PACS: Step One of the Growth Plan

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 A number of important factors influenced the addition of PACS in the radiology department at Schneck Medical Center in Seymour, Ind., nine months ago. In addition to storage headaches related to film and the desire to improve workflow and report turnaround time, the implementation of PACS was the first step in upgrading Schneck’s imaging department.

This progressive, 166-bed community hospital is eyeing an expansion of its radiology services, including the use of a new-generation 64-slice CT scanner and performing noninvasive cardiovascular imaging studies. PACS was a key first step to enable this growth as well as helping to increase the efficiency and productivity of the department and handle the oncoming volume of data that will eventually be produced by the department.

Schneck provides clinical services to more than 120,000 residents of southern Indiana and performs more than 48,000 radiology procedures annually. Imaging services include diagnostic x-ray, ultrasound, CT, MRI, nuclear medicine, mammography, bone densitometry, and special procedures. The radiology staff includes 30 technologists and two radiologists who work with 100 referring physicians, and the hospital’s radiology department sees 125 to 150 patients daily, says Rita Baker, director of diagnostic imaging services.

Selecting a reliable and scalable PACS that would accommodate the department’s workflow and meet the hospital’s budget was not a simple task. Baker was part of the PACS development team that included a PACS administrator, the facility’s two radiologists, the IT department, and administration personnel. To cost-justify implementing PACS, Baker says the team highlighted how the hefty costs associated with film, processing, and hard-copy storage would be eliminated immediately. They also looked into the future of the department, its expansion, and how the installation of a 64-slice CT scanner as well as digital mammography would require PACS.

Search and rescue

After a six-month stretch that included numerous site visits and onsite vendor presentations, Schneck selected an image management system and began planning for its implementation. They went live with two CR readers in November 2005 and, a couple of months later, GE Healthcare’s Centricity PACS SE. “We wanted to go with a company that would be here for the long term,” says PACS Administrator Suki Wright. “We have witnessed [over the years] how the number of PACS vendors has dwindled. We did not want to get involved with a vendor that would not be around for the long haul.”

Currently, all modalities, except for mammography, which is still analog, send images to PACS. The image management system is integrated with MEDITECH’s electronic medical record system, radiology information system, and hospital information system.

Throughout the implementation process, GE helped the PACS team evaluate the department’s analog workflow and examine how daily operations would change in a digital environment. The company also was involved in determining the necessary changes that had to be made to the facility’s internal and external infrastructure for enterprisewide access to electronic images and reports. “When we finally did go live, it went very smoothly,” says Wright. “We had a couple hiccups here and there, but they were nothing that we could not be fixed that day.”

According to radiologist Neil Staib, MD, medical director of the diagnostic imaging department, the starting point for any viable PACS is to be seamlessly integrated with the hospital’s other information systems, in this case the EMR, HIS, and RIS. “Information can go back and forth from the radiologists to the referring physicians,” he says. “The radiologist also has access to all the patient information and medical record at his or her fingertips.” Schneck patients now have a virtual record containing medical history and critical information, including digital imaging studies, which can be accessed by authorized radiologists, specialists, and referring doctors.

Upon going live with PACS, the radiologists quickly realized that they were able to read and dictate imaging studies in a more efficient manner. In general, radiologists are in short demand and work in an environment where medical imaging services are in high demand. “With PACS, you can really leverage the ability of the radiologist to more efficiently view, read, dictate, and report studies,” says Staib. “PACS allows for a more efficient way to do radiology.”