PACS involves difficult decisions for even the largest hospitals, but smaller outpatient imaging centers often find dealing with PACS purchasing questions even more perplexing.Problems faced by stand-alone imaging center administrators differ from
PACS involves difficult decisions for even the largest hospitals, but smaller outpatient imaging centers often find dealing with PACS purchasing questions even more perplexing.
Problems faced by stand-alone imaging center administrators differ from those of hospital administrators and require unique solutions. These issues were detailed in a recent paper (Radiol Manage 2003;25:36-41).
"Typically, most information about PACS concentrates on solutions and requirements for hospital radiology facilities," said T.J. Farnsworth, vice president of marketing and strategic development at RadVault in Hayward, CA. "For imaging centers, the financial justification for PACS may be less immediate than for hospitals."
Once the justification is made for the financial viability of PACS in an imaging center, the next question is how to finance PACS acquisition.
"This decision will depend largely on how you cost-justify your PACS, as well as the shape of your business model," Farnsworth said, "It will usually come to a decision between capital purchase or contracting with an application service provider."
In the hospital-dominated marketplace, PACS has traditionally been treated as a capital acquisition.
"For most imaging centers, however, owning a PACS is more of a problem than a benefit," Farnsworth said.
ASPs increasingly represent a successful financial alternative for imaging centers.
One of the largest considerations with PACS is how to store the digital images. There are currently three options:
? onsite
? offsite ASP
? onsite ASP: hybrid option in which an ASP vendor installs and manages onsite storage archives based on a per-procedure fee
The onsite ASP concept enables healthcare facilities to have an onsite image archive without having to make a costly initial investment in archive hardware. This strategy overcomes the main objection some radiologists have in relinquishing control of images to remotely hosted ASPs.
It allows the facility to acquire its own onsite archive, while spreading the ownership costs out over a longer period of time. Like the offsite ASP contractors, onsite ASPs usually take responsibility for implementation, maintenance, and upgrading of the archive.
Another issue is physician resistance to change. Whereas hospitals have the ability to dictate to their internal referring physicians that imaging studies are henceforth to be delivered digitally to desktop PCs rather than on film by sneaker net, the roles are likely to be reversed in a private imaging center environment.
Imaging centers often find dealing with cultural resistance to digital imaging among their client physicians a more delicate matter.
A Victory for Radiology: New CMS Proposal Would Provide Coverage of CT Colonography in 2025
July 12th 2024In newly issued proposals addressing changes to coverage for Medicare services in 2025, the Centers for Medicare and Medicaid Services (CMS) announced its intent to provide coverage of computed tomography colonography (CTC) for Medicare beneficiaries in 2025.
The Reading Room: Artificial Intelligence: What RSNA 2020 Offered, and What 2021 Could Bring
December 5th 2020Nina Kottler, M.D., chief medical officer of AI at Radiology Partners, discusses, during RSNA 2020, what new developments the annual meeting provided about these technologies, sessions to access, and what to expect in the coming year.
ACR Collaborative Model Leads to 35 Percent Improvement with Mammography Positioning Criteria
July 1st 2024Noting significant variation with facilities for achieving passing criteria for mammography positioning, researchers found that structured interventions, ranging from weekly auditing of images taken by technologists to mechanisms for feedback from radiologists to technologists, led to significant improvements in a multicenter study.
New Study Shows Non-Radiologists Interpreting 28 Percent of Imaging for Medicare Patients
June 28th 2024While radiologists interpreted approximately 99 percent of all non-cardiac CT, MRI and nuclear medicine studies in hospital and emergency department settings for Medicare beneficiaries, new research shows significantly less radiologist review of cardiac imaging and office-based imaging.