Everything On-Line PACS avoids implementation hazards

A principle called Everything On-Line (EOL) - based on the notion that all images must be available to the radiologist at every workstation at all times - is helping a Dutch hospital avoid hazards found in many PACS implementations.

Every PACS plan must be evaluated before the actual implementation can commence. But in order to properly judge the quality of the plan, this evaluation should contain an overview of the likely hazards to which PACS will be exposed, according the researchers.

"Based on our experience, there are several possible pitfalls when introducing a digital radiologic images archive," said Peter van Ooijen, formerly IT manager of the Daniel den Hoed Clinic at University Hospital in Rotterdam, now with the Groningen University Hospital department of radiology in Groningen, the Netherlands.

According to van Ooijen, PACS implementations face common pitfalls:

?difficulty obtaining system acceptance by the radiologists
?misplaced emphasis on storage rather than retrieval performance
?decreased data transfer capacity
?underestimation of digital storage capacity
?unpredictability of radiologic workflow
?limited functionality of archive media

To achieve a successful PACS installation, these pitfalls must be eliminated. The good news is the hazards can be avoided with careful planning and by putting demands on the vendor, van Ooijen said. He and his colleagues at the Daniel den Hoed Clinic developed the concept of Everything On-Line.

"The EOL principal emphasizes the increased importance of retrieval over storage and thus covers a large number of the pitfalls," he said.

The EOL PACS (marketed by Rogan Medical Systems) is a full internal and external DICOM solution with a large RAID-5 online archive and a large DVD-R online storage backup.

"By using a large RAID-5 configuration of up to several terabytes for the online archive, all past data from the last months and years are available immediately online, which eliminates the dependency on radiologic workflow, prefetching, and autorouting," van Ooijen said.

The EOL PACS, with its nonerasable DVD-R, also provides a standardized and scalable storage system.

"All these properties, along with the use of Windows NT for both the server computer and the workstations, increase the ease of radiologist acceptance," he said.