Term Paper on "Picture Archive Communication Systems PACS"

Term Paper 25 pages (7576 words) Sources: 1+

[EXCERPT] . . . .

Picture Archive Communication Systems (PACS)

The Effects of Picture Archiving Communications Systems (PACS) and Computerization on Radiology Workflow and Turnaround Time

Medical diagnostic imaging has experienced numerous innovations since the discovery of X-rays in 1895 that allowed physicians to look inside the human body for the first time without using a scalpel. Perhaps some of the most important of such innovations to date have been the introduction of computer-based radiology information systems and picture archiving communications systems. While these technologies are still being refined and new uses for them are being identified, it is clear that these innovations represent the beginning of a ubiquitous computing element in radiology. The vast majority of organizations planning to implement picture archiving and communications systems (PACS) are acutely aware of the need to integrate the hospital information system (HIS) and radiology information system (RIS) with the PACS; however, relatively few are aware of the fundamental challenges associated with its implementation and administration. To determine the effects of these innovations, this paper will provide an analysis of how the advent of radiology information systems (RIS) and picture archive communication systems (PACS) have affected today's radiology department, including reduced turnaround times required for examinations, improved and streamlined workflow, immediate delivery and accessibility of digital images virtually anytime anywhere. A summary of the research will be provided in the conclusion.

Review and Discussion

Background and Overview. According to Geracimos (2004), "Radiology is considered a branch of medicine that uses radioactive substances, electromagnetic radiation and sound waves to create images of the body, its organs and structures for the purpose of diagnosis and treatment"; properly used, these systems can help clinicians understand how effectively the body and its internal organs and structures are operating (B01). Radiographers today are increasingly relying on computer-based digital imaging equipment to produce images of the tissues, organs, bones, and vessels of the body (Holcomb 17).

Innovations in the supporting technology in recent years, though, have provided radiographers with the ability to provide these services faster than ever before, with the digital results being available to clinicians almost as soon as the images are taken: "The equipment is all computer-based these days," reports Cathy Parsons, vice president of the American Society of Radiologic Technologists; "You put the patient on the table, make the exposure, and the image is almost immediate" (Holcomb 17). In this dynamic environment, it is little wonder that clinicians and patients alike may be confused by the rapid advances taking place around them, a factor that may constrain wider acceptance until they have proven themselves over time. In this regard, Stanney (2002) points out that in the field of radiology in particular, "A number of new technologies will not be accepted by physicians or patients because of unfamiliarity, conventional prejudice, or outright ignorance of the benefits" (954). Clearly, though, understanding and applying these new technologies has assumed greater importance than ever in many medical applications as new uses for them continue to be identified. To this end, the benefits of these innovations in radiological applications are discussed further below.

Benefits of Radiology Information Systems (RIS). Information that is required for radiological applications is increasingly being managed by several autonomous medical information systems including hospital information systems (HIS), radiological information systems (RIS), and picture archiving and communications systems (PACS) (Breant, Taira & Huang 88). According to Albensi, Ilkanich, Dini, and Janigro (2004), "Simply put, an image is a visual representation of some measurable property of an object, person, or phenomenon. Imaging systems create and record images for the eye to view and the mind to experience. Some imaging systems create a visual map of what the eye and brain can already see and perceive"; still other types of imaging systems transduce visual data that is frequently indiscernible to the human eye into visible forms (1127). In their essay, "Evidence-based Radiology: Requirements for Electronic Access," Bui, Taira, Dionisio, Aberle, El-Saden, and Kangarloo (2002) report that, "Imaging is an effective method for screening (e.g., mammography), for documenting the presence or absence of a disease or condition (i.e., testing of a medical hypothesis), and for managing many medical conditions (e.g., follow-up of cancer).

Part of the challenge in this process in the field of radiology is to avoid misrepresenting the essential character of the object or phenomenon. "Therefore, it is important to choose an imaging system that will do the job and assist in solving a scientific question, rather than a system that is not appropriate for the application or that simply produces beautiful graphics and serves little practical use" (Albensi et al. 1127). Since their introduction in recent years, Abelha, Machado, Alves and Neves report that PACS have enjoyed the same type of reaction to new technologies that their counterparts have in other industries by providing their users with a taste of what can be accomplished with such innovations while still being constrained by a number of limitations. To date, these authors report that a great deal of attention has been focused on better understanding these constraints, and in identifying solutions to them. "The overall trend has been away from seeing the process as one of encoding heuristics derived from an expert," they say, "towards modeling the domain on which the expertise operates" (5).

One company that recognized that practical applications of these new technologies is Ris Logic Inc.; Ris introduced its radiology software at a Cleveland Convention Center trade show in May 2002 (Robinson 4). The client server software, called Ris Logic CS, is designed to help users comply with the Health Insurance Portability and Accountability Act of 1996 which was intended to protect health insurance coverage for people when they change or lose their jobs, and to bring uniformity to the electronic transmission of health information (Robinson 4). The company's director of marketing, Christine Boehm, reported that the company believes demand for the new software will help Ris Logic duplicate the growth pattern that emerged after its launch at its Radiology Society of North America show of Version 4.0 of its software the previous year. That version of the software automated record-keeping functions such as billing, appointment scheduling and patient reports for outpatient radiology centers (Robinson 4).

In 2001, Ris Logic more than doubled its customer base to 33 clients from 16 the previous year, with four new customers signing on shortly after the Radiology Society show, Ms. Boehm said. The new software will make managing a group practice with multiple office sites easier, Ms. Boehm said. The integrated patient information means basic data for each person and procedure is entered into the system once and everyone in the radiology practice has access to it. Ms. Boehm said that feature saves time and reduces the possibility of mistakes (Robinson 4).

Ris Logic has grown to 24 employees from three at its founding in 1999, and it isn't finished yet. Ms. Boehm said the company wants to hire another salesperson as well as someone to work on product implementation. One of the company's newest customers is Kentucky Diagnostic Center, a three-office diagnostic imaging business in northern Kentucky. Sam Grippa, president and CEO of Kentucky Diagnostic, said he needed to replace his old DOS-based scheduling system as his business grew. Mr. Grippa said he chose Ris Logic because its software is Windows-based and easy to use. "I did look at some other (software systems), one that I'm not sure even I could learn," Mr. Grippa said. "I look at it this way - if I have to put someone on hold to look up the information they need because I have to figure out how to access my computer system, I've wasted too much time" (Robinson 4). Grippa reported also appreciating the licensing terms for the Ris Logic software. "I don't have to call for permission every time I add something," he said (Robinson 4).

In their article, "Just the right prescription," the editors of Communications News (2005) report that the Kansas Spine Hospital in Wichita specializes in neurosurgery, spinal surgery, pain management and radiology; this facility is also one of the first hospitals in the country to completely digitalize patients' medical records, including prescriptions and clinical records to x-rays and other radiology images, and make them accessible by computer (24). The goals for the completely digital system were established by the hospital's development team and required that a digital telecommunications system before the institution opened in 2003. According to the healthcare provider's CIO, Michael Knocke, the initiative's objectives included ensuring that there was a reliable and durable digital telecommunications system in place that featured open standards that would allow seamless integration and convergence with its data network; the information system was also required to be one that would permit future growth and migration to new technologies and capabilities (Just the right prescription 24).

To meet these objectives, the hospital collaborated with Great Plains Communications of Wichita, one of the area's providers of communications solutions for the healthcare industry. Following a needs assessment, Great Plains suggested that a Toshiba Strata CTX670 business-communications system with… READ MORE

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