – HIGH SPEED FILTER IMPLEMENTATION

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CASESTUDY – CONE BEAM CT IMAGE RECONSTRUCTION

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CLINICAL

Productisation
Domain Expertise Consultancy
Services
• Health Level 7
• HL7 Integration
• Integrating Healthcare Enterprise • Radiology Information Systems
• Tele-Health
• Clinical Decision Support Systems • Hospital Information Systems
• EMR
• Clinical Physician Order Entry • Lab Information Systems
• HITSP
• HIPAA
HL7 INTEGRATION
HL7 family of standards is the
foundation for the next generation
healthcare information systems.

HIS –RIS-PACS Integration

BizTalk Accelerator/ C++ Native

HL7 Engines

MLLP/Folder based
communications

IHE Profile Compliance

C A S E S T U D Y

HL7
HL7 PARSER WORKFLOW
INTEGRATIO
INTEGRATION
N
CASESTUDY – HL7 PARSER INTEGRATION

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CASESTUDY – WORKFLOW INTEGRATION OF HEALTHCARE

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CASESTUDY – HL7 INTEGRATION

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INTEGRATING HEALTHCARE ENTERPRICE
Integrating the Healthcare Enterprise an initiative promoting
and supporting the integration of systems in the healthcare
enterprise.

Improve Focus

Workflow All IHE profiles

Information Accuracy
IHE Connectathon™

Information
Availability

Cross-System
Functionality

C A S E S T U D Y

IHE
CASESTUDY – IHE COMPLIANT MODALITY MACHINE

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CROSS-ENTERPRISE DOCUMENT SHARING [ XDS ]
 IHE’s IT Infrastructure Profile
• Cross Enterprise Document Sharing(XDS)
Standardization in registration/sharing of EHR documents between healthcare
enterprises Patient Identity
Source

 XDS-related IT Profiles Patient

Identity
• Cross-Enterprise Document Media Interchange(XDM) Feed
Addresses the protocol of transfer of XDS documents and metadata over CD-R/USB Query
media and email/ZIP attachments Documents
• Cross-Enterprise Document Reliable Interchange(XDR) Document Document
Addresses the interchange of XDS documents in the case of Point-to-point networks Registry Consumer
• Cross-Enterprise Sharing of Scanned Documents(XDS-SD)
Register
Addresses integration of legacy media like paper/film/scanner formats with the Provide and Document
structured HL7 CDA format Register Set
Document Set
Retrieve
Document
Documen Document
t Source Repository

• ebXML Expertise
• IHE has adopted ebXML and specifically ebXML
Registry for its Document Sharing Profiles.
C A S E S T U D Y • NeST prior expertise in ebXML implementation can be
leveraged to provide quick solutions for its vendors

XDS
CASESTUDY – XDS INTERFACING IN HIS/PACS SCENARIO

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DECISION SUPPORT SYSTEMS
Computer Aided Differential Diagnosis Techniques
 Uses Decision Trees
 Statistical approaches
Baye’s Rule
Discriminant Analysis
 Logistic Regression
 Inference Techniques
 Rules
 Logic
 Semantic Networks

Features
 Fully Integrated to ICD-9 Codes
 Aids Diagnosis Accuracy
 Immediate access to Specialist level expertise
 Visual clues to Diagnoses
 Integrated to large databases
 Diseases
 Syndromes/Manifestations
 Treatment Protocols
CLINICAL PHYSICIAN ORDER ENTRY

CPOE System Features Point Of Care System Suite

 Standardized Ordering  Future Medication Ordering System
 Patient oriented decision support  Drastic Reduction In Medication/ADE Errors
 Patient Safety Checks  Productivity increase in Order processing
 Regulatory compliance including Security

CPOE System Integration

 Integration to CDSS for decision support
 Billing Integration to diagnosis through ICD – 9/10-CM codes
HIPAA
C A S E S T U D Y

HIPAA

Security Expertise
Privacy o Sound knowledge of HIPAA 1996 (Law 104-191)
o Experts & Professionals
o Certified Security Specialists
o Retrofit HIPPA compliance to legacy Equipment
Electronic o Design HIPAA compliant middleware from scratch
Transactions(EDI)
CASESTUDY – HIPAA COMPLIANT MODALITY MACHINE

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TELE-HEALTH/eHEALTH
Remote communication of information to facilitate clinical care

• Telemetry
• Tele Radiology – ACR Standard
• Remote Surgery

C A S E S T U D Y

TELERADIOLOGY
CASESTUDY - TELERADIOLOGY

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ELECTRONIC MEDICAL REPORT
EMR acts as the backbone for delivering
immaculate patient care, establishing efficient
processes and maximizing profitability.

HL7 Interface
Dictated Audio History & Allergies

Voice Recognition Drugs &

Immunization
EMR

Scanned Charts Patient Schedule

Diagnostic Images Reference Content

Patient Lab Data

C A S E S T U D Y

EMR
CASESTUDY – EMR ENHANCEMENT
HITSP

Hospital Information Technology Standards Panel

•Recommendations/Compliance
Nest ‘s knowledge management initiatives help keep track of the latest developments in
field of healthcare integration standardization

Interoperability Specifications Expertise

•IS-01 EHR Lab Results Reporting
Integrating EHR/non-EHR CDS packages to LIS/Locator Services
•IS-07 Medication Management
Redefining access to necessary medication/allergy information for all relevant
stakeholders
•IS-77 Remote Monitoring
Integrating EHR packages to remote patient monitoring interfaces/devices

• Re-Modeling Expertise offered

• ‘Early Implementers’ can benefit from adhering to emerging standards
• Can analyze and re-model existing solutions to conform to HITSP
recommendations
• Also migrate custom solutions to use latest integration technologies
RADIOLOGY INFORMATION SYSTEM

Radiology Information Subsystems

o Patient Management
o Registration
o Searching
o Order Management
o Creation
o Scheduling
o Searching

Features
o Modality Worklist Generation
o Patient Information Reconciliation
o HL7 Compliance
o HL7 interfacing to third-party HIS packages
RADIOLOGY INFORMATION SYSTEM
Services
HOSPITAL/ o Migration of legacy Clinical /Hospital
CLINICAL Information systems to latest platforms
MODULES o Integration to RIS/PAC packages
o Conformance to healthcare protocols
like HIPAA/IHE

ADT FINANCIAL ACCOUNTING

APPOINTMENT SCHEDULING HOUSEKEEPING

BILLING CRITICAL CARE

BLOOD BANK PAYROLL

CLINICAL DECISION SUPPORT PHARMACY

DIET & NUTRITION RECEPTION & REGISTRATION

DISCHARGE SUMMARY SECURITY & ADMINISTRATION

EMR STORES & WARDS

EQUIPMENT INTERFACING

Productisation
o All modules of typical Clinical/ HOSPITAL/
Hospital Information systems can CLINICAL
be productized
MODULES
o Inter module integration
LAB INFORMATION SYSTEM

Legacy Migration Services

•Rejuvenate legacy LIS solutions
Nest can upgrade outdated Lab information solutions

Seamless Laboratory Integration

•EMR Interfacing
Integration with external EMR packages is essential advantage
•Web outreach

• Productisation/Features
• Orders/Results Management
• HL7/ASTM Interfacing support
• Workload Balancing/Capacity Scheduling
SKILL SUMMARY
SKILL SUMMARY

Over 1500 man-years of medical domain experience

Excellent Quality Standards
CMMIL L5 Company
Lower defect density
IP protection
ISO 27001 Certified
Product Support Experience
Focused on health care services only
Independent Testing Team
Scalable skilled resource pool
THANK YOU