Funding shortfalls hamper DIN-PACS purchasing

Funding shortfalls hamper DIN-PACS purchasing

Initial DIN-PACS installations set to go online in mid-year

The military's Digital Imaging Network-Picture Archiving and Communications Systems (DIN-PACS) project continues to move forward, despite funding difficulties that have limited purchase orders. As required by their participation in the project, both the Agfa and IBM teams completed benchmark testing of their product improvement plans (PIP) at the Joint Imaging Technology Program (JITPO) office in Fort Detrick, MD, in January.

JITPO is evaluating the data generated during the PIP process, which was designed to ensure that manufacturers would continue to deliver state-of-the-art systems after the contract was awarded. Among the features required under the DIN-PACS contract is structural integration of the radiology information system into the PACS software and advanced features relating to technology such as image compression and teaching files, said Capt. Jerry Thomas, chief of radiological physics at the Uniformed Services University of the Health Sciences in Bethesda, MD. Thomas is the leader of the technical committee that developed the DIN-PACS request for proposal (RFP).

Capped off by the PIP testing, the last year has been quite eventful for the project. The IBM consortium landed the first DIN-PACS award with a $7.3 million PACS at Portsmouth Naval Medical Treatment Facility in Portsmouth, VA (PNN 3/98). Soon after, the IBM team received orders for 10 U.S. Army sites valued at about $25 million (PNN 4/98). Those 10 sites in the U.S. Army's Great Plains Region hope to create a virtual radiology environment where radiology images and resources could be shared among the region's facilities (PNN 6/98).

Shipments have begun to one of the Army sites, Fort Riley, and the PACS at its Irwin Army Community Hospital is expected to go online in April or May, said David Anderson, client executive for DOD medical systems at IBM, which maintains its Global Government Industry division in Bethesda, MD.

Equipment has also arrived at the Portsmouth facility. IBM hopes to bring the system online in the second quarter, Anderson said.

The IBM team also installed PACS technology at the Naval Clinic on Diego Garcia Naval Base in the Indian Ocean and U.S. Naval Hospital Roosevelt Roads in Puerto Rico. In addition, the team has installed equipment at several military facilities in Japan, including United States Naval Hospital Yokusuka, Medical Branch Clinic at Sasebo Navy Base, Medical Branch Clinic of Iwakuni, and Medical Branch Clinic of Atsugi.

IBM consortium members include ADAC Laboratories (RIS), Applicare Medical Imaging (workstations), Brit Systems (archives), Meta Solutions, and Science Applications International. Bay Networks has recently joined the IBM team, while Eastman Kodak has left the consortium.

The Agfa team landed its first DIN-PACS order in mid-1998, a $1.5 million contract from the Pentagon Clinic (PNN 8/98). Later in the year, Agfa won an award valued at $5 million from Walter Reed Army Medical Center in Washington, DC (PNN 1/99).

Installation at the Pentagon Clinic is slated to begin this month, said Bob Cooke, head of Agfa's Impax Solutions for the NAFTA region. An installation schedule for Walter Reed is being developed, he said.

Other members of the Agfa team include Cerner (RIS), Mitra (RIS integration), and Cabletron (networking components).

While DIN-PACS spending was estimated to be as high as $135 million, actual spending in 1998 was about $40 million. When the DIN-PACS contract was issued, the Department of Defense anticipated that the DIN-PACS deployments during 1998 and 1999 would be primarily in new medical facilities, Thomas said. Current funding shortfalls within the DOD's medical departments will necessitate extension of the time needed to make DOD medical treatment facilities filmless, however, he said. New construction sites will be the first to receive DIN-PACS systems.

"For the next two years, there aren't funds to deploy DIN-PACS extensively into our existing fixed facilities within the Air Force and the Navy," he said. "The Army is doing limited DIN-PACS deployment in existing facilities."

Current contracts out for bid include new construction at the Naval Medical Clinic in Key West, FL, and the Naval Hospital Lemoore. The Navy also plans initial deployment of DIN-PACS and telemedicine technology aboard many of their large ships, including aircraft carriers and amphibious assault ships, Thomas said.

"1999 will be very exciting," he said. "We will now be able to kick the tires on the DIN-PACS vision that we conceptualized three years ago."

Thomas remains optimistic that DIN-PACS will electronically link all healthcare facilities in the three military services. The military had hoped to achieve that goal by 2003.

"Will we complete it in five years? I don't know," Thomas said. "That depends on the level of funding we receive from Congress."

The first dedicated DIN-PACS funding will not be available until 2000 or later, once Congress approves the allocation. All DIN-PACS purchases made so far have been supported with money that was appropriated for new facilities, budgeted for MDIS sites, or appropriated from other projects.

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