LARGE-SCALE PACS IMPLEMENTATION

The transition to filmless radiology is a much more formidable task th an making the request for proposal to purchase a (Picture Archiving an d Communications System) PACS. The Department of Defense and the Veter ans Administration have been pioneers in the transformation of medical diagnostic imaging to the electronic environment, Many civilian sites are expected to implement large-scale PACS in the next five to ten ye ars. This presentation will relate the empirical insights gleaned at o ur institution from a large-scale PACS implementation. Our PACS integr ation was introduced into a fully operational department (not a new ho spital) in which work flow had to continue with minimal impact. Impedi ments to user acceptance will be addressed. The critical components of this enormous task will be discussed, The topics covered during this session will include issues such as phased implementation, DICOM (digi tal imaging and communications in medicine) standard-based interaction of devices, hospital information system (HIS)/radiology information s ystem (RIS) interface, user approval, networking, workstation deployme nt and backup procedures. The presentation will make specific suggesti ons regarding the implementation team, operating instructions, quality control (QC), training and education. The concept of identifying key functional areas is relevant to transitioning the facility to be entir ely on line. Special attention must be paid to specific functional are as such as the operating rooms and trauma rooms where the clinical req uirements may not match the PACS capabilities. The printing of films m ay be necessary for certain circumstances. The integration of teleradi ology and remote clinics into a PACS is a salient topic with respect t o the overall role of the radiologists providing rapid consultation. A Web-based server allows a clinician to review images and reports on a desk-top (personal) computer and thus reduce the number of dedicated PACS review workstations. This session will focus on effective strateg ies for a seamless transition. Critical issues involve maintaining a g ood working relationship with the vendor, cultivating personnel readin ess and instituting well-defined support systems. Success depends on t he ability to integrate the institutional directives, user expectation s and available technologies. A team approach is mandatory for success . Copyright (C) 1998 by W.B. Saunders Company.