A common phrase in Parisian healthcare circles right now is “la région sans film.” Thanks to an ambitious enterprise-wide PACS project spanning the city’s extensive public hospital network, going filmless looks an achievable objective. Managers at the AP-HP (Assistance Publique- Hôpitaux de Paris) have sought to harmonize the practice and centralize the electronic organization over all its hospitals, allowing easy cross-reading between hospitals and protecting patient privacy, according to Dr. Daniel Reizine, a radiologist at the Lariboisière Hospital and coordinator of the project.
The goal, set in 2005, was to implement PACS across the organization within three years. The plan was to store all images online for at least five years. To achieve this, the PACS implementation was divided into three stages: storage, image viewing for radiologists, and image communication to clinicians. For each step, a transverse deployment over the AP-HP was used, harmonizing the practice between departments, and a centralized yet distributed architecture was developed, Reizine said.
The AP-HP is the main public hospital system of the city of Paris and its suburbs. Established in 1849, it is the largest public hospital system in Europe, with a total of 22,000 hospital beds (14,000 acute care, 8000 convalescent and long-term care). It provides healthcare, research, prevention, education, and emergency medical services and employs more than 90,000 people, including 15,000 medical doctors.
From the outset, the 47 hospitals were divided into hospitals with a PACS (two), which were excluded from the first stage of the project; hospitals without CT and MRI (25); and hospitals with at least one CT or one MR unit (20). The last group comprises 10 smaller hospitals, with 300 to 500 beds that carry out 50,000 to 100,000 examinations a year, and 10 larger hospitals, with more than 500 beds and 100,000 examinations a year.
