When Regions Hospital got serious about automating its patient record, administrators there decided that PACS would have to be part of it. As a first step, they replaced the legacy radiology information system with a module from Epic Medical, which had provided the IT system chosen as the backbone of the hospital's electronic medical record. Next they called in their PACS vendor, Merge Healthcare, along with Epic to figure out how to bring these two disparate information technologies together, not just for the 1300 healthcare providers working at the Level 1 trauma center in the hospital's home base of St. Paul, MN, but for staff across its 18 HealthPartners outpatient clinics and medical offices.

“We saw the value of having a tight integration between our PACS and electronic health records,” said Kim LaReau, Regions Hospital chief information officer (CIO). “So we asked our vendors to come together and help us create this integration.”

As the Obama administration gears up a multibillion dollar reimbursement program to encourage the adoption of electronic medical records (EMRs), which was part of the American Recovery and Reinvestment Act passed earlier this year by Congress, CIOs and IT administrators are facing both an opportunity and a challenge. For more than a decade, hospitals have been combining radiology information systems and PACS, creating the infrastructure to connect patient files to images and send them instantly across hospitals or around the globe. From one perspective, PACS vendors and the radiology community have already done much of the heavy lifting needed to bring U.S. institutions into the 21st century of computer-
driven healthcare efficiencies. But from another, these efforts now must be brought into line with a broader effort that reconciles the many different elements of medical practice.

The effort now under way at Regions Hospital will bring a PACS installed initially in 1997 into this broader fold of healthcare IT, an integration that reflects the noblest goals of the Obama administration's effort: to make the practice of medicine in the U.S. more efficient and to reduce errors. In seeking this integration, Regions Hospital chose the IT system from Epic Medical as the central focus.

“We adopted the philosophy that Epic was our electronic [medical] record and that we would always look to them first for a solution when we got rid of disparate products, such as the RIS,” LaReau said. “We knew that Epic would never provide all the pieces, like the PACS piece.”

But that's not to say that the process can't go the other way. In the coming months, Louisiana State University Health System will upgrade and expand its RIS/PACS to stretch across 10 hospitals and hundreds of outpatient clinics as the first step toward instituting a comprehensive EMR. GE Healthcare will run this $12.5 million RIS/PACS effort, which LSU administrator Lee Bairnsfather, Ph.D., expects will serve as a model for the other components of a comprehensive EMR system.