PACS has gone from a tool that only large, high volume organizations could afford to a more prevalent system for facilities of all sizes. Now, more and more facilities are installing a PACS in their cardiology and vascular departments to manage echocardiograms, cardiac catheterizations, CTs and other procedures. Selling the idea to physicians and administrators can be a challenge and it’s easy to underestimate how to get the most out of the system once it’s implemented. Inside Cardiac Imaging talked to several facilities about their experiences with implementing a cardiovascular PACS.
“PACS for cardiology is so important because we’re such a visual subspecialty,” says Peter Frommelt, MD, pediatric echocardiologist at Children’s Hospital of Wisconsin. Having studies only on a CD or videotape doesn’t allow for all of the important players to access the images. “We live and die by our images. The ability to have images that are widely available and easily accessible is really the lifeblood of a good program.” The hospital became the first all-digital pediatric echo lab in the country in 1998. “We’ve been so pleased with our early push to a PACS solution for cardiology,” he says. “Despite our pain and suffering, we’ve been well rewarded.” Eight years of digital information are invaluable for patient care and research purposes, he adds. Children’s uses syngo Dynamics from Siemens Medical Solutions.
“If you’re going to be a cutting-edge cardiology department, whether small or large, you have to have certain technologies,” says Mark Weber, manager of clinical services for the Health Alliance, a group of six hospitals in the Cleveland, Ohio area. “If you’re going to sell yourself in the community as a state-of-the-art cardiology program, you have to be a state-of-the-art cardiology program.”
Fight physician fears
Despite the benefits that physicians will experience, jumping the hurdle of obtaining their buy in can be a challenge. “In some cases, the physicians involved don’t want to make the leap,” says Weber. “They are content with burning CDs.” Volume, however, does have to be high enough to justify investment in a PACS, he says. “You really have to convince them that their workflow will be better. You are buying this because it will improve patient care, it will make information more accessible in more places, and consulting and referring becomes a lot more practical.”
CDI originally implemented a PACS from Camtronics, now Emageon, in 2000, and physicians at the Alliance hospitals have become passionate about it, says Weber. When upgrades are scheduled, “they get a taste of how it used to be,” he says. They don’t have full functionality and “realize that they don’t know how they did it before.” Some physicians practice at other hospitals that don’t have a PACS, which also garners appreciation for the system.
Frommelt says that his PACS provides a seamless recall of both current and archived studies of the same patient that videotape can’t begin to compete with. “That’s pretty well known but pediatric cardiologists are frightened of giving up tapes,” he says. “They want long sweeps. They want to tape everything that the technologist does.” However, he has been successful getting them to focus on one-beat clips for diagnosing even complex congenital heart disease.
Selling the benefits of PACS to physicians can help facilities get what they need from those physicians. “Our physicians practice at a variety of hospitals,” says Kelly Neal, director of cardiovascular services at Washington Hospital in Washington, Pa. “It’s important for us to be able to offer the ability to report on images remotely. One of the biggest gains is that physicians can remotely eyeball a catheterization as it’s being done.” Her facility uses Horizon PACS from McKesson.
Not all cardiologists have to be dragged into a new realm of technology. A small group of cardiologists chosen to be the first to go live with the Agfa HealthCare Heartlab cardiovascular product suite at Florida Hospital Waterman in Tavares, Fla., paved the way for their colleagues. “We chose a few to try it out and they loved it,” says Cynthia Lenninger, cardiodiagnostic supervisor. Other cardiologists saw the trials and wanted to use the system also. The facility was able to go live earlier than planned. “They didn’t want to wait,” she says.
Show me the money
Hospital administration holds the purse strings so selling the need for PACS is vital. Weber worked with the vice