Radiology has long been the technological leader within the healthcare industry. The shift from film to digital images over the past decade is a permanent sea change, but the tools that support this move – particularly a RIS/PACS – are largely temporary.
At some point, your hospital or radiology practice will face the decision of what to do with an out-of-date RIS/PACS that no longer meets your needs or those of your patients. But deciding whether to replace your system can be daunting, according to some industry experts.
“This is what happens with all PACS. They hit an end-of-life,” Rick Perez, administrative director at Winthrop University Hospital in New York told Diagnostic Imaging. “When you get to that point and start talking about new software and updates, you realize you’ll be replacing almost everything. Those upgrade costs can add up to the point where buying a new PACS is less expensive.”
Finding the right system, though, can be a challenge. Any RIS/PACS must be affordable, faster, and integrated with prior studies, voice recognition and information from the electronic health record. In addition, a growing number of providers are placing emphasis on improved mobile connectivity.
To Replace or Not To Replace?
It’s likely your RIS/PACS will outlive its value long before you pull the trigger on investing in an upgraded model. The average system lifespan is between seven years and 10 years, but changes and regulatory requirements start to knick away at efficiency almost immediately.
The actual price you’ll pay for a replacement varies based on your needs and whether you choose an in-house system or one based in the cloud. Ultimately, your expenditure will include the capital purchase price, as well as costs for installments, upgrades, training and any recurring staff needs.
Fears about this total cost investment and time spent on data migration can hamstring your decision about a replacement. In fact, transitioning your information can take up to 90 days, according to a white paper published by the medical information technology and communications company Sectra. But hesitation presents risks.
“Organizations should understand that delaying RIS/PACS replacement can have very serious consequences to clinical efficiency and financial health,” the paper’s authors wrote. “Falling behind on standardization, working with an out-of-date operating system, and lacking comprehensive tools for workflow optimizations and image viewing are all hazards.”
In addition, operating with an old RIS/PACS can make it harder for you to keep up with the ever-changing requirements laid down by your referring physicians, affiliated organizations and patients.
Sectra recommends you keep your eyes open for red flags in several areas – administrative, clinical, information technology (IT) and the market – when analyzing your current RIS/PACS and its vendor.
For example, a PACS that stifles your competitiveness, doesn’t provide usable analytics, doesn’t meet Meaningful Use requirements, or can’t support your billing and reporting needs should likely be replaced. You should also consider a new system if you can’t customize your old one, if it has a confusing interface or if it doesn’t offer next-generation workflow tools that optimize your productivity. Also, make sure it meets current security or emerging standardization protocols.
You should also consider other vendors if your current one no longer offers state-of-the-art systems or if they won’t share product details about their RIS/PACS offerings. Also, double-check that any RIS/PACS you consider can smoothly integrate with modern operating systems.
Making the Switch
Before green-lighting a new PACS purchase, identify your priorities and your unmet needs. For Perez’s Winthrop University Hospital, its top priority was ensuring any new technologies could work properly with its existing tools.
“Our No. 1 concern was integration – how would the new PACS work with our electronic medical record? How would it sit with Meaningful Use as we moved forward?” said Perez, who is also a fellow with the Association of Medical Imaging Management. “How was everything going to fit and make our radiologists more productive? We wanted a system that would be able to grow with us and give us the data we needed to run our department more efficiently.”
To meet that goal, Winthrop purchased a cloud-based PACS service from Carestream that offers image review, storage and distribution to both on-site and remote providers. This type of system can potentially reduce yearly expenditures. According to Carestream data, using a cloud-based PACS can cut costs by up to 30 percent.
There are several other PACS vendors offering up-to-date systems. McKesson, a healthcare services software solutions company, offers its Horizon Medical Imaging™ RIS/PACS. This system allows you to keep multiple files open simultaneously, and the Horizon Rad Station™ keeps patient reports and information in a central location, giving you electronic access. In addition, Philips’ IntelliSpace PACS integrates with a facility’s infrastructure, tying into any existing systems.
Regardless of which replacement PACS is selected, finding the right time to switchover will be one of your biggest obstacles to implementation, Perez said. You can’t close your facility completely, but you can select a time when the fewest staff members are on call.
“The timing has to be perfect to leave the doctors working in the hospital on the old system temporarily while you’re getting the new one up and running,” he said. “It requires a lot of coordination – phone lines, back-up lines, making sure the software is loaded in time. It’s all so important because you’re going to bring over all your files.”
Build in time for several dry runs before you make the official change-over, Perez said. The practice time gives you the opportunity to ensure the new RIS/PACS works well with your electronic health records, as well as your billing system.
Getting a new RIS/PACS can bring more benefits than simple technological advancement. It can directly impact how you and your colleagues work, as well as how you feel about your jobs.
“A new system can help you feel more engaged in your daily workflow,” according to Becky Wozmak, PACS administrator at Wentworth-Douglass Hospital in New Hampshire. Wentworth-Douglass purchased a replacement system from McKesson.
“[The replacement] PACS has really given our physicians and staff much greater control and ownership of their work,” she said.
Perez echoed Wozmak, saying, overall, his providers were pleased with the new system and appreciate that it can run smoothly with their existing tools with few problems.
He cautioned, however, that you should look beyond your present-day needs when selecting a new system. What you need now might seem minor when compared to your needs a year or more from now.
“Plan more for future growth. One of the hardest things to do is replace a system, but look for what you’re missing and what you’ll need to make things better,” he said. “What will actually happen is a cloudy crystal ball – especially in these times of change we’re going through. But, you still have to look at what else is coming and figure out how to integrate it.”