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Picture archiving and communications systems are becoming part of hospital and healthcare facility infrastructure, as vital to enterprise operations as facilities management or accounting. But to justify what is often a large purchase, a return on investment analysis is often necessary to motivate the financial powers that be to invest in PACS. Over the next dozen pages, you will meet hospitals large and small, rural and urban, that have made the PACS investment - and proved the ROI.

After making a $7 million PACS purchase, Bethesda Healthcare System saved about $157,000 per annum. In the first 12 months of PACS operations, film savings of $396,000 were achieved. Year one total savings in the imaging department amounted to over $1 million.

Likewise, Christus Health System in Houston recognized $415,000 in film cost savings, a 14 percent reduction in lost films, 14 percent increase in imaging department volume, reduced the cost per radiology exam by $5.06 and sped services wait time by almost 33 percent.

The results are real, too, at Mercy Medical Center in Des Moines, Iowa, that saw a 40 percent increase in revenue per FTE to $70,508. Over the first two years of the PACS implementation, the facility will save about $2.1 million.

These are just three of the seven facilities who have shared their PACS ROI stories, so please read on.


By Fran Lutz, Administrative Director, Center for Advanced Imaging, Bethesda Memorial Hospital & Bethesda Outpatient Imaging Center at Bethesda Health City, Bethesda, MD

Bethesda Healthcare System made a strategic decision to invest in PACS technology when its executive management team conceded that traditional x-ray film management would never achieve the information access expectations of its physicians, patients and medical staff. In 2001, Bethesda Healthcare System was typical of many U.S. hospitals - a not-for-profit community hospital with 362 licensed beds, with an annual volume of165,000 diagnostic procedures interpreted by a team of 10 radiologists.

In 2001, the imaging department had problems managing films - problems associated with retrieval, storage space for filing, and delivery of films where they were needed in a timely manner. Efforts to improve film file room functionality had been made without much impact on performance. Staff was added. Procedures were changed. Complaints continued. CEO Robert Hill decided to personally investigate. The experience of working a one-day 8-hour shift was enough to convince Bethesda's technology oriented chairman that hospital-wide conversion to digital image management was necessary.

The imaging department needed more than a PACS. It also needed a major upgrade of its existing radiology information system. The timing happened to coincide with a search by Siemens Medical Solutions for a partner to launch its new SIENET Integrated Radiology Suite, a fully integrated brokerless RIS/PACS solution. Bethesda agreed to become a major beta site for Siemens new NOVIUS RIS. And as one of the first hospitals in North America to implement a fully integrated RIS/PACS, Bethesda Healthcare's executives decided that the hospital would openly share its experiences over the five-year life of the product - including financial information - with the healthcare industry.

The new RIS was installed in October 2001. The go-live date for the PACS was May 2002. From the outset, the performance of the integrated system more than exceeded expectations. The impact on providing better service to ER patients was profound. ER physicians had immediate, unprecedented access to images. With the new system, turnaround times from exam order to completion of procedure dropped from of an average of 54 minutes to an average of 42 minutes for all modalities, with an average of 32 minutes turnaround time for diagnostic radiology. For emergency patients, every minute counts. The increase in imaging department efficiency positively impacted patient treatment. Patient care decisions were expedited. Emergency department efficiency overall improved. While not as dramatic, workflow efficiencies generated by the integrated RIS/PACS impacted every single hospital department within months of implementation.

The Financial Case for PACS

Hospitals without PACS know that they must make this expensive investment sometime in this decade. PACS has become an infrastructure issue, a component of a hospital information system and