Hey Mac, I have been in the South Pacific where communication was spotty and am just now catching up with all that has occurred with the SP etc. I do not have private messaging so I will address your questions as best as I am able here.
Our contractual radiology refreshes were not annual - they were usually a one time provision of a purchase contract or sometimes as separate purchases on older systems we were keeping that had already under gone a contractual refresh. A purchase affords the buying entity some leverage to include such language as protection against an upgrade that will make the system obsolete too soon after purchase. Upgrades of these systems are not like Adobe upgrades - they are rarer and the purchasing entity is likely to live with the system for a few years.
It would be too disruptive to do refreshes annually as it requires some down time (or at least slow down)and retraining of staff. A stand alone (as in not part of a system purchase contract) refresh is also done but you might go 5 years before doing so and it has to be considered as an option against a backdrop of the rapid evolution that is always occurring in imaging, the specific advantages linked to the refresh and the expense of paying for a refresh that is not part of a contract versus just getting a whole new system. Sometimes the value is not deemed worth the trouble. For example, I have seen instances where one or more refreshes were skipped and then picked up when the following refresh comes along. So things vary quite a bit.
While a refresh may be software-based, there are other things that affect it, e.g, a hardware-based upgrade such as new workstations, or a more sizeable hardware upgrade (aka a "fork-lift" upgrade of some of the imaging systems). These considerations influence when a software refresh occurs. Most dramatic is the purchase of a whole new system which then affords the purchaser the opportunity to leverage a refresh into the language of the contract as noted above.
It is hard to know exactly how the Novarad refresh will go. It will start with each institution being assessed as to where they stand (their current version of software, their equipment, mobile and offsite requirements etc.). Also, what size workload can Novarad and Sphere handle in a given period as staffing will play a role with over 400 sites on the table.
While this refresh looks relatively straightforward it probably is not as simple as it appears. Novarad likely wanted to enhance other aspects of their software that have little to do with Glassware and so the retraining etc. is likely more than just Glassware education. Also, some institutions may need storage enhancements and will want to look at the integrated solutions Sphere offers, which is a good thing but not part of the refresh per se and may involve a separate bid process.
It is hard to get more specific than that but I will say that there are some thorny issues that will make this refresh very attractive to the institutions. Patients flow between healthcare systems and take their medical records with them. Digital imaging studies are not as easily transferred as paper records. I can't tell you how many times the docs complained about this as they cannot get the disparate systems to work together.
Imagine patients walking in with a disk of their imaging studies from another institution but they do not come up on your system. The old days of Apple and Microsoft writ large. There are huge liability issues here - do you reimage the patient (often with associated risks of contrast reactions and more that I won't go into here)and if you do what has changed since the unreadable study was taken? This happens all the time and is a huge problem. Especially since the transfers to another institution often involve serious, time sensitive healthcare issues. The practice of medicine is greatly hampered if Radiology (and Pathology) results are unavailable.
The other big advantage is the ability to get this imaging information on different devices and in a variety of settings. We coped with this pretty well at my old hospital but to do so all devices (phones, at-home computers) were provided by and set up and maintained by the hospital at considerable IT expense. Glassware will improve this situation although the HIPPA issues remain and will have to be managed.
Hope this helps some. Seems the board moved away from here while I was away.
