PACS extends real-time radiology to rural clinics

Full-blown PACS is no longer just for large metropolitan hospitals. A 100-bed hospital in Kalispell, MT, is using PACS to improve the delivery of healthcare in even more remote rural clinics and facilities.

PACS can provide much-needed imaging services to low-image-volume, financially lean rural community facilities.

"Prior to PACS, diagnostic imaging services were at best a once-a-week event at rural community hospitals in northwest Montana," said William O'Leary, a radiology technician at Kalispell Regional Medical Center.

Now, with PACS implemented at KRMC and teleradiology service extended beyond the local Kalispell Valley, images are available in less than an hour, initial voice clip report summaries in two hours, and completed reports in six to 10 hours.

"Facilities located across the continental divide, including clinics on the Blackfoot Indian Reservation and underserved community hospitals, have real-time full PACS capabilities," O'Leary said.

KRMC's network addresses the chronic shortage of radiologists and diagnostic imaging services Montana has faced for years. Previously, a part-time radiologist would travel one day a week to each community hospital, sometimes as far as 175 miles, to read exams. Alternatively, the clinic would mail film to a radiologist to read. The report would be returned days later on a cassette tape, with or without the films.

O'Leary said KRMC realized it could succeed with PACS if it could capture additional referrals while providing higher quality radiology service to smaller surrounding communities. The KRMC PACS was financed in part by grant money from Federal Rural Health and Indian Health Services.

Remote images are captured on PACS quality control workstations and prepared for transmission over a T1 line back to KRMC's image server.

Since KRMC is staffed by radiologists 24/7, the rural community hospitals and remote clinics have the same access to radiology services as if the scans were performed at KRMC, O'Leary said.

Referring physicians can view in-progress studies on the KRMC Web server. Once the study is read, the voice clip summary, final image montage, and transcribed report are made available through the KRMC Web server via the PACS Web viewing software.

"KRMC provides image and report archiving on a per study basis to minimize data storage equipment expenditures at the rural hospitals and clinics," O'Leary said.