This year, 2014, marks the 20-year anniversary for RamSoft, Inc., a perfect vantage point from which to view 20 years of participation in the evolution of the imaging informatics industry for Vijay Ramanathan, president and CEO, and Siva Ramanathan, chief technology officer. RamSoft was founded in 1994 by N. Ramanathan, PhD, also known as Dr. Ram, a distinguished faculty member at the University of Toronto, with roots at the Toronto General Hospital. He is the father of Vijay and Siva.

The philosophy and commitment behind RamSoft to apply leading-edge medical imaging research and innovation to improve healthcare technologies still is based on the vision set out by Dr. Ram and continues through the leadership of RamSoft’s executive team. For 20 years, RamSoft has been a driving force behind radiology’s digital transformation, developing an industry and providing the state-of-the-art RIS/PACS and teleradiology solutions that are available today. Vijay and Siva Ramanathan take a look back with much pride at what inspired the company to begin, it’s incredible growth over 20 years, and where they’re heading next. 

Seeing a Light in the Dark

Though 20 years may not seem like enough time has passed to use the words “dark ages”, it’s definitely appropriate. Back in 1994, the Internet was the next big thing in technology — big enough that TIME did a cover story on it, but so unfamiliar that people usually had to begin by explaining what it was. Computers were only for geeks and most radiologists weren’t using them.

“The reality is that larger, academic-type institutions were the only ones that had PACS due to the complexity and cost of PACS. The majority of clinics were film and paper based,” explained Vijay, who created RamSoft’s first version of medical image management software while studying at the University of Waterloo, where he earned a BASC in computer engineering. “Everything was on hard copy and additional staff were needed just to retrieve film jackets and lay them out for the radiologists. Convincing prospects that Internet-based PACS was the next big thing in radiology was a bit of a challenge.”

From the Ramanathans’ perspective, the biggest problem to solve in radiology was to speed up this process. At the time, there were a large number of imaging centers that didn’t have onsite radiologists, so the process of getting the film, delivering it to the radiologist and getting the report back to the referring physician could take a week or more. Oftentimes, if there were a question about the exam, the patient would need to be called back for a return visit. By today’s standards, this would simply not be acceptable.

Dr. Ram was known to always be tinkering with some new software he was working on—always attempting to bring technological advances and efficiencies to healthcare. Eventually, he decided to work on his software full-time to create a solution for radiologists that was universal and compatible with off-the-shelf computers and networks. It needed to be cost effective for everyone.

“Growing up with access to computers, we were old enough to help, and also very interested. By the time RamSoft was founded, I was working part-time while in high school, and Vijay was testing the products and writing manuals,” recalls Siva, the company’s software guru, who also holds a BASC in computer engineering from the University of Waterloo.

One of RamSoft’s first products that came to market was UltraIQ system for ultrasound. During that same period, RamSoft was developing their first PACS UltraPro. Version two of UltraPro was Internet based, one of the first such products to hit the market. “We were a home-based startup company, so not many people knew about us,” Vijay states. “We didn’t have any funding, so we had to work twice as hard to get clients. Some of those clients are still with us. We’ve grown together, and that’s rewarding.”   

Moving from Now into the Future

With a solid company and foundation of image management solutions, RamSoft continues to influence change in the industry. Two teenagers who once tinkered alongside their father have brought new groundbreaking solutions to radiology over the years and now sit at the helm of this ever-growing organization, committed to continuing down the path of ultimately improving patient care by improving radiology workflow.

“From our perspective, it’s been very exciting. We’ve been able to evolve with the changes in healthcare and quickly deliver our newest solutions, thanks to our customers input and the hard work of our team,” Vijay explains.

As technology has experienced a revolution in the past 20 years, RamSoft has been able to harness that progress by developing a novel software platform that replaces a traditional PACS, RIS, teleradiology and document management solution.

“Our focus over the years has been to develop these key components from the ground up. Our biggest differentiator is the foundation of our platform.  Features are controlled by licensing, not interfaces of different products cobbled together,” says Vijay. Such innovation eliminates the numerous challenges with synchronization and greatly simplifies software use, administration and reduces cost in the long run.

“The frontier we’re seeing now,” Vijay says, “is a mobile and touch-friendly one. This is really the Apple effect we’re witnessing, just as Microsoft changed the world by bringing personal computers into the home. At RamSoft, we are always trying to bring the latest solutions to our customers, even when the market hasn’t fully adopted them yet.”

Despite the rapid advancement and continued expectation for advancement in technology, there always remains a learning curve. A great example is RamSoft’s embedded speech-recognition software.

“We introduced our embedded speech recognition solution shortly after introducing transcription solutions. Initially,” explains Siva, “we had very few takers for the speech recognition product; partly because of accuracy and partly because of comfort level. Fast forward to present day, where people use speech-recognition technology everyday on their phones. And just like our phones, our customers who use it wouldn’t think of going back to a world where they didn’t have it. They place a high value on the ability to report, sign and send immediately.”

Keep on Keeping On

Ultimately, the two RamSoft leaders couldn’t agree more that technology enables saving more lives. The initial challenges with image management and archiving have been resolved using state-of-the-art RIS/PACS and software solutions to enable efficient workflow and communications. The new challenges for radiology and for all of healthcare focus on data, analytics and interoperability.

“Definitely an area of focus for us,” says Vijay, “is creating intelligent software that aids the radiologist in key decisions. As an industry, we’ve begun to amass a lot of information. We need to distill that data very quickly.”

The ability to get new products to customers quickly and working together with them to get feedback on these products helps RamSoft continue to deliver exactly what their customers need.

“We have had several customers that have been with RamSoft for almost 20 years. I can’t underestimate the importance of having these great customers. These are the people that taught us radiology,” explains Vijay. “All of these customers have been instrumental in making our vision a success.”

And what keeps the RamSoft team moving forward? What is it really about for Vijay and Siva?

“For me, the real driver is knowing that what we’re doing is really changing people’s lives,” says Siva.

“We carry a greater responsibility in our business—there’s no such thing as good enough,” Vijay adds. “Things can always be improved. That’s what keeps us going.”