PACS implementation in Russia faces unique challenges

The pace of PACS adoption in Russia is lagging behind that of other industrialized nations. Overall, the medical informatics picture there remains largely a cottage industry, according to a research paper presented Thursday.

A need exists for large global PACS vendors to enter Russia , but they must overcome considerable challenges. Roadblocks include the Cyrillic alphabet, a requirement that all medical records be kept in paper form, and lack of approval of digital signatures by the Russian legislature, a Moscow-based research team said. Another problem is a scarcity of medical informatics specialists.

Together, these factors give a strong edge to local vendors for medical informatics systems. Many operate with a relatively small staff and find it difficult to keep up with the latest developments in technology and standards for digital data management.

The study was conducted by researchers from the GAZPROM Polyclinic and Moscow State Medical and Stomatological University, both located in the capital.

In investigating radiology information system/PACS options for the GAZPROM Polyclinic, the researchers finally settled on a locally produced "VIDAR" RIS that is used in 500 institutions throughout Russia. In the absence of PACS in many institutions, the RIS is often pressed into service to manage and archive radiology images. The RIS does not support the DICOM query/retrieve function, however, and once images are stored in the RIS, they must be viewed and processed through it as well.

The RIS does provide tools for patient registration, examination scheduling, protocol support, patient medical record keeping, examination status tracking, support for statistical and economic reporting, consumables calculation, and diagnostic image archiving and management.

The last function is the most problematic for radiology departments. A broader focus would be more helpful, the researchers said. Some local companies have sensed this need and are entering the market with PACS-like products. That step, however, raises the question of RIS/PACS integration.

A number of vendors, including Agfa, have developed products to ease the process of RIS integration, the researchers said.