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Imaging Informatics – The only constant is change in the PACS marketplace

June 13, 2016
From the June 2016 issue of HealthCare Business News magazine

By Michael “The PACSman” Cannavo

Famed ballet dancer Twyla Tharp once said, “The only thing I fear more than change is no change. The business of being static makes me nuts.” While medical imaging has changed and continues to change, it is more like a metamorphosis or evolution than a radical transformation. The basic form and function of PACS really hasn’t changed that significantly in over a decade, yet several improvements have been made to it.

Many of these changes are related to technological advancements while others are connected to addressing operational needs. Faster local and wide area networks are allowing for larger studies to be transmitted, and allow for real-time image processing in the advanced visualization arena. Faster CPU speeds and more advanced operating systems allow for items like zero footprint viewers (ZFV) that are browser-independent to be used.

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Imaging has eliminated what one company calls the “silo syndrome." This is a technology deficiency that inhibits organizations from effectively distributing imaging and related data across a network. Instead, imaging has become one of many clinical systems that can be pulled together to help create the full electronic health record (EHR). This is crucial in helping to obtain Meaningful Use dollars for facilities and physicians as well as allowing for the creation of a personal health record (PHR).

Most estimates reveal that over 95 percent of hospitals in the U.S. employ some form of PACS, with a large majority of those on their second, third or even fourth generation PACS. About half of these facilities stick with the incumbent vendor and simply upgrade to the latest version of software (usually with a hardware refresh as well) while the balance switch vendors entirely. Those who stick with the same vendor will sometimes perform a PACS optimization as well. A PACS optimization is a detailed study of how their PACS is being used and ways end users can get the most out of the system. It includes looking at the hardware and software, archive and network for potential upgrades, evaluating the disaster recovery plans and discussing bottlenecks and issues. It features a full operational review that goes from check-in to check-out, reporting, advanced software use and areas of similar functionality.

It also includes use and optimization of the radiologists’ reading stations, change management protocols, policies and procedures review, legal reviews that include addressing records retention, ways to meet the MQSA (Mammography Quality Standards Act) requirements, dose management and reporting, critical results, and emergency room (ED) discrepancy reporting. It is important to have clearly defined roles and responsibilities for everyone involved with the PACS. This is crucial if a facility is to have a smooth running PACS.

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