Feature | June 29, 2011 | Jim Morgan, vice president, medical informatics, Fujifilm Medical Systems U.S.A. Inc.

Making the Swap: Considerations for a Successful PACS Replacement

Replacement strategies for picture archiving and communications systems (PACS) have evolved in consort with advances in medical imaging technologies. Facilities want a new PACS to help improve workflow by streamlining processes, enhance patient care by integrating imaging with other IT systems – such as electronic medical records/electronic health records (EMRs/EHRs) for full patient history information, and achieve a lower total cost of ownership and return on investment than their existing PACS.

Healthcare providers understand that a PACS is no longer just a medical device for viewing patient images, but rather a communication tool that can help drive clinical acceptance across all specialties. These considerations come into play as facilities seek out their PACS replacement.

Workflow is dependent upon end-user functionality and clinical acceptance. Radiologists want a cleaner, simpler user interface that minimizes clicks, provides single sign-on and quickly presents the requested images and data. Facilities should inquire whether the PACS vendor can enable access to medical imaging via any browser or hand-held device, such as an iPad, so that radiologists and referring physicians have on-the-go access to image and information stored in the PACS, RIS and CVIS/CPACS applications. Institutions understand that increasing the speed of access to patient images and information improves workflow and creates a loyal referral base that can boost patient referrals.

Tied closely to workflow is the use of PACS as a communication tool, especially to provide critical results, images and reports to referring physicians. Access to the full radiology report and patient record translates to a higher quality of care and higher physician satisfaction.
When selecting a replacement, a facility should ensure that the PACS can provide access to reporting tools — such as critical results reporting and peer review applications — on the PACS workstation integrated to the clinical application (versus disconnected from the user-interface) to create efficiencies for the radiologist.

Improving workflow also means having the appropriate diagnostic tools, including advanced 3-D visualization and fusion capabilities, on the PACS workstation. Integrating solutions for cardiology, endoscopy and other image-intensive specialties onto one PACS platform creates scales of economy that reduce the cost of maintaining the infrastructure. While many vendors can provide these advanced tools, it’s often via complicated third-party integrations that mean more vendors and a greater risk of complications, among other potential problems.

While the overall cost of PACS has gone down over time, facilities understand that current technology can further reduce their initial and ongoing system costs. Virtualization reduces the physical number of servers, which decreases power consumption and cooling requirements, and increases clinical efficiency by hosting several applications. A virtualized environment further lowers storage management costs – traditionally the high cost of PACS – while software-only implementations help keep costs in check by enabling sites to purchase and use their own hardware. A facility can inquire whether the vendor it is considering has had its virtualization solution validated and certified, to establish its level of expertise in this area.

Today more than ever, a PACS provider should be a partner, not just a seller. A company’s reputation and current stability are critical. Healthcare facilities should seek a PACS from a vendor they can rely on to understand the big picture, that is, the role of medical imaging in diagnosis and treatment across multiple clinical specialties.

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