From the April 2013 issue of HealthCare Business News magazine
By Michael Gray
Have we reached the next generation of PACS? Despite the promises of vendors, I don’t think so. Many of the radiology PACS solutions highlighted at the 2012 RSNA, for instance, did not exhibit the features and functionality that I use to define the next-gen PACS. While there were notable improvements here and there in most of the PACS systems I reviewed, I don’t believe a single system exhibited all of the characteristics that would classify it as a “next-generation” PACS. For the most part, the radiology PACS available today are simply current generation PACS, and unfortunately, they do not seem to be keeping pace with market expectations.
What do I mean by a next-gen PACS? What the next generation PACS looks like depends on perspective. For the radiologist, it will include advances in diagnostic applications, automated measurement tools (tumor measurements), multi-facility/multi-PACS work lists prioritized by clinical and service level commitments, consolidated display of key EMR data, and quality and productivity analytics to measure it all. The technology will be based on server-side rendering and feature adaptive streaming to the display platform, so reading off site will be just as fast as reading on-site.
For the IT department, the next-gen PACS will be a more open system with fewer proprietary header tags and more hardware agnostic. It will interoperate better with a vendor neutral archive. That means forwarding to the VNA all updates to the meta-data associated with the image data, changes to the actual image data (presentation states and key image notes), and synchronizing the PACS directory database to match that of the VNA. The PACS will be able to keep better track of the data as it is moved from PACS to VNA and eventually purged from the VNA.
For the clinician, the next-gen PACS will provide a better clinical viewer accessible through the EMR portal. This may be an integrated viewing application that is a subset of the diagnostic viewer or a completely independent viewing application. Once again, the display technology will feature server-side rendering so it will perform admirably over low-bandwidth networks, and an absolute zero or near zero client so the viewing application will be compatible with Windows, Mac and mobile platforms as well as multiple browsers.
For the CFO, if this next-gen PACS is going to be partnered with a VNA, it will cost considerably less than the standalone PACS. The savings should come from the removal of the infrastructure and functionality associated with the “archive” subsystem. If a standalone clinical viewer is already in place, then the cost of the next-gen PACS should also reflect the absence of the PACS vendor’s clinical viewer.
