Picking your next PACS

When it comes time that your PACS desperately needs replacing, the path can take a few turns. Do you stay with the same vendor? Go with another vendor that an affiliated facility uses? Or do you shop around?  And since you’re again new to the market, what should you expect of a next-generation PACS? That’s the topic of this month’s cover story.

About a third of the respondents to our Top Trends in Health Imaging & IT Survey last fall told us 2010 was the year to upgrade or replace their PACS. But when it comes to choosing a vendor for a PACS project, the majority of facilities (70 percent) go with a different vendor. Most just start from scratch.

Once the radiology workhorse, PACS is now an enterprise tool to facilitate a swift and better diagnosis through image sharing. While PACS used to harness radiology and orthopedic images, as more medical specialties jump on board, such as ophthalmology, pathology and colonoscopy, the scope of the project and data requirements escalate.

Today’s PACS buying team is demanding an open system that can integrate and clearly interface with myriad health IT systems, other PACS, clinical applications such as voice and advanced visualization software, imaging devices and storage systems.

The CMIO and enterprise IT team is working hard along with radiology, too, to define the ideal method of incorporating medical images into the EMR. Right now, it’s most common to access images via links that launch a web viewer like XDS-I. But how many images are enough? Many facilities agree physicians should have access to all images as well as reports. Yet, presenting data in a user friendly manner to a wide cross-section of generalists and specialists is very challenging.

Personal health records (PHRs) could be the next area of PACS integration, with RSNA now working on a two-year pilot project with the National Institute of Biomedical Imaging and Bioengineering (NIBIB) to create an internet-based network for patient-controlled sharing of medical images.

When it comes to picking a next-generation PACS, here are some musts. The PACS should: interface well with health IT systems; provide a robust web-interface; offer quick user login; provide workflow and cost benefits; have a clear data migration plan; deliver guaranteed uptime; and a clearly defined go-live and support plan.  A solid partnership with the PACS vendor is also a must.

If you’re knee-deep in PACS planning, take a look at the chart on page 6—it offers detailed, practical advice. Good luck!

Mary C. Tierney, Editorial Director