University Hospital pioneers PACS in Lithuania

Vilnius University Hospital is the only hospital in Lithuania to have a PACS. The 1000-bed teaching hospital, which handles around 300,000 outpatient and 30,000 inpatient visits each year, has been chosen to showcase electronic image management in the former Soviet state. The prohibitively high cost of hardware and software, however, discourages Lithuania from contemplating widespread PACS implementation.

This is not the first time doctors at VUH have tried electronic communication. In 2000, the hospital joined the Baltic International Telemedicine Network, a project offering hospitals in Estonia, Latvia, and Lithuania the chance to discuss difficult clinical cases with colleagues at Uppsala University Hospital in Sweden. Radiologists from Vilnius initially sent relevant images to Sweden by e-mail or as hard copy. This system was subsequently replaced by the use of a document camera for printed images and a direct DICOM connection.

The experimental telemedicine project has now finished, but digital imaging remains central to workflow, thanks to the PACS installation. A digital network links the radiology department's MR scanner, four-slice CT scanner, and two digital x-ray units. Radiologists can report soft-copy images on four dedicated workstations, each located next to a RIS terminal, or review images on an additional double-monitor workstation.

"As with all new things, some of the radiologists were suspicious at first, but now they like the system," said Dr. Nomeda Valeviciene, at associate professor of radiology at VUH. "We have many young doctors in our department now, and they are used to working with computers. It is easier for them to look at a patient's history and compare the images."

Nine additional clinical departments are linked to the PACS via a Web server. These include the neurology and surgery departments.

"In a university hospital, it is very helpful for us to discuss images with doctors in other departments," Valeviciene said. "This week we had a difficult case involving neuroradiology, so the neurologists were able to look at all the images acquired in the radiology department on their own computers."

The central PACS archive has a 40-GB RAID and a jukebox for longer-term storage of digital images and reports. Images may also be printed if they need to be sent to physicians at hospitals outside Vilnius. Patients referred to the hospital may also arrive with x-ray films. Discussions have just started with one nearby hospital with a new computer system about the possibility of transmitting images electronically between the two sites.

"In the future, perhaps in 10 years, I hope more hospitals in Lithuania, even in the small towns, will have PACS so we can transfer our images electronically using computers," Valeviciene said. "But it needs time and, of course, money."