Military looks to MDIS for future cost savings

Although potential expenditures for the U.S. military's medicaldiagnostic imaging support (MDIS) project may appear massive,the goal is to save money over the long run.

The Department of Defense, unlike most civilian hospitals,can make the necessary financial investment to gain efficiencybenefits from picture archiving and communications systems, accordingto Lt. Col. Fred Goeringer.

"Like the rest of DOD, the defense medical establishmentis downsizing," said Goeringer, the MDIS project manager."Demands will be placed on us over the next half a decadethat call for improvements in productivity while sustaining andperhaps improving our quality."

The MDIS contract was awarded in September to Loral, a NewYork aerospace firm, and Siemens Medical Systems. The two firmscooperated in designing a comprehensive PAC system to meet MDISspecifications. They won a competitive bidding contest againsta group led by PACS supplier Advanced Video Products (SCAN 10/9/91).

While Siemens brings medical imaging expertise to the partnership,Loral Western Development Labs of San Jose, CA, serves as theprime contractor for MDIS. Loral will supply a powerful centralimage storage system as well as fiber-optic communication links,said Frank Lanza, Loral president and COO. Siemens Gammasonicswill provide MDIS with its Apple Macintosh-based LiteBox workstations.

Both firms cooperated in developing MDIS software and integratingthe computer and imaging equipment of many subcontractors, includingDigital Equipment, Eastman Kodak, Lumisys, Sybase and Tektronix,he said.

MDIS purchasing authority has been granted for a period of12 years, including four years of equipment purchases and eightyears of subsequent service and equipment maintenance. Althoughonly about $20 million in purchases has been approved to date,MDIS has been granted an acquisition ceiling of $290 million,Goeringer said.

About half of MDIS expenditures should be allocated for equipment,with the other half supporting operations and maintenance. Capitalexpenditures for the first four MDIS sites are expected to totalabout $50 million, he said.

The first MDIS sites are:

• full PACS for the new $280 million Madigan Army MedicalCenter in Tacoma, due to open in March;

• teleradiology links between Luke Air Force Base Hospitalin Phoenix and smaller Air Force hospitals;

• a centerpiece Air Force PAC system, slightly smallerthan the Madigan installation, at Wright-Patterson Air Force MedicalCenter in Dayton; and

• integration of PACS into the existing Brooke Army MedicalCenter in San Antonio.

"We must establish proof that these (PAC systems) workin routine military health-care settings and then proliferatethe technology from there," Goeringer said.

Although the Army and Air Force initiated MDIS and wrote itsspecifications, the DOD's Office of the Surgeon General is authorizedto write delivery orders for Navy and VA hospitals as well.

"A major thrust within the military during the 90s willbe to achieve interoperability of hospitals and health-care providersamong the three services," he said.

Technological developments in both the computer and defenseindustries have enabled the implementation of large-scale PACSwith diagnostic on-screen resolution and rapid, one-second imageretrieval times, Lanza said.

"Having 100 workstations located throughout one hospitalor many hospitals requires not computer speed as much as the abilityto retrieve and fetch the images electronically. We brought thattechnology from the (military) reconnaissance business along withadded software enhancements," he said.

MDIS is already providing dividends to Siemens in its civilianPACS business. The vendor won a bid in November to supply a majorPACS installation to Hammersmith Hospital in London. Siemens willinstall computed radiography and other digital imaging equipmentas well as digital communications for a new x-ray department underconstruction at Hammersmith. Over two years, 137 terminals willbe installed in departments within the hospital.

"The MDIS program has given us a unique opportunity totake the technology we developed in conjunction with Loral andprovide solutions to the challenging problem of a comprehensive,hospital-wide image distribution system," said Gregory J.Barone, president and CEO of Siemens Gammasonics.