Cardiac Imaging

CW Q&A: Cleerly’s Image Transfer Solution

Big data analytics and advanced imaging modalities have the potential to transform care for patients with cardiovascular disease. And yet transferring colossal data files remains a huge challenge for hospitals and providers, impeding cardiologists’ workflow and patient care. 

We sat down with Cleerly CTO Nick Nieslanik to learn about how Cleerly is tackling the image transfer problem with their new solution, Proxy.  

Let’s start with some background. Who are you, and how did you wind up at Cleerly? 

Sure, my name is Nick Nieslanik and I’m the CTO here at Cleerly. I’ve got 20 years of experience in technology. I spent the first half of my career at Microsoft working on large-scale software-as-a-service platform endeavors. I transferred to consulting after that, and that led me to digital health, which aligned with my personal passion for finding things that make a difference in people’s lives. That’s why I joined Cleerly. As the CTO, I am helping shift the paradigm of cardiovascular care toward the development of an AI-powered care pathway.

Tell us a little about Cleerly and how it’s different from other heart disease solutions.

Cleerly’s goal is to prevent heart attacks, and we’re doing that by establishing a new standard of heart disease care. Our machine learning algorithms analyze CT angiography scans and generate a comprehensive report of a patient’s coronary artery disease.  

The current standard is to treat the symptoms of the disease and not the actual disease. Cleerly’s AI-powered care pathway allows people to see real quantitative analysis of their coronary arteries.

In our coronary CTA analysis reports, we start by saying, ‘This is how much disease is in your arteries by plaque composition.’  And we quantify that plaque in stages. Below that we show the lesions — which are the stenoses restricting that artery – and we frame that around information specific to the patient. We have a couple of other great features that I am not really at liberty to talk about, but pending FDA clearance it would give us some more framing for that disease state within the person. 

So basically, funneling CTA scans through our pathway gives doctors and patients insights into their heart health they didn’t have before.

Let’s dig into your new workflow solution, Proxy.

Cleerly has to take in a large quantity of data, and then we have to send back a lot of different insights to a lot of different people. Proxy helps us do that. With Proxy, we have automated the uploading process of CCTA scans from local systems to Cleerly’s cloud service. A single Cleerly Proxy installation can be used as an endpoint to receive CCTA scans from one or more imaging modality, PACS, or vendor-neutral archives. Each scan can then be uploaded into the Cleerly service for one or more providers to review and share results with patients. 

How is Proxy different from solutions already available?

It’s a good question. There are a large number of image transfer solutions out there in the marketplace. They’re really middlemen services that have very different requirements for integration. Because they’re mainly focused on image transfer, they generally have a ton of features that don’t align with the actual cardiovascular care pathway that doctors need. Proxy is an end-to-end solution. It eliminates that middleman. We can provide that IT and security comfort for them so they can focus directly on patient care.

Tell us about the Proxy implementation process.

It’s a turnkey solution. We can get it up and running at a site in under a day. We have monitoring and tracking capabilities so that the site doesn’t have to incur a bunch of overhead. Right when it’s installed, it shows up as an endpoint directly in the customer’s imaging modality. There’s very little training involved, the report distribution and consumption can go back into DICOM and right into the PACS as well as back into an EHR, through HL7 integration. 

Ultimately, we can drive the reporting and the analytical insights to all the different stakeholders in the system quickly, meeting them right where they already are.

How is this going to affect physicians and patients in their day-to-day lives?

Our goal is to be seamless, so in large part, Proxy is invisible. It’s just a way to transfer data such that we can get all the data back where physicians were already working. The idea here is that there’s already a worklist that the imaging folks are using. And there’s already a patient chart and an EHR that the cardiologist is using. We’re making sure our insights are there when clinicians need them. 

The impact on the patient is that we get great quantifiable analysis for coronary artery disease back to the appropriate doctors in an extremely timely and reliable fashion. They can make a decision quickly and they can treat that patient with confidence.

Patient data privacy is always a concern. What makes Proxy secure? 

One of our primary goals here is to alleviate all the security concerns for the IT staff at the hospital or the imaging center. I don’t think a day goes by when you don’t hear about some kind of data breach in the news somewhere in the world. 

We built Proxy with hardened images, hardened software, hardened communication protocols, and end-to-end encryption, with the idea that we can present this to IT, security, and governance staff and give them the confidence that their data and the patient’s data is always going to be safe. 

How does Proxy fit into Cleerly’s overall infrastructure?

I think about Proxy as our hub. In each location, Proxy gives us an opportunity to be in this hybrid cloud world where some things are in the cloud and some things are in the health system. We need a footprint there so that we can provide a hub for data distribution directly to providers. This is our foothold for that. So strategically, I look at Proxy as an opportunity to provide as much value to our customers as we can over the coming years.

What do you think will be the key to Cleerly’s success over the next few years? 

Maniacal urgency. Because changing the fundamental standard of cardiovascular care is so hard, if we aren’t attacking every problem head-on with as much urgency as we possibly can, we won’t affect the change that we need to get people on board. 

For more information on Cleerly Proxy, visit

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