Deploying PACS beyond the physical and virtual walls of the radiology department or imaging center, regardless of size, provides the opportunity to extend beyond the reach of diagnostic imaging to a broader range of caregivers and enabling improved efficiencies, cost savings and better patient care.
Training is Key
Education is an integral component of implementing an enterprise PACS, according to Barbara Nagle Bodyk, PACS administrator and manager at the 300-bed Greater Baltimore Medical Center, which processes approximately 150,000 studies on their PACS annually.
Greater Baltimore began installing components of the AMICAS’ Vision Series enterprise PACS in the spring of 2005, and went live in August 2005. “Over the course of those four months, we continued installing, testing and training with our staff,” Bodyk recalls.
Various subsets of medical professionals received training at different times and for different purposes. “We conducted training sessions by appointment, in addition to open-house settings. The radiologists gained initial access and training on the PACS in July and August, followed by the technologists, who had to learn how to use modality worklists in every department, as well as learn how to access images via PACS and through the Meditech EMR. Finally, the referring physicians had to learn how to access the images via our Meditech EMR.”
Even with smaller facilities, these types of training sessions can be beneficial. When Bustleton Radiology Associates, an ACR-accredited, radiologist-owned and operated facility that images 100-plus patients a day, implemented Viztek’s Opal-RAD PACS in 2005, the entire deployment took approximately one week.
The process went smoothly, says Anthony J. Limberakis, MD, president and CEO of Bustleton, with a Viztek representative guiding each of the three radiologists through a tutorial for two days. This sped the deployment process and eliminated the natural learning curve when working with a new system. “While there was some lead time to integrate our voice recognition system into the PACS and RIS, we were reading soft copy within a week. Because of the training, it was a smooth transition.”
“Communication and education are just huge components of the acceptance of PACS in an enterprise situation,” Bodyk says.
Great Baltimore’s enterprise PACS connects three joint ventures, including Medical Imaging of Baltimore, where the hospital’s MR and PET/CT images are acquired, and Advanced Radiology—both of which are physically attached to the hospital.
Due to the large size of MR and PET/CT studies, the hospital has to account for the expanding storage volume. “Within a hospital’s budget, you have to account for any equipment that is attached digitally to the PACS environment. This year, we added a CR system, so we had to make sure that we had enough SAN [storage area network] storage to make sure we were covered for our increased study volume. Because we pay for our web-based PACS according to our study volume, it determines what we pay annually for support.”
So that the various proprietary systems to interact with PACS, Greater Baltimore modified different DICOM fields to make studies come across correctly. “We have 40 systems from various vendors that connect to our PACS within the radiology department, and we have learned that each vendor has different nuances to DICOM that we have successfully worked through,” Bodyk says.
Bustleton experienced similar DICOM communication issues between its GE Healthcare’s digital mammography unit and its Viztek PACS soon after installation. GE and Viztek worked together, Limberakis says, to resolve the issue between disparate DICOM settings within a few weeks.
Smaller facilities gain autonomy
PACS healthcare enterprises of any size, large, medium and small facilities, see the benefits. PACS helps to make 25-bed Floyd Valley Hospital in LeMars, Iowa, more competitive and independent, says Radiology Director Denee Hardyk. Each year the facilities processes about 11,500 imaging procedures. Aspyra’s enterprise PACS is their PACS of choice.
PACS brought autonomy to Floyd Valley Hospital, Hardyk says, because the facility “owns the images. For example, we do not have interact with the vendor IT department, in order to grant access for additional users—everything can be handled in-house.”