PICTURE ARCHIVING AND COMMUNICATION SYSTEM-ASYNCHRONOUS TRANSFER MODENETWORK IN A MIDSIZED HOSPITAL

This article describes the pathway to full implementation of a hospita l information system-picture archiving and communication system-wide a rea network (HIS-PACS-WAN) in a 300-bed acute care hospital, and the l inking of th at system to two other off-site medical centers. The PACS included direct digital capture of computed tomography (CT), magnetic resonance (MR) imaging, nuclear medicine, and ultrasonography images into an Olicon archive. Plain radiographs and fluoroscopy images were digitized manually and archived into an Olicon system. The active arch ive included current images on each Olicon workstation and the juke bo x. Long-term archiving of the images on removable optical discs, which would be loaded manually by an operator every time a request for one of these studies appeared on the operator's monitor, also was implemen ted. Ability to store, retrieve, and display simultaneously the physic ian's report of each procedure along with the images was an ultimate g oal. The WAN is to be used for teleradiology and teleconferencing amon g the three medical centers involved in this study as well as other of f-site locations. Phase I included the design and installation of the local area network (LAN) in the Department of Radiology at Olive View- UCLA Medical Center. This included the clinics and the inpatient and h ospital-wide fiber-optic network and its linkage to the local telephon e company. Phase II involved linkage of the Olicon workstations to ima ging equipment. This implementation has been delayed significantly bec ause of inadequate needs assessment, absence of planning for forward-c ompatibility to imaging equipment, and incompatibilities in DICOM conf ormance among vendors. Every PACS project must include an in-depth nee ds analysis, which should be updated yearly because of rapid turnover of technology. Although this analysis should have a heavy emphasis on clinical needs, it must incorporate the hospital-wide needs for an int egrated information systems network. Integration of PACS, HIS, RIS, an d a dictation/transcription system is a complex task that requires a f ull-time, clinically oriented project officer for successful completio n. Copyright (C) 1997 by W.B. Saunders Company.