Transcript HealthtechnetPACS

PACS: An Overview
Healthcare
Technology
Network
George H. Bowers
Health Care Information Consultants, LLC
© Copyright 2004 Healthcare Information Consultants, LLC
Picture
Archiving and
Communication
System
PACS
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System that collects, stores, and
distributes electronic images through
the enterprise.
Presents digital images to the clinician
with tools to manipulate the images.
One component of the Electronic
Patient Record.
Digital
Imaging
Device
High
Speed
Network
Storage
Media/
Archive
Elements
of
PACS
Database/
Workflow
Mgmt.
System
Review
Workstation
Diagnostic
Workstation
Digital
Imaging
Device
High
Speed
Network
Storage
Media
Elements
of
PACS
Database/
Workflow
Mgmt.
System
Review
Workstation
Diagnostic
Workstation
Digital
Imaging
Device
High
Speed
Network
Storage
Media
Elements
of
PACS
Database/
Workflow
Mgmt.
System
Review
Workstation
Diagnostic
Workstation
DICOM
Digital Imaging and Communications in Medicine
PACS Issues
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RIS or no RIS
Partial (mini) PACS?
Interfaced or integrated?
Separate archive or integrated archive?
Why is PACS hot?

Benefits
– Eliminate film handling.
– Improves productivity.
Traditional
With
Request for CT
exam received in
Radiology
Begin
Tech schedules
patient in RIS
Requests
Transportation for
patient
Tech sends
contrast to nursing
unit
With or without
contrast?
Patient Arrives
Tech checks
patients orders
and arm band.
Technologist
completes request.
Request is placed
in film jacket in
reading room.
Radiologist signs
report
Final report
available in RIS
Without
Patient
demographics
entered into CT
scanner
Patient is brought
into room and
exam is completed
Tech prints exam
on film.
Exam is completed
in RIS and
electronic logbook.
Exam documented
in Pt. chart.
Transportation
called to take
patient back to
room
Patient is moved
to inpatient holding
area.
Film librarian
hangs films on
viewing board
Radiologist
interprets images
and dictates report
Transcriptionist
transcribes report
into RIS
Errors?
No
Does Pt.
have prior
studies?
No
Yes
Yes
Film librarian
searches for prior
studies
End of Process
Film Librarian
clears the reading
board
Film librarian files
film jacket
End of Process
Fully Automated and Integrated
With
Begin
Request for CT
exam received in
Radiology
Tech reviews
electronic
schedule.
System requests
patient
transportation
With or without
contrast?
Nursing
administers
contrast in unit.
Patient Arrives
Tech checks
patients orders
and arm band.
Without
Tech pulls patient
demographics
from worklist.
Errors?
Patient is brought
into room and
exam is completed
No
Yes
Radiologist
corrects report.
Exam is completed
in PACS and RIS
Radiologist signs
report
System notifies
transportation
Final report
available in RIS
Patient is moved
to inpatient holding
area.
End of Process
Radiologist pulls
exam from work
list on his
workstation
Radiologist
dictates
impression using
voice recognition.
PACS Benefits
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Reduces likelihood of errors
Faster turnaround
Reduces costs associated with handling
film and paper
Eliminates lost film
Why is PACS hot?
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Response to powerful new imaging
equipment:
Multi-detector CT
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Up to 16 images on a single rotation
No increase in radiation
New MRIs
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Faster=more images
Quieter
Why is PACS hot?

SHORTAGES!
– Radiologists
– Radiologic Technologists
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No solutions on the short term horizon.
The Challenge
1994
1,500 images per day
2002
16,000 images per day
2006
80,000 images per day
Who sells PACS?
Imaging equipment manufacturers
• Siemens
• GE
• Philips
Who sells PACS?
HIS Vendors
 Cerner
 McKesson
 Eclipsys
 IDX
 Misys
 Siemens
 GE
Who sells PACS?
Film Vendors
 AGFA
 KODAK
 Fuji
Who sells PACS?
PACS (as a primary
product) vendors
 Amicas
 Brit Systems
 DeJarnette
 DR Systems
 Dynamic Imaging
 Emageon
 Stentor
PACS Trends
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Single-tier architecture
Broker-less integration.
Greater workstation capabilities.
Moving out of radiology.
Getting cheaper.
Greater CIO involvement in the
selection process.
PACS Resources
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http://www.diagnosticimaging.com/
http://www.imagingeconomics.com/
http://www.scarnet.org
http://radtutor.mcw.edu/clubpacs/index.p
hp
http://www.auntminnie.com
http://www.ahra.com