Choosing Web-based PACS

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hiit040605The power and reach of the web is empowering the health imaging world — completing the loop from radiology to specialist and back to the referring physician and even the patient. Healthcare providers utilizing web-based PACS to distribute digital images enterprise-wide and remotely are further meeting the needs of their radiologists (literally). Clinicians and referring physicians are reaping the benefits, too. While these physicians can access patient images in a film-based environment, albeit cumbersome, the web offers timelier and more convenient access to electronic images from a PC located anywhere inside or outside the hospital.

Web-based PACS reengineers workflow and redefines the boundaries of medical care and treatment. Take for example, Inland Imaging. Based in Spokane, Wash., this medical imaging provider is comprised of 55 radiologists, five vascular surgeons and 350 employees who provide imaging services to 14 hospitals and clinics spread throughout Washington and northern Idaho.

Wanting to electronically store and distribute digitally-acquired, diagnostic images to radiologists, surgeons, and other physicians across 14 hospitals, and to provide secure access from physician offices and from home, the organization installed Phillips Medical Systems’ iSite Enterprise PACS (formerly Stentor iSite PACS). The PACS has virtually connected all the hospitals together.

“A patient can show up with a cracked spine at a hospital located 90 miles away in Pullman and the physicians there may be unsure whether they want to put the patient in a helicopter and fly him or her to Spokane for neurosurgery,” says Jon Copeland, CIO of Inland. “What they can do is call Spokane and ask the doctors there to take a look at the patient’s images since they are instantly available via PACS. The doctors also can call a neurosurgeon at home, who can log in from a home system using the web viewer to look at the spine and help make a judgment call. Without a shared, single image environment, this would be impossible.”

Web-based PACS’ claim to fame has been its ability to provide users a single operating system, a single user interface and a single database so that the physicians can deliver optimal care in any environment. Online electronic images can be accessed instantaneously. In addition, a web-based system offers its users access to all applications, such as embedded advanced visualization software and orthopedic templating tools, at any computer, in any location.

Leveraging the web

Capital Health System is another organization that chose web-based PACS. This 589-bed dual-campus, acute-care teaching hospital in Trenton, N.J., installed Dynamic Imaging’s IntegradWeb PACS that provides the organization with complete functionality and authorized accessibility to the PACS from PCs in various locations.

Why was web-based PACS “the” choice? “Films were being lost,” says Yaakov Applbaum, MD, Capital’s chairman of radiology. “My favorite stories were those of the trauma surgeons where hip films would be done in the trauma bay and the patient would be moved to CT. By the time the patient was at CT, the hip films were lost. Internally we needed PACS to survive. Once we decided to get a PACS, we wanted to be able to compete favorably with other institutions in the area and make it easier for referring physicians to see patient images. To facilitate that, we went with a web-based system that has 100 percent functionality outside the hospital equal to inside the hospital.”

“Anything that a radiologist can do on the PACS at the hospital, the radiologist can do remotely,” says Applbaum. “We wanted the physicians to be able to utilize the system within and outside the hospital without knowing the difference. Another thing we were looking for was simplicity of use. We did not want a system that required a CD to download software. We simply wanted the physician to be able to log into a website, and with a username and password, retrieve his or her patient information.”

Mercy Medical Center in Baltimore, Md., transitioned its radiology services onto a web-based environment after replacing their existing PACS with Amicas’ Vision Series web-based system. “For a long time I think that people viewed PACS as a tool for the radiologist or for their department,” says Jim Stalder, CIO of Mercy. “While that is certainly still the case, the folks who refer patients in for [medical imaging] exams also need more access to this information. Often times, depending