Changing PACS Vendors: Getting It Right the Second Time Around for Radiology and the Enterprise

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hiit040502.jpgChange is never easy, but when the switch involves a PACS vendor, it can be downright difficult. (Cue up “Breaking Up is Hard to Do.”) The reasons for a PACS divorce vary from dissatisfaction among radiologists and the IT staff to integration issues to economics. Whatever the reason(s), the process of deploying a replacement system differs from installing a first PACS. It’s kind of like remodeling instead of building a new house. Things can get ugly, but the end result is usually well worth the effort.

For starters, the second-, third- or fourth-time PACS buyer has a more mature understanding of PACS and its true priorities and costs. The experienced buyer also comprehends both department needs, in this case radiology, as well as the bigger picture enterprise requirements. But the experienced buyer comes with baggage including legacy systems, imaging equipment and historical data that must be migrated. Can the site leverage some of its initial investment? Can you reuse workstations and monitors? How will the enterprise handle historical images? And how does migration fit into the purchase decision?

This month, Health Imaging & IT visits with several facilities that have navigated and survived a PACS divorce and remarriage to learn how to minimize the pain and maximize the benefits—and create a new, united family.

The search for the next PACS vendor

Secrets to a Successful Replacement PACS

Experienced insiders share tips to boost the odds of a successful second PACS deployment.

“Educate radiologists and involve them in the decision-making process,” recommends Hugh Scott, head of PACS services at National Naval Medical Center in Bethesda, Md. A high degree of engagement and involvement among radiologists and other users is more likely to result in satisfactory workflow (and less likely to lead to a break up.)

“If the site is migrating PACS and not RIS, be sure the solution conforms to IHE (Integrating the Healthcare Enterprise). It will streamline the next selection and conversion,” says David Mendelson, MD, associate professor of radiology, Mount Sinai Medical Center in New York City.

Don’t overlook your existing vendor in the shopping process. Your current vendor may be able to provide cost-savings because migration should be a limited issue, says Mendelson. (Maybe your first love is true after all.)

Looking for a second (third or fourth) PACS vendor differs from the initial search. No longer a nervous first-time bride, the facility and buying team members may be a bit jaded; they are certainly more experienced with the ins and outs of digital image management. Smart second-time buyers draw on their experience to improve the next installation. “The search for the second PACS is more specific than the initial search,” points out Larry Ranahan, CEO of Meridian Imaging Group in Mundelein, Ill. “The first search tends to focus on imaging and radiology. Our second search was enterprise-oriented and included all of the components of what it takes to manage the business of radiology.”

Genesys Health System in Flint, Mich., found itself with a significant amount of proprietary hardware and data at the end of its initial PACS contract. “The hardware and data needed to be swapped out even if we remained with the first vendor,” recalls CIO Dave Holland. Genesys learned from its experience and placed adherence to open standards as a top requirement in the search for the second vendor.

At the same time, the health system realized that imaging was evolving. “We wanted an enterprise image repository that could play with different vendors across the enterprise, so that each ‘ology’ could choose best-of-breed systems to work with the enterprise archive,” explains Holland. Genesys Health System ultimately opted for Emageon’s UltraVisual PACS. The second solution met its goals, enabling Genesys to leverage its investment in hardware and will allow clinicians to interpret and read DICOM images across the enterprise.

Leveraging that initial PACS investment may be a primary criteria for the second system. The National Naval Medical Center in Bethesda, Md., opted for the low bidder for a three-phase PACS installation in 2000. Unfortunately, the inexperienced vendor could not meet radiologists’ needs. “Two years into the implementation, we convinced the powers-that-be to cut our losses and not continue with phase two,” recalls Hugh Scott, head of PACS services.

The decision left the center with a very limited budget, and it needed to optimize