A recent GlobalData report sheds light on the future growth and adoption of Picture Archiving and Communication Systems (PACS). “US Picture Arching and Communication Systems (PACS) Market: Increasing Adoption to Drive Growth,” found that the market will:

• Grow by 13% annually for the next seven years
• Reach $2.5 billion in 2015, up from $1 billion in 2008

The report also found that PACS adoption will be driven by:

1. Small and mid-sized hospitals looking to cut costs and increase efficiency.

2. Large hospitals looking to replace legacy PACS to take advantage of single desktop solutions, advanced clinical application, and seamless Radiology Information System (RIS)/PACS integration.

The report also discusses the role of the Health Information Technology for Economic and Clinical Health Act (HITECH Act) on the future of PACS. As smaller hospitals increase healthcare IT infrastructure spending in the next two years, the market is likely to experience increased adoption of integrated PACS/Electronic Medical Records (EMR)/RIS.

For larger hospitals that already have a PACS in place, the funds will likely be spent toward a robust EMR system.

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PACS Adoption to Experience Significant Growth by 2015 was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

That’s because Iowa Health System – the state’s first and largest integrated health system – has partnered with McKesson for an enterprise Horizon Medical Imaging™ Picture Archiving and Communication System (PACS) implementation.

Iowa Health System conducts an increasing number of procedures every year, and needed a solution that could help physicians and staff deliver high-quality, timely patient care now and in the future.

The healthcare system chose McKesson to replace its former PACS vendor in order to meet its growing diagnostic imaging needs.

The PACS implementation will provide:

• Fast, easy access to files, images and results for radiologists
• The ability to make decisions more quickly for physicians
• Enhanced service for patients, their families and communities in general

With the new PACS in place, Iowa Health System will gain a competitive edge moving into 2010 and far beyond.

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34 Iowa Healthcare Facilities Soon to Benefit From PACS Implementation was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

In a recent post, the British Medical Advisor Jobs blog highlights some of the many benefits of PACS on patient care and physician efficiency. We’ve summarized that information and created the “Top 5 PACS Benefits” list:

1. PACS reduces the need for film in diagnostic imaging, saving on both the costs to buy film and the space needed to house film.

2. PACS facilitates quick and easy access to patient images and reports.

3. PACS can help reduce the number of duplicate images since previous results are available electronically.

4. With PACS, tests can be performed anywhere, as results can be shared electronically with other remote facilities.

5. Physicians can acquire a chronological view of patients’ radiology histories.

What benefits would you add to our top 5 list?

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Top 5 Benefits of a Picture Archiving and Communication System was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

February 21-26
Abdominal Radiology Course 2010
Orlando
The Abdominal Radiology Course 2010, presented by the Society of Gastrointestinal Radiologists and the Society of Uroradiology, will highlight new and emerging diagnostic imaging technologies for abdominal and pelvic pathology. The course, designed for practicing radiologists and those in training, will feature lectures, panel discussions and interactive workshops.

March 3-6
11^th Annual Advances in Breast Imaging and Interventions
Las Vegas
This course, presented by Stanford Department of Radiology, will address current advances in breast imaging and interventions. Attendees will discover how advances in digital mammography, ultrasound and MRI are impacting the way physicians diagnose and evaluate suspicious masses. The course will also discuss how techniques to improve interpretation and patient assessment are helping physicians make better cost-effective decisions for optimal breast cancer detection.

Subscribe to the Medical Imaging Talk blog via RSS feed or email to receive updates on all the latest medical imaging news. Or follow us on Twitter.

Finalize Your 2010 Calendar With Upcoming Radiology Conferences was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

For Provena St. Mary’s Hospital in Kankakee, Illinois, digital mammography is an integral part of its strategic plan to put the most advanced technology in the hands of staff and deliver the best possible care for patients.

In this digital mammography video from Provena St. Mary’s, hospital administrators, radiologists, oncologists, OB/GYNs, nurses and even breast cancer patients share insight on the benefits of the system.

“Digital mammography allows us to manipulate data generated by mammograms in such a way that gives us more information than we’ve ever had before,” Dr. David S. Lang says in the video.

Benefits discussed in the video include:

• Capability to evaluate even the smallest calcifications
• Earlier detection of breast cancer, which can improve survival rates
• Ability to diagnose patients locally without having to refer them out
• Enhanced information and storage retrieval, and the ability to send data to other institutions

Watch the full digital mammography video to discover more.

Click here to view the embedded video.

Digital Mammography Video Highlights Benefits for Patient Care and Workflow was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

Driving the growth of the mammography equipment market are:

1. Technology advancements

2. Increased public awareness

3. Highly efficient digital technology

4. Low dosage featured in digital equipment

5. Increased use of digital mammography equipment

The report, “US Mammography Equipment Market: Product Innovations to Drive Growth,” found that the Full-Field Digital Mammography (FFDM) equipment segment contributes the largest amount of revenue in the overall mammography equipment market. FFDM accounted for 95% of all revenue in 2008.

Moreover, the study found demand for digital mammography from both patients and clinics has increased significantly, following the 2005 results of the Digital Mammographic Imaging Screening Trial (DMIST). The DMIST, conducted by the National Cancer Institute, concluded that the accuracy of digital mammography is significantly higher than film-based mammography – particularly with women under 50 and those with extremely dense breasts.

As an increasing number of radiology departments realize the benefits of integrating digital mammography into their diagnostic imaging workflow, these projected numbers may grow even further. Those benefits include:

• Single view of a patient
• Reduced workflow disruption
• Improved resource utilization
• Integration to Radiology Information System (RIS)
• Enterprise-wide communication with Picture Archiving and Communication Systems (PACS)

Has your healthcare organization integrated digital mammography into the diagnostic imaging workflow?

Mammography Equipment Market Projected to Grow to $585 Million by 2015 was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

Glen Falls Hospital

Glens Falls Hospital and its affiliated private practice radiology group, Adirondack Radiology Associates, needed a way to effectively manage medical imaging and reports across the enterprise. Faced with fragmented imaging records across a wide geographic region and facilities, these providers opted for a Picture Archiving and Communication System (PACS) implementation to create a unified view of patient records and increase clinician productivity and satisfaction.

The Medical Imaging Talk Blog discusses the successful PACS implementation with Dr. Dan Chernoff, radiologist and director of radiology at Adirondack Radiology Associates.

How has the recent implementation of the PACS improved efficiencies and cost savings?
The PACS improves department efficiencies in a myriad of ways, including no lost or misplaced films, images available to multiple users simultaneously, much more efficient soft-copy review of studies compared to film, much better and faster access to prior studies for comparison, and faster turn-around time from imaging to diagnosis.

What reaction have you received from staff and doctors in regards to the PACS implementation?
The response to PACS from staff and clinicians has been overwhelmingly positive. Gone are the days when clerical staff and clinician time was wasted pulling studies from a film library, shuffling through a huge film jacket and discovering films were lost or signed out. Being able to view imaging studies from home has been a god-send not just for radiology calls but also for clinical specialists on call (e.g. neurosurgery, orthopedics).

In terms of introducing staff to the new system, what lessons learned would you offer other hospitals and clinics?
Radiology staff and radiologists were trained directly by McKesson. These radiology super users then trained all others once they were up-to-speed. A lesson I can offer others is to assume that some users will be difficult to train and/or reluctant to change their method of accessing radiology studies. Either accentuate the positive and accept some level of dissatisfaction over change, or have a plan to satisfy “special needs” providers. For example, we did not plan well for PACS in the OR. The mobile carts were not well accepted, and we went back to printing film for the OR until their needs were met.

Can you give some specific examples of how the PACS implementation has affected staff?
The orthopedists, neurosurgeons and neurologists on call were extremely happy that they could review studies at home and do not have to drive in to see every ER patient for whom there is a questionable imaging finding.

For radiologists, we implemented a Master Patient Index, allowing studies performed at the hospital and the radiologist-owned outpatient imaging centers to be contained within a single “virtual jacket” for each patient. This has saved untold hours of trying to get images up from disparate PACS databases for comparison purposes and has probably saved a life on more than one occasion – without for the combined database, a critical comparison would not have been made in the name of expediency.

Were there any surprises during the PACS implementation?
Lack of planning, or more properly lack of thorough consultation, for the OR was one mistake. At the time of purchase, we did not have the resources to fully implement a fault-insensitive system (backup servers, backup network, etc). We are now about 75% there and would like to be at 100%, as PACS is now mission-critical for the hospital.

What risks are there for hospitals that choose not to move forward with a PACS implementation?
Risks to not implementing a PACS include lower department efficiency, higher costs, lack of scalability, slower turn-around time, opportunity to lose images and overall poorer patient care due to limitations of image storage on film.

What do you think will be the next greatest advancement in Radiology Information Systems (RIS)?
I think advances in RIS will include improved data mining tools, more standardization to allow interoperability with other information systems, growth of SAAS or hosted RIS, opening of radiology scheduling to patients and referring physicians, growth and integration of critical results reporting software, and growth of integrated decision-support tools.

Q&A With Dr. Dan Chernoff: The Formula for a Successful PACS Implementation was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

Allan Noordvyk

For Picture Archiving and Communication Systems (PACS), the future looks very bright. Medical Imaging PACS is quickly becoming the standard for healthcare organizations across the country. In fact, thousands of healthcare enterprises have already upgraded to PACS technology – with more organizations joining the list every day.

Earlier this month, Imaging Economics sat down with Allan Noordvyk, director of radiology/product management for the McKesson Medical Imaging Group – along with Tim Kulbago of Merge Healthcare and Michael Green of Agfa HealthCare North America – to discuss the future for PACS.

Below are excerpts from the Imaging Economics interview with Noordvyk:

How have PACS systems changed over the last decade?

Noordvyk: PACS is considered a mission-critical component for patient care and service delivery; hospitals cannot afford for the system to be down. Hospitals are replacing the single use/departmental solutions that do not improve efficiencies or position them for future success (and health care dollars). Products and improvement must focus on workflow and productivity enhancements, not just adding a button or isolated feature. Real improvements help hospitals improve their operations, service delivery, patient care outcomes and operational goals.

There’s a sense of urgency in the market – hospitals that haven’t planned for the future may get left behind. Buying another scanner is not a solution for long-term success – investing in IT is. And image management is at the core.

PACS is now pretty standard in most large hospital settings. What about community hospitals and imaging centers? What’s the biggest barrier to adopting a PACS system these days?

Noordvyk: In reality, few facilities have not adopted PACS. [The issue is that] facilities are re-evaluating their PACS decision. Does their existing PACS position them for future success, government funds, etc? They’re looking for replacement solutions that deliver on the promise (and take them into the 21st century).

What are customers demanding these days regarding PACS? Are you seeing that radiologists are becoming savvier about digital imaging and technology in general?

Noordvyk: Radiologists and administrators are looking for solutions that enable them to acquire, distribute, and archive medical images and diagnostic reports across the enterprise. Integrating images from multiple modalities with clinical patient data, streamlining the department’s workflow, and contributing to improved radiologist efficiency.

Additionally, they need systems that provide referring physicians with patient images as part of a comprehensive medical record. The status quo is not a viable business plan – they’re looking for vendors that get them closer to their goals and objectives and deliver on expectations.

We hear a lot about thin-client, Web-based, and even zero-client PACS systems – what are the key benefits of each? Who needs what most?

Noordvyk: McKesson pioneered the concept of the zero-download PACS client with our eJacket interface for referring physicians. The two main benefits of zero-download are immediate access to patient information from a new device and cross-platform support. Both are of increasing importance as recent generation iPhones, Blackberries and other PDAs become commonplace in the hands of health care workers and thus mobile access to images on modest, non-Windows platforms is increasingly in demand.

If it’s done correctly, zero-download clients can also be zero-training clients. However, the technology currently available for zero-download clients remains insufficient for high-performance sophisticated image manipulation and the underlying required network and data management strategies. Thus, for radiologists classic downloadable Web clients are still required.

What are the latest trends? How is PACS continuing to enhance workflow and efficiencies for radiologists?

Noordvyk: Health care providers/radiology service providers are finding the limitations in the PACS they purchased years ago hinder their success now, have not lived up to the promises and their expectations, and are restricting their ability to plan for future success. Users are often still forced to use 19th-century workflow and technology but in an increasingly more complex and demanding 21st-century environment.

What you’ll be seeing from McKesson is optimizing workflow and productivity in the breast center. By minimizing the duplication of effort caused by disparate systems and removing redundant hardware, the potential for errors is reduced. The automation of tasks provides maximum efficiency for the radiologists and other clinical personnel while providing better, safer patient care.

Discover even more about PACS’ future by reading the full Imaging Economics article.

Medical Imaging Thought Leader Shares Insight on PACS’ Future was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

Health Management Technology Magazine: Health Management Technology is a monthly publication dedicated to helping IT professionals stay current on the latest healthcare advances. Its content focuses on electronic medical records, revenue cycle management and networking infrastructure. The site is a comprehensive resource, complete with event listings, polls, the latest news, tips, videos and blogs.

Hospitals and Health Networks Magazine: HH&N is the flagship publication of the American Hospital Association intended for hospital and system executives. In addition to articles on electronic records, healthcare management and hospital information systems, the site provides an event calendar, blogs and podcasts.

Journal of Radiology Nursing: This official journal of the Association for Radiologic & Imaging Nursing is intended to help radiology nurses practice with compassion, competence and commitment to their patients. Articles focus on education, administration, research, patient care and case studies. Recent articles include “Diagnostic Imaging: Radiation Dose and Patients’ Concerns” and “Radiology Nurses Roles and Opportunities with Central Venous Catheter Education.”

Suggest a publication to include on our list in the comment section below.

Resources for the Latest Healthcare Advances was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com

Dr. Jonathan B. Kruskal

The advancement of medical imaging technologies, such as Picture Archiving and Communication Systems (PACS) and Radiology Information Systems (RIS), is contributing to a host of clinical advantages. At the top of that list of advantages are radiology risk management and improved safety – for patients and staff alike.

During the 2009 RSNA Scientific Assembly and Annual Meeting, Dr. Jonathan B. Kruskal shared insight on safety and risk management in radiology departments. We sat down with Dr. Kruskal, chairman of the Department of Radiology at Beth Israel Deaconess Medical Center in Boston, to learn how RIS can contribute to reduced errors.

How can RIS help reduce errors in clinical radiology departments?
RIS allow certain loops to be closed, such as communication of abnormal results and follow-up of recommendations for abnormal results. But it can also be used for and linked to facilitating a peer review process, a quality and safety reporting and management process, and minimizing variation in reports and communication to referring physicians through structured reporting. I believe that in the future, RIS will be an essential component for any quality program.

You spoke during RSNA 2009 on radiology risk management. What were some of the top points you made during your session?
During my RSNA talk, I covered radiological errors. The major points I made are that errors occur commonly. We all make mistakes, but it is essential to use analytic processes to turn each error into an opportunity for improvement.

I described a new error classification system that, instead of focusing on the human component, will bring in the spectrum of latent or organizational contributors and will place the patient at the center of this classification. The essential message is that when an error occurs, a variety of other minor contributors have also been set in motion to facilitate this error from taking place. Error detection systems are essential in order to manage errors, minimize the degree of harm, manage personnel involved and identify contributing factors so they can be eliminated.

What measures have been taken at Beth Israel Deaconess to reduce errors and improve radiology risk management?
At Beth Israel Deaconess, we have established a comprehensive program as was recently described in our manuscript, “Strategies for Establishing a Comprehensive Quality and Performance Improvement Program in a Radiology Department,” in RadioGraphics. We have a triple reporting system:

• The first is a web-based patient safety reporting system managed by our Health Care Quality Department in the hospital.
• The second is a mandatory peer-review process where each physician is expected to peer-review at least 5% of his or her prior year’s volumes – these are actively managed and audited.
• Lastly, is an intradepartmental web-based reporting system for all errors, be these technical or clinical.

It is our cultural expectation that all staff, be they technical, physician or trainees, participate and report all errors freely, including those that are near misses. These are all managed by our Quality Management Team, who audit and seek trends.

Can you offer a real-world example illustrating how errors were reduced through radiology risk management?
To reduce errors, we have a vigorous evaluation of all reported errors and link this to ongoing safety walkabouts and hazard analyses. All errors undergo root cause analysis, seeking to identify contributing causes. Any sentinel event undergoes a thorough root cause analysis with action plans and assigned accountable personnel to follow-up and ensure that this strategy is working.

A good example was a wrong joint injection under fluoroscopy. The error was immediately detected and reported, and disclosure was made to all relevant personnel, including an apology to the patient. A same-day visit to the site took place to identify exactly what happened, and a root cause analysis then took place 48 hours later.

At this analysis, the human factors were fully evaluated, from the decision to order the study to the interaction with our schedulers, office staff, technologists, sonographers, nurses, radiology fellow and radiology attending. We also looked at the contribution from the patient to identify any potential patient factors that may have contributed to this.

We then looked further at the latent contributors and identified a number of contributing factors to this error. Specifically, an unusual abbreviation was used in the requisition. All other steps were performed correctly, including performance of a time-out. However, the time-out demonstrated some variation in that the requisition was not read out aloud, but the patient ID, the perceived request and the location of the correct left third toe were all verified. The patient, indeed, even verified the procedure.

Latent contributors were that the section was understaffed (one staff member was out sick) and the attending had read over 170 cases before. The fellow was experienced and excellent, and therefore, the attending perceived no risk in working with this fellow. Both the fellow and the attending never had any prior similar experiences.

As a result of this root cause analysis, we have now established a new policy for not using even unfamiliar abbreviations when scheduling. We have also introduced a scripted pre-procedure time-out so that all elements of the time-out are not only documented, but described, and are all participated in, specifically in reading out the requisition for the study. Subsequent to this time, we have not had a wrong site procedure.

Looking ahead, how do you foresee technology advances allowing for even greater radiology risk management?
In terms of further reducing errors in radiology departments, several steps need to take place.

Beyond simply adhering to the Joint Commission requirements that all hospital systems have error reduction systems and perform vigorous root cause analyses, cultural shifts are required. All staff working in a department must view errors as important opportunities for analysis and identification of contributing factors. In addition, this cultural shift will require the free, anonymous and non-punitive reporting of errors so that opportunities for improvement can be identified.

The requirement that all trainees now undertake an outcomes project is a unique opportunity for training in this culture. We now expect each of our residents to undertake a month-long quality and safety rotation where they are exposed to the tools of quality and safety. They also undertake a project aimed at improving safety for all patients and staff in our department.

In addition, the ability of RIS to link to PACS and to allow peer-review, easy, auditable, manageable reporting of all events will facilitate this improvement. This could also be further improved by allowing dosage of radiation exposure to be continuously recorded within the studies. That way, when a study is ordered, the ordering physician is fully aware of what prior studies have been performed and what the patient’s prior exposure dose is.

Radiology Risk Management: Q&A With Dr. Jonathan B. Kruskal was posted at Medical Imaging Talk. | http://www.medicalimagingtalk.com