Enterprise PACS in a New Enterprise

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Sky Ridge Medical Center opened its doors on Aug. 20, 2003. The 106-bed full-service, acute-care hospital serves the younger, tech-savvy communities southwest of Denver. The new hospital strives to provide comprehensive care and features private rooms, healing gardens, a medical library for patients, business center and amenity suites. A significant investment in cutting-edge technology and commitment to the filmless and paperless model complements our patient-centered environment.

Adjacent to the hospital is a new, fully leased four-story medical office building housing more than 100 physicians representing various medical specialties. A second building mirroring the first is due to be completed this April.

The initial vision for Sky Ridge focused on bringing high-quality, community-based care to rapidly growing suburban areas. The first goal was achieved when the hospital opened in August. The hospital administration is planning for a fairly robust expansion. The long-term plan calls for a 335-bed hospital and potentially a third medical office building. Moreover, hospital administration and cardiologists aim to become a top-tier community hospital for heart disease.


Building a new hospital brings a unique opportunity to create the ideal model. You can develop an enterprise based on streamlined workflow and optimized clinical care. One of the drivers that ultimately determine the success in meeting these goals is the picture archiving and communications system (PACS).

At Sky Ridge, as in any new hospital, we had a number of factors working to our advantage. We did not have to contend with any legacy issues or integrate older equipment into the system. The hospital is completely wired with fiber. The core network is Gigabit fiber, CAT 5, which runs throughout the hospital and to communications closets in the medical office buildings. The core network is Layer 3 and redundant with T1 backup connectivity. The PACS network resides on a separate VLAN, with the Radiology Imaging Associates network and Merge eFilm serving as backup. We rely on a multiple RAID, EMC CX600 with six usable Terabytes for storage. A Plasmon DVD deep archive provides long-term storage.

On the human side, referring physicians had not established image viewing patterns in this hospital. This gave us the opportunity to establish the standard. Still, as with any new venture, we encountered some constraints. Nothing in the hospital could be truly tested before going live on day one. Everything - the PACS, HIS, RIS, phone lines, workflow patterns - was uncharted territory. To further complicate matters, key members of the PACS team were working at other sites or had numerous additional tasks during the installation process. We needed to find and deploy a solution that could be up and running smoothly at the outset.

The PACS process began 18 months before Sky Ridge opened its doors. We employed a team approach that involved radiologists, other specialty physicians and administration. The team thoroughly researched PACS to understand what the technology offers in terms of workflow, dissemination of information, patient care and costs. Then we established a vision for our hospital.

Our first goal was similar to most facilities. We wanted efficient, fairly intuitive image distribution for our referring physicians. This enhances their workflow and speeds patient care. We knew PACS also could help with technologists' and nurses' workflow by cutting down on the number of repeat studies and other workflow interruptions, such as the calling of results. Another consideration was the tight labor market. PACS is an attractive proposition because it increases job satisfaction and identifies a hospital as a forward-thinking, technology-based organization - which helps lure technologists motivated to continue growing and learning through their careers.

Another hospital goal focused on excellence in cardiology. The new enterprise PACS was an opportunity to bring other specialties into the electronic storage and dissemination arena. Cardiology was a natural fit because the hospital aims to establish itself as a cardiac care facility. Finding a PACS solution that satisfied both cardiologists and radiologists was a challenge. We needed a PACS that stored echocardiograms, EKGs and cardiac catheterization images and reports, allowed segmented worklists for radiologists and cardiologists, and provided referring physicians with uniform access to all cases,