pacs: an overview healthcare technology network george h. bowers health care information...
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PACS: An OverviewPACS: An OverviewHealthcare
Technology Network
George H. BowersHealth Care Information Consultants, LLC
© Copyright 2004 Healthcare Information Consultants, LLC
PictureArchiving andCommunicationSystem
PACSPACS
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.
StorageMedia/Archive
ReviewWorkstation
DiagnosticWorkstation
Database/Workflow
Mgmt. System
HighSpeed
Network
Digital ImagingDevice
Elementsof
PACS
StorageMedia
ReviewWorkstation
DiagnosticWorkstation
Database/Workflow
Mgmt. System
HighSpeed
Network
Digital ImagingDevice
Elementsof
PACS
StorageMedia
ReviewWorkstation
DiagnosticWorkstation
Database/Workflow
Mgmt. System
HighSpeed
Network
Digital ImagingDevice
Elementsof
PACS
DICOMDigital Imaging and Communications in Medicine
PACS IssuesPACS Issues
RIS or no RIS Partial (mini) PACS? Interfaced or integrated? Separate archive or integrated archive?
Why is PACS hot?Why is PACS hot?
Benefits– Eliminate film handling.– Improves productivity.
Traditional Traditional
BeginRequest for CT
exam received inRadiology
Tech schedulespatient in RIS
RequestsTransportation for
patient
With or withoutcontrast?
With
Without
Tech sendscontrast to nursing
unitPatient Arrives
Tech checkspatients ordersand arm band.
Patientdemographics
entered into CTscanner
Patient is broughtinto room and
exam is completed
Tech prints examon film.
Exam is completedin RIS and
electronic logbook.Exam documented
in Pt. chart.
Transportationcalled to take
patient back toroom
Patient is movedto inpatient holding
area.
Technologistcompletes request.
Request is placedin film jacket inreading room.
Radiologistinterprets images
and dictates report
Film librarian filesfilm jacket
Transcriptionisttranscribes report
into RISErrors?
Radiologist signsreport
Final reportavailable in RIS
End of Process
End of Process
No
Yes
Film librariansearches for prior
studies
Film librarianhangs films onviewing board
Does Pt.have priorstudies?
No
Yes
Film Librarianclears the reading
board
Fully Automated and IntegratedFully Automated and Integrated
BeginRequest for CT
exam received inRadiology
Tech reviewselectronicschedule.
System requestspatient
transportation
With or withoutcontrast?
With
Without
Nursingadministers
contrast in unit.Patient Arrives
Tech checkspatients ordersand arm band.
Tech pulls patientdemographicsfrom worklist.
Patient is broughtinto room and
exam is completed
Exam is completedin PACS and RIS
System notifiestransportation
Patient is movedto inpatient holding
area.
Errors?Radiologist signs
reportFinal report
available in RISEnd of Process
No
Yes
Radiologist pullsexam from work
list on hisworkstation
Radiologistdictates
impression usingvoice recognition.
Radiologistcorrects report.
PACS BenefitsPACS Benefits
Reduces likelihood of errors Faster turnaround Reduces costs associated with handling
film and paper Eliminates lost film
Response to powerful new imaging equipment:
Multi-detector CT Up to 16 images on a single rotation No increase in radiation
New MRIs Faster=more images Quieter
Why is PACS hot?Why is PACS hot?
Why is PACS hot?Why is PACS hot?
SHORTAGES!– Radiologists– Radiologic Technologists
No solutions on the short term horizon.
The ChallengeThe Challenge
1994 1,500 images per day
2002 16,000 images per day
2006 80,000 images per day
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?
Who sells PACS?Who sells PACS?
PACS (as a primary product) vendors
Amicas Brit Systems DeJarnette DR Systems Dynamic Imaging Emageon Stentor
PACS TrendsPACS Trends
Single-tier architecture Broker-less integration. Greater workstation capabilities. Moving out of radiology. Getting cheaper. Greater CIO involvement in the
selection process.
PACS ResourcesPACS Resources
http://www.diagnosticimaging.com/ http://www.imagingeconomics.com/ http://www.scarnet.org http://radtutor.mcw.edu/clubpacs/index.
php http://www.auntminnie.com http://www.ahra.com