DEC keeps options open in emerging PACS field

Digital medical imaging has progressed beyond the innovation stageof technological development. It may, however, require two orthree additional years to move into widespread commercialization,said Jack L. Bowie, health-care imaging marketing manager forcomputer vendor Digital Equipment (DEC).

Partial picture archiving and communications systems (mini-PACS)are more in demand than total PACS because clinical users caninvestigate the technology while limiting risk and investment,Bowie said. Large universities that initially explored the conceptof fully digital radiology departments considered the possibilitiesof the technology more than its economics and practicality.

"Innovators tend to be more focused on the technologyitself because that is where the problems are," Bowie said."As we get more into the early adopter stage, users are lookingat the real business issues. Are there cost savings? Is a betterlevel of care provided?"

Many PACS technology questions still need sorting out. Noone knows, for instance, what the accepted workstation resolutionwill be--2K, 4K or 1K--or how data compression will be implemented.As the technology shakes out, so will the appropriate source forPACS equipment.

"I don't think any of us--whether an (imaging) modalityvendor, computer/HIS vendor or specialized PACS vendor--reallyunderstands what the ultimate delivery structure for PACS willbe," Bowie said.

DEC's strong position in the hospital information systems marketmakes the firm a natural player in PACS, but the computer firmis not ready to jump in head-first. DEC is keeping its PACS optionsopen, developing technology in cooperation with other vendorslike Siemens, individual clinical sites such as the MallinckrodtInstitute, and third-party integrators.

"We don't feel that we understand enough about the marketto say we are going to build a PACS product. That just doesn'tmake sense to us. Our primary role is to work with key customersto satisfy their need for image management through various integrationprojects," he said.

DEC was one of the 21 computer vendors to endorse the advancedcomputing environment (ACE) initiative in April (SCAN 4/24/91).The ACE group supports the use of an open computing environmentusing Unix operating software on reduced instruction set computing(RISC) microprocessor technology as well as Intel microprocessors.

ACE competitor Sun Microsystems is a major supplier of workstationsfor use in medical imaging. Sun, however, is primarily a supplierof computer platforms rather than a developer of clinical applications,Bowie noted.

"I see us doing a lot more of the integration work ourselvesthan some of the other (computer) vendors would. We consider ourselvesa leading supplier of base platforms, but there is also a needfor software strategies that must develop around standards andintegration issues," he said.

Progress is being made in developing the ACR/NEMA standardfor PACS integration, he said. Rather than merely providing standardimage output from scanners over a 25-pin plug, the industry isworking to make PACS compatible with existing computer networkingsystems.

"An overall network focus makes a lot of sense. It iswhere the world is going today," he said. "We stillhave a long way to go, but it (ACR/NEMA) is certainly making progress.Vendor support seems higher now."