Health Imaging & IT - October 2007 - (Page 55) e n t e r p r i s e pA c s : W h e r e d o t h e o p p o r t u n i t i e s a n d c h a l l e n g e s l i e? out there that have the all-inclusive package: a RIS, PACS, HL7 engine, practice management, and billing offering,” he says. “That kind of system, where you’re not putting together too many disparate systems, is probably the better path to take.” future pAcs paradise As PACS access moves beyond the radiology department and into the enterprise, it’s only natural that other image-generating specialties will want to take advantage of these systems. Currently, there are cardiac-specific PACS, orthopedic-specific PACS, radiation therapy-specific PACS, and a few pathology-specific PACS on the market. Other specialties, such as endoscopy, ophthalmology, and microscopy, create visible light (VL) images and also will want to be part of a future enterprise PACS. Integrating these specialties will provide system-wide access to their diagnostic reports and images, allowing healthcare practitioners to further expand their diagnostic capabilities. Obviously, from an enterprise standpoint, it makes little sense to have a collection of independent PACS keeping medical images within each department—which requires a back-up and disaster recovery for each individual specialty. An enterprise image-management strategy will be required to centralize the archiving of this data, both for economy of scale and electronic health record capabilities. John Koller, a healthcare information technology consultant and president of Larkspur, Colo.-based KAI Consulting, notes that such an enterprise-level image archive has the potential to significantly lower the cost of ownership of a PACS. “The long-term life-cycle costs associated with managing these images can be significantly lower by creating an enterprise archive, if you look at what it costs to migrate from PACS vendor to PACS vendor,” he says. “Historically, when you go into your first PACS, it’s a learning opportunity. You end up buying it, you get into the vendor, and then once you figure out what you really want and go out and buy it, you have to go through a lengthy and expensive migration of your data from the original PACS to the new system. Some of these can take months or years and cost ten of thousands or hundreds of thousands of dollars or more. “By building a common, standards-based image archive, what you’ve done is started to virtualize the PACS front end. This enables a user to deploy a department-level PACS and plug and unplug it without having to migrate images that have been accumulated over a long period of time. This allows any new PACS to come in and start accessing the images using standard formats such as DICOM to query and retrieve the images and information that is a hospital asset.” HealthImaging.com In addition, an enterprise PACS that provides image management for all specialties will need to have a single platform architecture, to allow efficient systems administration, according to Herman Oosterwijk, president of Dallas-based PACS education training and education firm OTech. He also recommends that such a system be strictly standards-based to ensure interoperability with existing, as well as future, healthcare IT products. “If you’re looking for an enterprise-level PACS that can bring together all imaging specialties through one system, you’ll want to have it built on a single architecture and provide one user interface [with tools for various specialties]; otherwise support and management will be very difficult to do,” he says. Health Imaging & IT | O C T O B E R 2 0 07 55 http://www.mergehealthcare.com http://HealthImaging.com
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