Case Study | July 22, 2009

Implementing ImageGrid costs less than the annual service contract of HBDI’s legacy RIS/PACS.

Huntington Beach Diagnostic Imaging and Breast Center


The Customer: Huntington Beach Diagnostic Imaging and Breast Center (HBDI) in Huntington Beach, Calif., is a state-of-the-art imaging practice located adjacent to Huntington Beach Hospital. HBDI, originally part of Huntington Beach Hospital, provided inpatient and outpatient mammography, ultrasound, MRI, CT, nuclear medicine and X-ray services. As the new owner and medical director of HBDI, Naser Rahbar, M.D., primarily provides outpatient imaging services and leverages the proximity to Huntington Beach Hospital to also provide inpatient imaging services on an as needed basis. HBDI modalities include CT, MRI, CR, analog mammography, nuclear medicine and ultrasound.

The Challenge: Soon after acquiring HBDI, Dr. Rahbar was faced with significant challenges. On one hand, he had to invest in newer modalities and technologies, while keeping in mind the negative impact of the Deficit Reduction Act (DRA) on revenues. To make matters worse, Dr. Rahbar and his staff were not pleased with the lack of features and functionalities of RIS/PACS that they did have. Dr. Rahbar knew that he needed a fully integrated full-featured RIS/PACS to streamline his operations and provide him with the ability to read studies quickly and provide reports in a timely manner.

In addition, in order to grow the practice, he needed to vastly improve report distribution with referring physicians and provide them with the ability to view studies and reports very easily. In talking to various vendors, Dr. Rahbar realized that a fully RIS/PACS implementation could cost anywhere from $250,000 to $500,000. In addition, expensive annual maintenance contracts as well as the need for an on-site IT resource to manage the RIS/PACS, had to be kept in mind and budgeted for.

Some of the other RIS/PACS vendors were also going to charge him extra if he ever exceeded certain number of studies per year. A number of vendors had also submitted proposals whereby his upfront costs would be low, but in return, he would be charged on a per study basis. Dr. Rahbar felt that paying for a RIS/PACS on a per study basis would leave him at the mercy of the vendor and that he would be making payments with no end in sight. Making the right RIS/PACS decision was going to be critical to the long-term prospects of HBDI.

The Solution: Dr. Rahbar came across Candelis, Inc. at the Los Angeles Radiological Society (LARS) conference and exhibit and was quickly impressed with the highly cost-effective and yet feature-rich ImageGrid RIS/PACS appliance. Dr. Rahbar spoke to several of Candelis’ existing customers who said they were very satisfied with the solution as well as Candelis’ customer centric philosophy. The ImageGrid’s price point was a fraction of other solutions, and it’s “appliance” architecture meant that the solution could be implemented and maintained with minimal IT supervision. For the first time, Dr. Rahbar realized that he could quantify the total cost of ownership of a RIS/PACS and it would allow him to better plan for the growth of his new imaging practice.

Dr. Rahbar was also pleased that with ImageGrid PACS there are no additional fees to connect new modalities or workstations. Dr. Rahbar implemented ImageGrid RIS/PACS in two phases. ImageGrid PACS with 4.5 TB of RAID 5 archiving was implemented within a day and all modalities were easily configured to send studies to it. ImageGrid Referring Physician Viewer was configured to provide easy Web-enabled viewing of patient studies to the center’s referral base. ImageGrid’s Advanced Radiology Viewer provides Dr. Rahbar with all the tools and capabilities to read from the office or from home. Dr. Rahbar plans to upgrade mammography from analog to digital with the ImageGrid Mammography Viewer, enabling physicians to read studies from anywhere.

A few months later, ImageGrid RIS was implemented. As a Web-enabled application residing on the ImageGrid storage/server system, ImageGrid RIS allows radiologists, technologists and staff to better manage and access patient data and information from a single platform. ImageGrid RIS can be accessed from any workstation on a local area network (LAN). As a comprehensive workflow-driven solution, ImageGrid RIS is tightly integrated with ImageGrid PACS and captures every process from patient registration to final report delivery. An optional voice-recognition module (powered by SpeechMagic) enables radiologists to dictate studies and generate reports in a very efficient and timely manner. An optional mammography tracking module captures specific workflow issues and requirements of mammography, such as exam results, pathology results, follow-ups and statistical reports.

In order to comply with HIPAA requirements, HBDI is backing up all patient data on ImageGrid RIS/PACS, a tape library using the ImageGrid ILM (information lifecycle management) software module. The tape library can also be used as part of an ILM strategy, whereby aged studies can be solely maintained on tape.

The Results: The ImageGrid PACS Appliance was installed within a single day with no interruptions to workflow and the HBDI’s daily operations. “I replaced my previous RIS/PACS with the Candelis solution for what I was paying for on an annual maintenance contract. The transition was seamless,” said Dr. Rahbar.

ImageGrid’s inherent cost advantages mean that Huntington Beach Diagnostic Imaging and Breast Center will realize a significant return-on-investment (ROI), giving it the ability and the flexibility to devote financial resources to invest in the latest modalities for better patient care.

“Candelis has enabled me to better compete with far larger institutions at a fraction of the cost of other vendor offerings. Today, we are a 100 percent paperless facility, and we are able to profitably provide timely imaging services to patients and referring physicians,” said Dr. Rahbar.


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