Enterprise Image Management Makes the Grade

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 - Nurse

For many sites, PACS is an enterprise—rather than radiology department—investment. The enterprise approach packs a powerful punch. It delivers cost-savings, efficiencies and improved care. But as PACS extends throughout the enterprise—either to separate campuses or to other “ologies” beyond radiology—it can grow more complicated. Depending on the project, the enterprise may need to consider and develop or revamp interfaces, enterprise patient identifiers, network connections, legacy equipment and more. This month, Health Imaging & IT visits a few sites that have taken PACS to enterprise level to learn more about the benefits and best practices.

Interfaces optimize performance

Memorial Hermann Baptist Beaumont Hospital in Beaumont, Texas, is an enterprise success story. This 247-bed community hospital deployed Philips Healthcare iSite PACS and Xcelera Cardiology in 2006. At the time, the hospital’s image management needs were fairly pressing. For starters, the hospital was experiencing rapid growth. And, as a rural provider, the hospital aimed to become a complete healthcare system via a telemedicine program with Houston-based Hermann Hospital.

The key elements of the hospital’s enterprise solutions include PACS, the cardiology information system and key interfaces between the departmental systems and its hospital information system (HIS) and radiology information system (RIS). The HIS interface allows clinicians to access HL7 data such as patient demographics and lab results and DICOM images in a single session. The clinical module is very popular among referring physicians, says Director of Medical Imaging Chuck Self. In fact, the radiology department has grown its business from 75,000 studies annually to 130,000 exams since deploying iSite two years ago.

Self credits the successful implementation to a robust test process. After installing a test server, Philips worked with the hospital’s IT and administrative teams to map HL7 information and develop necessary interfaces. The IT department also installed a separate LAN for the radiology department so its traffic did not interfere with other hospital operations.

In addition to the LAN and PACS server, the hospital configured workstations to meet the unique needs of various user groups. On the floors, it converted enterprise 17-inch, flat-panel display systems into image review stations. The ER viewing solution is a bit beefier with 20-inch, 2 megapixel (MP) displays, and cardiac surgeons use mobile carts with dual 20-inch, 2MP displays to view cardiac cath images, cine loops and complete studies and review echo studies in the OR. Radiologists use a two monitor configuration that pairs a 21-inch, grayscale 3MP flat-panel for review of most images with a 20-inch color system for HIS, ultrasound, nuclear medicine and 3D applications. Other IT infrastructure includes a gigabit network backbone with gigabit switches for radiology modalities and cardiovascular systems.

One of the most powerful benefits of the approach, says Self, is that a hospital can realize cost-savings almost immediately after deployment. 

Voices of Experience

If the site needs an enterprise solution, look for a complete package that meets the needs of radiology and cardiology, says Coffee Health Group's Birt

Do your homework, says Self of Memorial Hermann Baptist Beaumont Hospital. Sites can estimate storage requirements by converting analog volume into gigabytes and terabytes and adding projected growth. Make sure that inter-site connections can support rapid transfer of images.

Avoid the lengthy RFP, says Bayhealth's Walczak. It can morph into a monster and add to everyone's workload. Each vendor under consideration must create a document that responds to the RFP, and then hospital staff must review all proposals. Generally, long RFPs correlate with long responses. Instead, develop a request for a solution that focuses on key components of the desired future state and asks vendors to share a plan for taking the hospital from point A to point B.

Determine which areas can benefit from enterprise image management. These include subspecialty review, central ER reading and referring physicians, particularly those who practice at multiple locations. Include all users ("customers") in the selection process; the committee should represent the needs of cardiologists, radiologists and technologists, says Birt.


The operative word in Bayhealth Medical Center’s enterprise solution is trim. The