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PACS and opinions: What to consider when upgrading a PACS

by Lisa Chamoff , Contributing Reporter
From the January/February issue of DOTmed HealthCare Business News magazine

Years ago, hospitals upgrading to a new PACS and archiving system had some fairly straightforward decisions to make. Purchasers – for the most part, just the radiology department – considered things like workflow, support and service and, of course, price.

These days, with the rapid increase in hospital mergers, a focus on the EHR, a shift toward enterprise imaging and a look ahead to the promise of artificial intelligence (AI), providers have much more to consider than they did just five years ago.

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Dr. Rasu Shrestha, chief innovation officer at University of Pittsburgh Medical Center, noted that 2020 was always thought of as “the future” and “the future is here.”

Providers need to think about the strategy around imaging from an enterprise imaging perspective, looking at imaging “as an asset and enabler of strategies throughout the health system,” Shrestha said.

As a result, radiology departments today rarely make this decision alone.

“Decision-making has gone to the C-suite, but it's important for radiology to have a seat at the table,” Shrestha said.

Learning to share
“Ten to 15 years ago, an organization would be looking for a PACS that met their own needs,” said Don Dennison, a consultant who specializes in imaging informatics. “The most common pattern now is a shared system where multiple organizations use a single instance of PACS.”

Four years ago, after Mount Sinai Medical Center merged with Continuum Health Partners, the system went through the process of switching PACS vendors. Continuum had a system from McKesson Radiology while Mount Sinai used one from GE Healthcare, which was ultimately awarded the new contract for the merged systems.

While the Continuum radiologists needed to get used to the new system, with its new user interface, it was important to move to one, said Dr. David Mendelson, associate chief medical information officer for the Mount Sinai Doctors Faculty Practice and the vice chair of radiology IT of the Mount Sinai Health System.

“In this age of mergers, harmonization is an important principle because it’s not feasible to support numerous different systems,” Mendelson said.

Each organization may have a range of services, from trauma to general radiology, that have different requirements in terms of workflow.

The PACS and vendor-neutral archive also need to be capable of handling multiple patient IDs, a change from when more hospitals were independent.

That leads to the question of whether to upgrade to an enterprise PACS – a system shared among multiple facilities and specialties, including cardiology, neurology, ophthalmology and even dermatology – a vendor-neutral archive, or both.
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