Cutting Edge Issues
Internet-Enhanced Physician Practices

Deploying a PACS: Issues to consider

Application Service Provider PACS: Analyzing Costs of Service

eHealth:
Towards A New World of Communications in Medicine

Case Study Zone
St Paul Radiology Goes Filmless

Who is eMed?
Mission Statement
Customer Base
Partnerships
Product Offerings
Support Services

Deploying a Picture Archiving and Communications System

Part 5

Deployment of PACS

When a consensus is reached favoring the deployment of an imaging network, who should be in charge? Being in charge of the entire project will include (but will not be limited to) the management of needs assessment, the definition of requirements, vendor selection, installation, integration testing, training and education, and long-term support

Should the information-services department or the radiology department take charge? In each institution, the factors influencing this decision could be different. What is consistent, however, is that one entity must take ownership of the project. Once the defined project is complete, the facility can then terminate project responsibility. It becomes clear very quickly that the information-services department does not usually have an appreciation of the clinical needs of the radiology department. In addition, it soon becomes apparent that the radiology department does not usually have an appreciation of large-scale project deployment in the information-systems world. These are very different cultures with very different business practices.

What about cardiology? Catheterization laboratories are generating more data than radiology departments daily. What consideration has been given to integrating these images into the patient’s medical record? How are institutions going to store them, and which images will be stored (for example, each individual bolus run or just those frames that are pertinent to the report)? Should a separate archive be developed just for cardiology or should facilities integrate those images into a single archive capable of storing all of the institution's images?

The Archiving Dilemma

It is necessary to review the archiving strategy of the enterprise. More often than not, reviewing the operations of the data center makes it apparent that consideration should be given to addressing the need for a new archive capable of handling all of the institution's information. Although the initial outlay is typically higher than any institution has expected, the resultant streamlining yields significant gains. It also positions the institution for further expansion and cost-effective operations in an area that is requiring more attention.

Stuart Gardner is president of SG&A Consulting, Inc. (http://www.sgaconsulting.com/) located in Arlington, Texas, providing PACS planning and deployment consulting services. He was on the Digital Imaging and Communications in Medicine Committee from 1985 to 1992.