Separate fact from fiction when purchasing a PACS

One of the main challenges potential buyers face in evaluating PACS is the need to separate fact from fiction. An abundance of information is available on the subject; some of it accurate, some contradictory, and much of it controversial.

Nonetheless, much of the information has helped physicians and administrators gain a better understanding of PACS and how it can be used in their facilities. But both vendors and end users must overcome preconceived notions about the strengths and weaknesses of the market and of vendors' products. Market leadership position is one of the primary factors that purchasers consider when evaluating PACS vendors. While there may be a sense of security in doing business with one of the "big six," market leadership varies, depending on whom you talk to on a given day.

When a 1989 survey of radiology administrators attempted to identify the leading vendors involved in PACS, the company that was selected as number 1 didn't even have a PACS product on the market. Knowledge of what constitutes a PACS was so limited that the administrators surveyed mistook modality workstations connected via a LAN for PACS components. (The true industry leader ranked number 4.)

It is also interesting that some of the largest PACS vendors have the most unstable programs in terms of continuity of partnerships. On the other hand, several of the smaller independents, such as E-Med, ALI Technologies, and DR Systems, keep plugging -- and in a few cases plodding -- along, content with their specific market niche.

The problem with PACS is that too many people, including vendors, have sought a one-size-fits-all solution. If PACS is to work it must fit a facility like a tailor-made suit: custom-fitted, but with room to let it out or take it in without drastically changing its look and feel. Presenting PACS to hospital administrators also requires taking that facility's specific needs and hot buttons into account.

The PACS marketplace can be separated into two sectors: knowledgeable ignorance on the consumer side and ignorant knowledge on the vendor side. Both are highly volatile. While each can learn from the other, both want control. And when control is at issue, listening skills often deteriorate.

Sites that have PACS are unquestionably among the best sources of information, but be careful to choose a "leading edger" over a "bleeding edger." Bleeding edgers sometimes take inordinate risks with high amounts of limited capital. Leading edgers tend to be more fiscally responsible, evaluating returns on investment against risk and needs against wants. Look at how a facility is using PACS and consider whether it addresses your needs. Ask pointed questions of a range of individuals at the site, from techs to purchasing personnel to file room clerks.

Seminars are also a good source of information, although quality varies. And a few useful tidbits can usually be garnered from journal articles, and even from vendor-provided literature.

The difference between ignorant knowledge and knowledgeable ignorance results from both the source of the information and the gullibility of the recipient. Be sure that whatever you hear makes sense, filter out what you don't hear, and fill in the blanks with informed, objective information. By keeping your eyes and ears open you should be able to embark upon on a safe journey to the land of filmless radiology.

Michael J. Cannavo is the president of Image Management Consultants, a PACS consulting firm based in Winter Springs, FL. He can be reached at (407) 359-6575 or via e-mail at pacsman@ix.netcom.com.