Osteoporosis is under-screened and under-diagnosed. With Rho, we aim to enable the initiation of preventative
care earlier in the course of the disease and ultimately reduce fracture incidence.
About Rho
How Rho works.
Rho is a medical device that flags patients with possible low bone mineral density on routinely acquired x-ray imaging, to prompt a clinical assessment of bone health. These are x-ray images that were acquired for other reasons (for example, a chest x-ray to rule out pneumonia). In this way, Rho operates as an opportunistic pre-screening system by generating new value from existing data.
Rho uses modern machine learning to flag patients with possible low bone mineral density. To train the model, researchers utilized over 60,000 x-ray and DXA pairs performed within 1 year of each other in outpatients at multiple imaging facilities over a 10 year period. Rho has been validated in three independent clinical datasets, and shown to have a high negative agreement (specificity; i.e., few false positives) and high area under the receiver operating characteristic curve, with lower positive agreement (sensitivity).
Rho is a medical device that identifies patients likely to have low bone mineral density from routinely acquired x-ray imaging. These are x-ray images that were acquired for other reasons (for example, a chest x-ray to rule out pneumonia). In this way, Rho operates as an opportunistic screening system by generating new value from existing data.
Rho uses modern machine learning to identify patients likely to have low bone mineral density. To train the model, researchers utilized over 60,000 x-ray and DXA pairs performed within 1 year of each other in outpatients at multiple imaging facilities over a 10 year period.
Rho was validated in independent test sets, including a Canadian dataset of 3729 unique individuals and a US dataset of 513 unique individuals (FDA De Novo decision summary, DEN230023). Results in the Canadian dataset and two further datasets, the Canadian Multicentre Osteoporosis Study and the Osteoarthritis Initiative, are described in our publication in the Journal of the American College of Radiology. The area under the receiver operating curve (AUC) was used as the primary endpoint.
The FDA granted De Novo marketing authorization for a version of Rho that displays a different output.
Rho is a software medical device, granted FDA De Novo marketing authorization, that analyzes a standard x-ray using artificial intelligence to screen patients who have possible low bone mineral density (BMD). Rho provides a notification in the form of a report to aid radiologists and/or physician interpreters in identifying patients with possible low bone mineral density (BMD) at L1-L4 or the femoral neck to prompt a clinical assessment of bone health. Rho should not be used to rule out low BMD. Radiologists and referring clinicians should follow recommended practices for screening and assessment, regardless of the absence of Rho report.
What is Rho?
Rho is a Health Canada-licensed software medical device that analyzes a standard x-ray using artificial intelligence to screen patients who are likely to have low bone mineral density (BMD). The output of Rho is a report that is provided to the healthcare professional reviewing an x-ray. The report presents a Rho Score between 1 and 10. A higher Rho Score indicates a higher likelihood of the patient having a DXA-derived T-score < -1 in at least one of the femoral neck or lumbar spine (L1-L4). This is meant to aid health care professionals in the assessment of risk of low bone mineral density (BMD). Rho produces adjunctive information. It is not a diagnostic aid.
What is Rho’s intended use?
Rho is an opportunistic pre-screening tool that analyzes standard frontal radiographs of the lumbar spine, thoracic spine, chest, pelvis, knee or hand/wrist performed in patients aged 50 years and older. The algorithm was developed using machine learning to provide information that may be useful for prompting the clinical assessment of bone health.
What is Rho’s intended use?
Rho is an opportunistic screening tool that analyzes frontal radiographs of the lumbar spine, thoracic spine, chest, pelvis, knee, or hand performed for any clinical indication in patients aged 50 years and older. The algorithm was developed using machine learning to generate a risk score that correlates with a patient’s likelihood of having low bone mineral density.
Why was my patient screened by Rho?
If your patient is aged 50 years or older and had an x-ray of the chest, pelvis, knee, hand or wrist, lumbar spine, or thoracic spine at an institution that uses Rho Enterprise, it is analyzed automatically after the x-ray is performed, unless the patient had a DXA within the period the institution has set. The physician reporting the x-ray reviews this information and can include it in the x-ray report.
What should I do if my patient is flagged by Rho?
As the physician reading the x-ray, you can choose to include this finding in your report.
As a care provider receiving this information, you can consider conducting a clinical fracture risk assessment. Based on this assessment, you can decide whether or not the patient would benefit from a DXA to accurately quantify the patient’s BMD and fracture risk.
Why would a primary care provider be interested in Rho results?
In the U.S., over 10 million people aged 50 years and over have osteoporosis, and 43 million have low bone mass (Wright et al., JBMR, 2014). About one in two women and up to one in four men aged 50 and older will break a bone due to osteoporosis (Bone Health and Osteoporosis Foundation). To intervene prior to a first fracture, a clinician must conduct a fracture risk assessment and, if appropriate, refer a patient for BMD assessment. A Rho result can trigger primary care providers to perform a clinical fracture risk assessment in patients who would benefit, with no additional imaging time or radiation. With Rho, we aim to enable the initiation of preventative care earlier in the course of the disease.
Why would a primary care provider be interested in Rho results?
Osteoporosis is a silent disease resulting in fractures which occur in 1 in 3 women and 1 in 5 men (Osteoporosis Canada). Screening for osteoporosis is underutilized. In a US claims study, 26.5% of women aged 65 to 79 were screened over a two-year period (Gillespie CW, Morin PE. Am J Med. 2017). Guidelines for screening with DXA vary by jurisdiction, and preventative care is often overlooked in today’s healthcare environment (LeBoff et al., Osteoporosis International, 2022). As many patients aged 50 and older undergo an x-ray for some reason (Mettler et al., Radiology, 2020), Rho can act as an opportunistic pre-screening tool utilizing this already captured data to identify patients who are more likely to benefit from further screening. With Rho, we aim to enable the initiation of preventative care earlier in the course of the disease.
Why would a radiologist be interested in Rho results?
Rho gives radiologists a finding they can add to the x-ray report for patients who may have low bone mineral density, with no additional imaging. By default, only Rho Positive reports reach PACS, so radiologists see a report only for flagged studies.
Why would radiologists be interested in Rho?
Rho gives radiologists a finding they can add to the x-ray report for patients likely to have low bone mineral density, with no additional imaging. Each institution sets the Rho Score threshold for sending reports to PACS.
How does Rho operate in a radiologist’s existing reporting workflow?
Rho automatically identifies when an eligible x-ray has been performed at an institution, analyzes it, and sends a Rho Report to the accession if the patient has possibly low BMD. The Rho Report is directly viewable in the PACS. When reporting the x-ray, the radiologist can review the Rho Report, and, if in agreement, can simply include this finding in their own words, or insert a pre-programmed macro through their voice dictation software.
How does Rho operate in a radiologist’s existing reporting workflow?
Rho automatically identifies when an eligible x-ray has been performed at an institution, analyzes it, and sends a Rho Report to the accession if the patient is likely to have low BMD. The Rho Report is directly viewable in the PACS. When reporting the x-ray, the radiologist can review the Rho Report, and, if in agreement, can simply include this finding in their own words, or insert a pre-programmed macro through their voice dictation software. The Rho Score threshold that triggers reports to be sent to PACS is configurable by the institution.
How fast does Rho work?
With the default configuration, the Rho report is usually viewable in PACS within minutes of the x-ray being uploaded to PACS. This latency can be customized based on your site’s requirements and IT infrastructure.
Does Rho screen patients even if they have had a previous DXA/BMD scan?
Rho has a configurable parameter which will prevent analysis of a patient who has had a DXA within X number of months. The default value for this is 24 months.
What if a patient has x-rays of multiple body parts in the same accession?
Rho will automatically identify this and will only send a single Rho Report for that accession.
What if a patient has x-rays of multiple body parts in different accessions?
In that case, the patient may receive multiple Rho Reports to different accessions. There will never be more than 1 report per accession. In the TNI dataset, Rho’s AUC was 0.85 or more for each body part (see Clinical validation results), but there will be times when Rho results for the same patient from x-rays of two different body parts will not match. Rho is not designed to diagnose or rule out disease. We believe that any suggestion of increased risk of low BMD warrants reporting, as the consequences are a simple clinical fracture risk assessment, however the physician reading the x-ray is free to use their discretion. Optionally, Rho can be configured to send one report per patient within a specified timeframe (e.g., per day or per week).
Can’t radiologists just flag patients when they see bone loss?
Low bone density is hard to see on conventional radiographs: osteopenia is not detected until 20 to 40 percent of bone mass has been lost (Brunader and Shelton, Am Fam Physician 2002;65:1357-1364). If someone had a femoral neck BMD of 0.858 g/cm², the mean for white women aged 20 to 29 in NHANES III (SD 0.120 g/cm²; Fujiwara et al., Osteoporosis International, 2008), the reference standard recommended by the WHO Collaborating Centre (Kanis et al., Bone, 2008) and the ISCD (2023 Official Positions), a 30% loss of bone mass would correspond to a T-score of -2.1. Similarly, at L1-L4, where the mean for non-Hispanic white women aged 20 to 29 in NHANES 2005-2008 is 1.064 g/cm² (SD 0.106 g/cm²; Looker et al., Vital and Health Statistics, 2012), a 30% loss would correspond to a T-score of -3.0. Clinical spine T-scores use the DXA manufacturer’s reference database, so the spine example is illustrative. Rho is designed to flag possible low bone mineral density from a DXA T-score below -1, an earlier stage of demineralization.
Shouldn’t we just flag all patients over 50?
Current recommendations are that patients 50 years and over undergo clinical fracture risk assessments and patients 65 and over be considered for DXA, but in practice, preventative care is not always top of mind. Flagging all adult x-ray patients in need of clinical fracture risk assessment is consistent with existing guidelines: the Bone Health and Osteoporosis Foundation’s 2022 clinician’s guide (all postmenopausal women and men aged 50 and older should be evaluated for osteoporosis risk; LeBoff et al., Osteoporosis International, 2022), the Osteoporosis Canada 2023 guideline (Morin et al., CMAJ, 2023) and the USPSTF 2025 recommendation (Nicholson et al., JAMA, 2025). Rho helps the physicians reading x-rays identify the patients who are most likely to benefit from this risk assessment which helps clinicians prioritize their limited time. The table below shows that when age is used as a predictor of low BMD, the area under the receiver operating characteristic curve (AUC) is about 0.6 in both females and males, but using Rho as the predictor of low BMD, the AUC is significantly higher.
AUC using Rho or age as a predictor of low BMD
Analysis group
n
AUC with age as predictor
AUC with Rho as predictor
Females
3111
0.62 (0.60-0.65)
0.89 (0.88-0.91)
Males
618
0.58 (0.54-0.62)
0.82 (0.79-0.85)
Shouldn’t radiologists just flag all patients over 50?
Current recommendations are that patients 50 years and over undergo clinical fracture risk assessments and patients 65 and over be considered for DXA, but in practice, preventative care is not always top of mind. Flagging all adult x-ray patients in need of clinical fracture risk assessment is consistent with existing guidelines: the Bone Health and Osteoporosis Foundation’s 2022 clinician’s guide (all postmenopausal women and men aged 50 and older should be evaluated for osteoporosis risk; LeBoff et al., Osteoporosis International, 2022), the Osteoporosis Canada 2023 guideline (Morin et al., CMAJ, 2023) and the USPSTF 2025 recommendation (Nicholson et al., JAMA, 2025). Rho helps radiologists identify the patients who are most likely to benefit from this risk assessment which helps clinicians prioritize their limited time. The table below shows that when age is used as a predictor of low BMD, the area under the receiver operating characteristic curve (AUC) is about 0.6 in both females and males, but using the Rho Score as the predictor of low BMD, the AUC is significantly higher.
AUC using Rho or age as a predictor of low BMD
Analysis group
n
AUC with age as predictor
AUC with Rho as predictor
Females
3111
0.62 (0.60-0.65)
0.89 (0.88-0.91)
Males
618
0.58 (0.54-0.62)
0.82 (0.79-0.85)
Clinical validation results (US)
Rho was evaluated in three independent clinical datasets to assess its performance (positive agreement [sensitivity], negative agreement [specificity] and area under the receiver operator characteristic (AUC) curve) at identifying patients with low BMD from frontal radiographs. Ground truth “low BMD” was determined if the DXA report for a patient had a T-Score < -1 for either femoral neck or lumbar spine L1-L4. Assessments were made with a set of x-ray/DXA pairs that included 6 types of x-ray that Rho can analyze (lumbar spine, thoracic spine, chest, pelvis, knee, or hand/wrist) in males and females. Performance was assessed in datasets that are independent from the dataset used to train Rho. The datasets included participants with a range of BMD values that cover the entire range of disease state, but included more participants with low BMD than the general population. Positive agreement (sensitivity) and negative agreement (specificity) and AUC in the test set populations are presented below. Subset analyses by sex, body part, age decade, race, and x-ray manufacturer are reported in the FDA decision summary (Table 2). Performance varied by subgroup, with lower sensitivity for the knee, and some subgroups were too small to estimate performance reliably. Source: FDA De Novo decision summary (DEN230023), Table 2, where positive agreement is reported as sensitivity and negative agreement as specificity.
Positive and negative agreement and AUC by analysis group: TNI, OMN and OAI
Analysis group
Dataset
n
Positive agreement
Negative agreement
AUC
All data split by dataset
TNI
3729
0.67 (0.66-0.69)
0.90 (0.88-0.92)
0.88 (0.88-0.90)
OMN
513
0.45 (0.41-0.50)
0.93 (0.90-0.96)
0.85 (0.82-0.88)
OAI
591
0.36 (0.31-0.41)
0.94 (0.92-0.96)
0.82 (0.79-0.85)
Sexes split by dataset
Females
TNI
3111
0.70 (0.68-0.71)
0.90 (0.88-0.92)
0.89 (0.88-0.91)
OMN
274
0.48 (0.42-0.54)
0.94 (0.89-0.98)
0.87 (0.83-0.90)
OAI
293
0.44 (0.37-0.50)
0.90 (0.85-0.94)
0.81 (0.77-0.85)
Males
TNI
618
0.49 (0.45-0.53)
0.90 (0.86-0.93)
0.82 (0.79-0.85)
OMN
239
0.41 (0.34-0.49)
0.92 (0.88-0.96)
0.83 (0.78-0.87)
OAI
298
0.22 (0.15-0.30)
0.98 (0.96-0.99)
0.79 (0.75-0.84)
Age decades split by dataset
50-59
TNI
844
0.64 (0.61-0.68)
0.95 (0.92-0.97)
0.89 (0.87-0.90)
OMN
106
0.43 (0.33-0.53)
0.95 (0.88-1.00)
0.88 (0.82-0.93)
OAI
177
0.26 (0.15-0.38)
0.98 (0.96-0.99)
0.77 (0.70-0.84)
60-69
TNI
1339
0.65 (0.63-0.67)
0.94 (0.91-0.96)
0.90 (0.89-0.92)
OMN
181
0.48 (0.40-0.55)
0.91 (0.86-0.97)
0.83 (0.78-0.88)
OAI
202
0.34 (0.25-0.43)
0.94 (0.90-0.97)
0.82 (0.77-0.87)
70-79
TNI
1031
0.69 (0.66-0.71)
0.86 (0.82-0.90)
0.87 (0.85-0.89)
OMN
176
0.48 (0.39-0.56)
0.93 (0.88-0.97)
0.88 (0.84-0.92)
OAI
181
0.38 (0.30-0.45)
0.88 (0.81-0.94)
0.78 (0.72-0.83)
80+
TNI
515
0.74 (0.71-0.78)
0.71 (0.62-0.80)
0.84 (0.80-0.88)
OMN
50
0.35 (0.21-0.50)
0.95 (0.85-1.00)
0.80 (0.69-0.90)
OAI
31
0.56 (0.35-0.75)
1.00 (1.00-1.00)
0.95 (0.88-1.00)
X-ray body parts split by dataset
Chest
TNI
1331
0.83 (0.81-0.85)
0.80 (0.75-0.84)
0.89 (0.88-0.91)
OMN
149
0.51 (0.39-0.62)
0.90 (0.80-1.00)
0.86 (0.81-0.92)
Lumbar
TNI
791
0.57 (0.54-0.60)
0.95 (0.93-0.98)
0.91 (0.89-0.93)
OMN
99
0.39 (0.29-0.50)
0.93 (0.86-1.00)
0.85 (0.79-0.91)
Thoracic
TNI
328
0.75 (0.71-0.80)
0.92 (0.84-1.00)
0.93 (0.89-0.95)
OMN
44
0.50 (0.35-0.65)
1.00 (1.00-1.00)
0.86 (0.76-0.94)
Pelvis
TNI
457
0.72 (0.69-0.76)
0.99 (0.97-1.00)
0.96 (0.94-0.97)
OMN
82
0.56 (0.44-0.68)
0.97 (0.92-1.00)
0.90 (0.84-0.95)
OAI
197
0.55 (0.45-0.64)
0.93 (0.89-0.97)
0.91 (0.88-0.94)
Hand/wrist
TNI
250
0.56 (0.50-0.61)
0.91 (0.85-0.97)
0.85 (0.80-0.89)
OMN
54
0.45 (0.31-0.61)
0.81 (0.67-0.95)
0.73 (0.61-0.85)
OAI
174
0.24 (0.15-0.33)
0.96 (0.92-0.98)
0.77 (0.70-0.82)
Knee
TNI
572
0.41 (0.37-0.44)
0.96 (0.93-0.99)
0.87 (0.84-0.90)
OMN
85
0.29 (0.18-0.39)
0.97 (0.92-1.00)
0.86 (0.79-0.92)
OAI
220
0.28 (0.21-0.36)
0.94 (0.91-0.98)
0.76 (0.71-0.81)
Races split by dataset*
White
TNI
3292
0.67 (0.66-0.69)
0.90 (0.88-0.92)
0.89 (0.88-0.90)
OMN
142
0.46 (0.38-0.55)
0.98 (0.94-1.00)
0.90 (0.86-0.94)
OAI
418
0.36 (0.30-0.42)
0.94 (0.91-0.96)
0.80 (0.77-0.84)
Black
TNI
24
0.33 (0.10-0.60)
1.00 (1.00-1.00)
0.77 (0.36-0.91)
OMN
114
0.36 (0.25-0.46)
0.95 (0.90-0.99)
0.86 (0.80-0.91)
OAI
147
0.40 (0.27-0.53)
0.95 (0.92-0.98)
0.86 (0.80-0.91)
Asian
TNI
134
0.74 (0.67-0.81)
0.96 (0.88-1.00)
0.93 (0.89-0.96)
OMN
134
0.47 (0.38-0.56)
0.91 (0.84-0.98)
0.84 (0.78-0.89)
OAI
5
0.00 (0.00-0.00)
1.00 (1.00-1.00)
0.83 (0.50-1.00)
Hispanic
OMN
123
0.49 (0.40-0.59)
0.88 (0.79-0.95)
0.80 (0.73-0.87)
OAI
10
0.20 (0.00-0.50)
1.00 (1.00-1.00)
0.98 (0.92-1.00)
BMI category split by dataset**
18.5 to <25
TNI
1584
0.75 (0.73-0.77)
0.87 (0.83-0.91)
0.90 (0.88-0.91)
OMN
147
0.58 (0.51-0.66)
0.81 (0.69-0.92)
0.82 (0.75-0.89)
OAI
32
0.45 (0.27-0.64)
0.83 (0.62-1.00)
0.75 (0.58-0.90)
25 to <30
TNI
1265
0.63 (0.61-0.66)
0.90 (0.87-0.93)
0.87 (0.85-0.89)
OMN
187
0.46 (0.38-0.54)
0.94 (0.89-0.98)
0.86 (0.81-0.90)
OAI
80
0.33 (0.21-0.45)
0.98 (0.93-1.00)
0.83 (0.75-0.90)
≥30
TNI
792
0.53 (0.50-0.57)
0.92 (0.89-0.95)
0.86 (0.83-0.88)
OMN
156
0.29 (0.20-0.37)
0.96 (0.92-0.99)
0.83 (0.77-0.88)
OAI
106
0.37 (0.22-0.53)
0.97 (0.94-1.00)
0.92 (0.87-0.96)
Manufacturer split by dataset
GE
TNI
1094
0.65 (0.62-0.67)
0.91 (0.88-0.94)
0.90 (0.88-0.91)
OMN
34
0.77 (0.56-0.86)
0.76 (0.61-0.82)
0.87 (0.76-0.96)
OAI
145
0.60 (0.49-0.71)
0.88 (0.82-0.93)
0.86 (0.80-0.90)
FUJIFILM
OMN
104
0.39 (0.30-0.49)
1.00 (1.00-1.00)
0.87 (0.81-0.93)
OAI
194
0.17 (0.11-0.24)
0.99 (0.97-1.00)
0.90 (0.86-0.93)
AGFA
OAI
84
0.44 (0.29-0.60)
0.95 (0.89-0.98)
0.89 (0.82-0.94)
Swissray
OAI
149
0.39 (0.28-0.50)
0.95 (0.91-0.98)
0.88 (0.83-0.92)
Imaging Dynamics
TNI
2616
0.68 (0.67-0.70)
0.89 (0.87-0.91)
0.88 (0.87-0.89)
Other
TNI
19
0.65 (0.44-0.83)
1.00 (1.00-1.00)
0.88 (0.69-1.00)
Samsung
OMN
125
0.47 (0.37-0.57)
0.91 (0.84-0.97)
0.85 (0.79-0.90)
Konica Minolta
OMN
80
0.38 (0.27-0.50)
0.97 (0.90-1.00)
0.90 (0.84-0.95)
Siemens
OMN
22
0.50 (0.31-0.68)
1.00 (1.00-1.00)
0.93 (0.79-1.00)
Canon Inc
OMN
106
0.45 (0.34-0.56)
0.94 (0.88-1.00)
0.85 (0.78-0.91)
Philips
OMN
21
0.56 (0.36-0.76)
1.00 (1.00-1.00)
0.96 (0.88-1.00)
Other
OMN
21
0.55 (0.30-0.80)
1.00 (1.00-1.00)
0.95 (0.89-1.00)
*Hispanic results are not shown for TNI (n=6). **BMI<18.5 kg/m² as OMN only had 3 patients in that group. Ground truth low BMD was defined by DXA (at least one of the femoral neck or L1-4 having a T-score <-1).
ROC curve
OAI
OMN
TNI
Clinical validation results
The frequency of low BMD at each Rho Score was derived from a retrospective, multi-center trial to assess its performance at assessing a patient’s likelihood of having low BMD from frontal radiographs, using DXA as the benchmark with which low BMD is diagnosed (at least one of the femoral neck or L1-4 having a T-score < -1). Assessments were made with a set of x-ray/DXA pairs that included 6 types of x-ray that Rho can analyze (lumbar spine, thoracic spine, chest, pelvis, knee, or hand) in males and females. Performance was assessed in datasets that are independent from the dataset used to train Rho. Two datasets included participants with a range of BMD values that cover the entire range of disease state, but included more participants with low BMD than the general population.
The sample sizes of these datasets, TNI and OMN (3729 and 513 x-ray/DXA pairs, respectively; one per patient), had over 80% power at a one-sided alpha of 0.025 to detect an area under the receiver operating curve (AUC) point estimate of 0.85 and a performance goal of 0.75.
AUC and 95% confidence intervals are presented for the entire TNI dataset, females and males, and from x-rays of the six body parts that Rho can analyze. In the OMN dataset, Rho achieved an AUC of 0.85 (0.82-0.88) and results by sex, body part and race are reported in the FDA decision summary (DEN230023, Table 2); sensitivity for the knee was below 30%. Results from 2 additional datasets (the Canadian Multicentre Osteoporosis Study and the Osteoarthritis Initiative) are also described in our publication in the Journal of the American College of Radiology. Source: AUCs from the FDA De Novo decision summary (DEN230023), Table 2; numbers of patients with and without low BMD from Bilbily et al., JACR, 2024, Tables 1 and 2.
AUC with 95% confidence intervals: TNI dataset
Group
n
n pos
n neg
AUC
Entire dataset
3729
3008
721
0.88 (0.88-0.90)
Females
3111
2633
478
0.89 (0.88-0.91)
Males
618
375
243
0.82 (0.79-0.85)
Chest
1331
1072
259
0.89 (0.88-0.91)
Lumbar
791
636
155
0.91 (0.89-0.93)
Thoracic
328
289
39
0.93 (0.89-0.95)
Pelvis
457
359
98
0.96 (0.94-0.97)
Hand/wrist
250
194
56
0.85 (0.80-0.89)
Knee
572
458
114
0.87 (0.84-0.90)
Frequency of low BMD at each Rho™ Score
For managers
3 questions2 questions
How is Rho priced and invoiced?
Our current pricing model is based on gross annual x-ray volume. Please contact us for specific details. Invoices for Rho are sent by email to the specified contact on file. Payment is due within 30 days of the invoice.
If I decide to purchase Rho, how fast can it become operational?
Once a purchasing decision has been made we will:
Send you our standard contract, often within 1 business day.
Coordinate with your IT administrator to ensure the technical requirements are met (see the IT administrators section for more details).
Conduct Rho installation, IT admin training, and configuration (often completed in 1 hour).
Circulate brief training material for radiologists.
Motivated sites can be up and running within 1 week of a purchase decision.
Can we run Rho retrospectively on patients who have received x-rays in the last 5 years?
It is technically possible to run Rho on patients who have undergone x-rays retrospectively. A list of patients who have not undergone DXA in a specific period of time and were flagged by Rho can be provided to you for outreach through their referring physicians. Please contact us to discuss specific details.
Can we run Rho retrospectively on patients who have received x-rays in the last 5 years?
It is technically possible to run Rho on patients who have undergone x-rays retrospectively. A list of patients who have not undergone DXA in a specific period of time and ranked by Rho score can be provided to you to perform outreach or provide these to your referral base. Please contact us to discuss specific details.
For IT administrators
7 questions
Are there any security risks to adopting Rho?
Rho is installed within your existing secured network. All traffic to and from Rho can be monitored and controlled by you. Rho consists of a DICOM node, a database and a number of microservices, deployed as containers. Rho purges the DICOMs sent to it daily, at 12 AM local time by default. Rho is designed to run within your existing security controls. With De Novo granting from the FDA as a SaMD, Rho has undergone a cybersecurity risk assessment. Contact 16 Bit for a list of cybersecurity features built into Rho, and cybersecurity recommendations for customers.
What are the technical requirements for Rho?
The minimum hardware and network requirements for the Secure Hospital Server (SHS) running Rho™ software are:
Dedicated virtual or physical machine running Ubuntu 22.04 LTS (or later) or RHEL 10.0 (or later) with the following minimum hardware specifications:
64-bit 2 GHz quad-core processor CPU with AVX support
24 GB RAM (system memory)
250 GB of hard drive space
Optionally: NVIDIA CUDA-enabled GPU
1 static IP address
Minimum 1 Mbps ethernet network connection
VPN access preferred for servicing (recommended with 2FA) to allow 16 Bit Inc. personnel to remotely and securely connect to the virtual machine over SSH
Network configuration to enable DICOM C-FIND and C-STORE operations between Rho and all applicable customer DICOM servers
Certain accessible endpoints
How long does it take to install and configure Rho?
Installation, IT administrator training, and configuration is often performed within 1 hour.
What are the servicing requirements?
Rho is configured to perform automatic daily backups, weekly backups, and cleaning of the hard drive. Rho notifies 16 Bit when these tasks are performed and if they are successful. As such, there are no regular servicing requirements. Software updates can be installed remotely via VPN.
What is involved in training IT administrators and radiologists to use Rho?
IT administrators are trained during the installation and configuration of Rho. This is done using a 10-minute interactive presentation. A similar presentation is provided to the customer to circulate to the radiologists that will be interacting with Rho. 16 Bit can provide additional training sessions upon request.
How do IT administrators and radiologists interact day-to-day with Rho?
IT administrators will not have to interact with Rho often. At time of installation, 16 Bit helps you configure Rho for your institution. But very occasionally, your team might want to change a setting, which you can do through its user interface. 16 Bit can also help with this, if needed. Radiologists do not need to use the Rho user interface. They see Rho Reports in PACS.
How do we know it’s working?
An IT administrator, or other interested party, can access the Rho Console through a web browser on the same network as Rho. This user interface displays a breakdown of which x-rays have been analyzed, whether a report was sent, and when a Rho-screened patient returns for DXA.
Have a question we didn’t answer?
Ask us about deployment, pricing or the evidence, and we will answer for your market.
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