DIN-PACS award will reshape PACS as vendors prepare for DOD buys

Teams led by Agfa and IBM best other PACS firms

The U.S. military's award of contracts for its Digital Imaging Network-Picture Archiving and Communications Systems (DIN-PACS) project has energized companies involved with Agfa and IBM, the leaders of the two consortia that were awarded the bids. DIN-PACS will change the landscape of the PACS market, helping established firms retain their leads while boosting some lesser known companies to positions of prominence.

The DIN-PACS awards were announced in late November by the Defense Personnel Support Center, the Department of Defense agency administering the request-for-proposal process. Of the five consortia vying for the bids, the DPSC chose teams led by Agfa and IBM, while rejecting bids submitted by consortia that included PACS players Imation Cemax-Icon and Siemens Medical Systems. GE Medical Systems pulled out of the DIN-PACS process just weeks before the bids were announced (SCAN 11/12/97).

DIN-PACS represents the next stage of military PACS purchasing after the Medical Diagnostic Imaging Support (MDIS) project, which was installed in the early 1990s at selected Army and Air Force facilities by Loral and later Lockheed Martin Medical Imaging Systems. MDIS turned Loral/Lockheed Martin into a major PACS player, but DIN-PACS is likely to have an even larger impact on the companies involved as the U.S. military pursues its goal of linking all its healthcare facilities with PACS technology.

The Agfa team is led by the Ridgefield Park, NJ, company as the prime contractor and provider of PACS software, with Cerner supplying the RIS, Mitra performing RIS integration, and Cabletron offering network components.

IBM's team is led by the computer giant's Global Government Industry division in Bethesda, MD, as prime contractor. Applicare Medical Imaging and its U.S. distributor Meta Solutions are providing RadWorks Windows NT-based workstations, Brit Systems is offering archiving technology, and DeJarnette Research Systems is supplying connectivity products. ADAC Laboratories is providing the RIS component, Imation is supplying its DryView laser printers, and Eastman Kodak and Science Applications International (SAIC) are also involved.

While the DIN-PACS companies aligned into separate consortia as part of the process, military hospitals probably will neither be limited to choosing products from one side or the other nor be required to install a massive PACS in one fell swoop. Instead, the DIN-PACS awards are a stamp of approval by the government that enables military hospitals to choose products from either side, according to Wayne DeJarnette, president of Towson, MD-based DeJarnette. The DIN-PACS RFP mandates that all products covered by the contract work together via off-the-shelf hardware and standards such as DICOM 3.0.

How was IBM able to triumph over other PACS companies with longer track records in the market? For one thing, the Global Government Industry division has a long history of providing the U.S. government with systems integration services for complex products from multiple vendors, according to Bill McGarvey, proposal manager for the division. The division got its toe wet in the PACS market with an installation at the VA Medical Center in Dallas, a project it is working on with Brit (SCAN 11/20/96).

The total value of DIN-PACS has caused some confusion in PACS circles. The DOD reports that the project has a spending ceiling of $250 million in its first year, an amount that will cover purchases from all companies in both the IBM and Agfa consortia. The contract includes four one-year option periods, which could bring the potential value of the contract to $1.25 billion over the next five years.

That's predicated on how much PACS technology military hospitals buy, a topic the DOD is not discussing. At least two facilities will acquire DIN-PACS: the Naval Hospital Portsmouth in Portsmouth, VA, and the Pentagon Triservice Health Clinic at the Pentagon. After that, it's anyone's guess, but the military has hinted that the DOD has ambitious plans, especially as it seeks to bring quality medical care to remote military outposts at an affordable price.

"The U.S. Surgeon General's goal is to have DIN-PACS in every defense medical treatment facility in the next five years," said Andrew Wechter, DIN-PACS program manager in the DPSC's medical directorate.

Ruud Kroon, managing director of Applicare, believes that PACS purchasing by military hospitals will be steady, although widespread conversion to filmless-hospital operations will probably not occur right away.

"We think that although the immediate implementation of hospital-wide PACS networks will probably not be imminent, preparatory buying will take place," Kroon said. "It will be a phased approach. From that perspective, we expect very large buying volume."

The buying process will probably begin immediately, and a number of U.S. military personnel were in evidence at this month's Radiological Society of North America meeting, perusing the PACS exhibits. Several vendors also trumpeted their selection as DIN-PACS vendors with booth displays.

Although DIN-PACS applies only to military hospitals, the private sector is likely to benefit as well. Vendors complying with the strict requirements of the project, such as HIS/RIS/PACS integration and the incorporation of speech recognition, will likely trickle their developments down to commercial sites, according to Robert Cooke, director of image management systems at Agfa.

"Some of the requirements that are very important for the PACS community in general that were set forth in the (RFP) were the integration of RIS into PACS, which hasn't occurred to date, and is obviously of great interest to us," Cooke said. "We intend to use our partnership with Cerner to develop necessary extensions to each of the products to provide the kind of integration that the military is looking for and hopefully what the (private-sector) market is looking for as well."