© PACS ©
This page describes briefly some ideas and problems associated with
a PACS. Generally a PACS must distribute images and the associate reports
throughout a medical system and fully integrate to the Hospital Information
System. PACS means different things to people. Radiology needs are not
the clinician's needs etc.
A PACS should allow the functional ability not only to distribute images
to the requestor but communicate to physicians for patient scheduling,
download patient demographics to modalities, track image location, and
to assemble collaborative material necessary to interpret the image.
For radiology purposes an integrated PACS should also have, either inherent
or by integration, semi-intelligent functions that enable it to keep track
of patient progress and alert the appropriate person, pre-fetch images
for interpretation, automatically route images to predetermined physicians,
provide a radiologist with an audible or visual alert for stat readings
etc. and lastly recognize and keep track of radiologist reading preferences
as well as their current location.
PACS is a double-edged sword; it can provide the means for institutional
survival or be the path to professional suicide depending upon how it is
sold to physicians and implemented. Deciding to purchase PACS can be, and
in most cases is, a career decision. At the very least the decision process
will be a trying, if not painful, experience. This will hold true regardless
of which vendor you choose. At this time no single vendor has the product
to implement the global solution, therefore a PACS should be a multi vendor
effort.
*** Vendors should have a type of MIRANDA read to them upon entering
any department to read: All information dispensed affects not only me but
my patients. Any and all information shall be recorded and construed as
if entered into a contract and shall be used as such. All verbal information
shall also be used in this manner with penalties applying to false statements.
***
The most important piece of advice is to choose your partners, vendors,
well. The operative word is partners because there will most likely be
more than one vendor involved and each associate vendor must live and work
together in the same environment.
Beware of anyone that claims it will be an easy process or that they can
do it all
- Every administrator, as a matter of pride, likes to have the latest
and greatest in equipment for imaging capabilities. Some times we must
question ourselves as to whether we really need it or is it beneficial
to the patient or organization. Another question is can the capital be
spent better. Full PACS, like all services and equipment, is not the solution
for everyone. There are alternative paths to reach a full PACS environment.
The best approach is creating an integration plan and to implement in phases,
one modality or service at a time; Mini-PACS.
- Mini-PACS offer ways to progress on a step by step method. Mini-PACS
also allows the opportunity to make mistakes that are easily fixed and
not detrimental to the whole system or implementation plan.
- Mini-PACS may be the solution for your immediate needs. It could be
a temporary solution providing the evaluation buffer and be the first of
many phases. It could also be the only affordable solution.
- Decisions must be made according to immediate needs and with future
applications or growth in mind. As everyone knows, the Hospital growth
plan may not take into account the radiology services technological growth.
- The decision to implement an image network should be made in conjunction
with your IS or Communications Director.
- In most cases IS knows of future hospital network expansion plans and
the latest technology changes. This knowledge in itself is valuable as
it gives insight to the intricacies of network communication management
and design.
- Another prudent decision may be to buy a product that you know is a
dead end yet will get the job done for now, this applies more toward a
Tele-Rad System for on-call Radiologists.
IMPORTANT NOTES
- The biggest bottleneck to image transfer is not the network but the
workstation. Most hospital networks can operate at 100 Mbs and theoretically
have unlimited potential transfer speed if they are constructed of fiber.
- Workstations are limited by the operating system, the BUS and the hardware utilized
for internal communications as well as network connections.
Last Updated by Peter C. Veader