"PACS is the most complex sell of all information products, involving clinical, IT, administrative, regulatory and other costs and operations," says DR Systems' Dill. The company, founded by radiologists, offers an inclusive, customized turnkey RIS/PACS system with feature-rich software functionality aimed at community hospitals and imaging centers. "People think they need a big name for a long-term relationship but that's not true. The OEMs' big ticket item is the imaging modality. They bundle PACS with the modality. They throw it in free, so the customer thinks it is a great deal but it's not really. They may be paying annual maintenance and not have the interfaces they need. They think adding vendors adds complexity and cost but there is a high cost of ownership if the system doesn't adapt to the work they need done."

He noted that it could be a problem to get software at a great price but then have to do your own integration. "The perception is cost savings but...cost is burdened by disruption and resources required for integration on premises. We make implementation as easy and undisruptive as possible," Dill promises. "Don't look just at initial price. Look at recurring costs and true cost of ownership."


Hospitals have IT departments and their own group running all their systems, so a lot of them are switching to software-only [PACS configurations]," observes Dee Dowske, Senior Marketing Manager, IMCO Technologies, Pewaukee, WI. The company makes IMCO PACS Lite. "Orthopedic centers don't have IT departments. It might be in their best interest to sell them a turnkey product--hardware and software."

Delia So, Marketing and Business Solutions Manager for Montreal-based Intelerad Medical Systems, Inc. offers these sound suggestions, "Don't rush into things, understand your market, players, and vendors for your needs. Study the market and yourself. In the long run you save money if you don't have to buy a new PACS every five years."

The flux in today's market drives many providers to go with the large OEMs that they trust will be around for some time to come, but that is often a more costly option, especially given the number capable, smaller PACS companies.

"The trap that most fall into is they buy a product that is not complete and end up having to add on, buy more, and get nickeled and dimed to death," says NovaRad's Shumway. NovaPACS is a complete enterprise-level offering installed at about 350 U.S. sites. He advises, "Compare apples to apples and get everything you need--disaster recovery, something for ER, the whole solution. You don't have to go with one of the legacy PACS."

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