Covering All the Bases

By Ed Heere, Founder of CoActiv Medical
Advance for Imaging & Radiation Oncology, May/June 2012

The increased demands of today’s health care climate have raised the bar for PACS systems.

The little understood but dramatic impact of health care reform and meaningful use, as well as today’s financial pressures to “do more with less” while meeting the demand for better health care, are trends driving vendors to refine and enhance PACS functionality. Propelling this volatile mix into the future will be the growing health care needs of aging Baby Boomers, shrinking Medicare payments and physician shortages in key specialty areas.

The modern PACS playing field is rapidly evolving as a result. To be successful, a PACS has to work hard, integrate as a team player with a range of other information systems, and cover all image bases from radiology to cardiology as well as newly emerging modalities and imaging disciplines.

Radiologist at workstation

Savvy manufacturers started preparing to meet these needs years ago, and the results of their efforts are evident today; the ability of smart PACS products to handle a broad range of diverse images in sophisticated ways now is de rigueur.

The benefits, of course, are more streamlined information flow throughout the enterprise and often beyond, as well as minimization of IT resources acquisition, maintenance and rapidly escalating local archiving expenses. As health care reforms cut back reimbursements on traditional radiology exams and financial constraints grow, a well-rounded PACS also will play a key role in helping radiology sites expand into related areas such as radiation therapy (RT) to enhance revenues. In the future, PACS may provide easy, simultaneous viewing of images by radiologists, attending physicians, surgeons, (local or remote) and even patients—before, during and after a procedure.

Another major trend is the growth of cloud-based PACS applications and storage, offering lower expenses, eliminating technology upgrades and enhancing flexibility to manage workflow and distribute images anywhere. The reason? Again, the financial crunch is forcing radiology practices to cut costs as well as to seek out creative new ways of doing business. Cloud-based imaging enables staffing from anywhere in the world which, in turn, significantly shortens exam turnaround and gives a practice a competitive edge. Conversely, radiology practices also can deliver services worldwide to address the opportunities of a radiologist shortage in many other countries.

With the trend toward performance-based care—only expected to grow in the future—both referring physicians and radiologists must focus on enhancing patient relationships. The easy image-sharing and immediate display offered by cloud-based PACS will enable better and easier patient consults. A handful of vendors have recently perfected the mobile aspect of this technology, and demand is growing. Of course, mobile technology gives radiologists more flexibility in where and when they work, much to their liking.

In parallel with these trends, the proprietary PACS technology still promoted by some manufacturers will rapidly become part of the past (good riddance) and the vendor-neutral archiving (VNA) format will take center stage in an effort to support universal image communication and sharing.

PACS users are seeking truly reliable technology, and many vendors are scrambling to create more stable and secure technology. Within these endeavors is an implicit vendor responsibility for the viability of radiology business operations such that PACS vendors will have to “put their money where their mouth is” with uptime and fail-proof archive guarantees.

As the new health care frontiers emerge, integration on every level also will grow. Full PACS/RIS/EMR integration will fulfill the demands of meaningful use. A seamless, efficient workflow is a must. Single-vendor solutions will allow flexible staffing and a more efficient and effective health care operation via unified user interfaces and cross department access.

As image sharing grows, radiologists will have to better manage images that arrive from other medical facilities and deal with growing data volumes. Tools that automate reconciliation of patient data and exam purging are likely to take root. In the future, PACS may literally speak to the radiologist with increased CAD, color, 3D, dynamic motion, multimodality image registration and perhaps even sound.

PACS, in addition to being a clinical application, is also likely to handle more business functions. For example, some savvy radiology practices have already set up Web sites that enable them to automatically take on hospital exam overages and deliver second opinions. Management of these incoming exams may become increasingly automated by new PACS functionalities.

Will your PACS admin ever become your webmaster or CIO? Unlikely, but the future is sure to hold many surprises.