No imaging system is an island -- or should be. The integration of Picture Archiving and Communications Systems, or PACS, is allowing these important tools for organizing and displaying radiology images to emerge as visualization hubs, bringing images from multiple systems together in a single user interface.
PACS integration solves the problem that sprang up at many hospitals during the past decade, as new digital imaging systems replaced the previous generation of film-based systems.
Although the new systems were more efficient, they were standalone or “stovepipe” systems. Images of one patient in a cardiac system, for example, were not viewable alongside images of the same patient on a mammography workstation. The result was wasted time on the part of hospital staff in finding and organizing a patient’s images -- adding to costs and potentially delaying diagnoses.
Recent product announcements target PACS integration
At the RSNA trade show in November, GE Healthcare launched Centricity OneView Global Reading. This integrates medical imaging applications, including mammography, orthopedic templating and advanced 3-D analysis, nuclear medicine and ultrasound, which were once installed on separate workstations, according to Dean Kaufman, senior marketing manager at GE Healthcare IT in Allendale, N.J.
GE Healthcare has two PACS offerings, Centricity for large hospitals and Centricity IW, a Web-based imaging system geared to smaller customers. Centricity IW was added to the company’s product line two years ago with GE Healthcare’s acquisition of Dynamic Imaging LLC. At RSNA, GE Healthcare announced a companion product, Centricity OneView Single Patient Jacket, which leverages GE's Smart Patient Matching technology to offer faster access to patient records across different systems for more timely reports.
GE Healthcare is not alone. Its PACS competitors are headed in the same direction -- and several are ahead. At the 2008 RSNA conference, Carestream Health Inc. announced SuperPACS, an architecture designed to bring together multiple imaging systems for viewing from a single workstation. In addition, other vendors, including Philips Healthcare and Amicas Inc., have added integration capabilities to their PACS offerings.
Hospitals reap benefits of PACS integration initiatives
Health care IT professionals are paying attention to the new products.
For example, Radiology Ltd., a diagnostic imaging service provider in Tucson, Ariz., is deploying an Amicas system that will let users view not only PACS images, such as CT scans or ultrasound images, but mammography and other images as well. Mammography systems have in the past often been standalone systems because mammography demands a higher degree of resolution than other medical imaging systems. “I’m very interested in a unified system. … Our radiologists demand access to these other systems,” said Ron Cornett, PACS administrator at Radiology Ltd., which moved from a client-server PACS system to a Web-based Amicas system in 2003.
I'm very interested in a unified [PACS] Our radiologists demand access to these other systems.
Ron Cornett, PACS administrator, Radiology Ltd.
Rick Adams, PACS administrator at St. John Health System, a medical center in Tulsa, Okla., has likewise implemented different digital medical imaging systems over several years. The result is a stovepipe system that, while useful, created obstacles for medical professionals who needed to view images from different systems.
“We went to a digital mammogram system about three years ago. But the radiologists weren’t able to look at more than just mammograms. They also need to look at ultrasound and MRI images. They couldn’t see a CT scan from the same workstation. They would have to walk to the other end of the hospital,” Adams said.
Adams said he was attracted to Carestream Health because Carestream’s SuperPACS technology enabled St. John to bring images created under a previous digital imaging system into a single “global worklist,” a searchable archive encompassing all systems. SuperPACS is a layer of software that enables Carestream’s PACS to connect to other PACS, thus creating a multi-modality workstation, according to the vendor. Carestream’s PACS can be viewed both locally and across the Web via a browser interface; in fact, four radiologists access the SuperPACS system from their homes, Adams said.
“In the past, if you brought in a new archive, it wouldn’t talk to the old one. You’d have to migrate millions of images. It would cost a lot and take a lot of time,” Adams explained. However, he said, the Carestream system was able to index seven years’ worth of existing images and bring them into its archive in only two weeks.
“Now if you’re looking at a mammogram and want to see other studies, like MRI, you can drag the image to your desktop” from the archive, Adams said. The time saved adds up, with one doctor telling Adams he thought he was working about 20% faster than before.
Lakeland Regional Medical Center in Lakeland, Fla., went through a similar PACS integration process. In the past, according to Hugh Autry, president of operations, the cardiology, radiology, nuclear medicine and ultrasound departments all used separate systems.
“We wanted to let the physician sign on once for all images, both on-site and remotely,” Autry said. To fulfill this need, Lakeland is converting from its previous imaging systems to Philips’ iSite.
“We found Philips the only system that had integrated cardiac and radiology [imaging] into one system,” said Autry. The systems remain separate, but images from both are presented in a single user interface, he explained.
Autry is planning to bring up iSite in January and will migrate images from the existing cardiac imaging system in March. Although iSite could also bring in mammography images, Lakeland plans to keep its mammography system separate, since those studies are performed at a separate site.
PACS integration capabilities not only yield dividends at hospitals and imaging centers, but they will also be important to PACS vendors as users move to the next generation of systems. In a recent PACS software survey, KLAS Enterprises LLC, a health care research firm in Orem, Utah, found that nearly 9% of large hospitals are planning to replace their PACS. As they do so, integration capabilities will be an important differentiator, said KLAS analyst Kirk Ising. “There’s a trend to start integrating or unifying the enterprise. Radiology and cardiology are looking to manage a common archive,” Ising said.
Stan Gibson is a Boston-area technology writer. Let us know what you think about the story; email firstname.lastname@example.org.
This was first published in December 2009