10 Things we learn from history of PACS

Source:    http://www.pacshistory.com

Buying new technology doesn’t always help. It might even make things worse! Big brand PACS without proper study of requirements is useless. Speed Is Not The Only Criteria.. People thought that starting imaging in digital environment will speed up the process (which happened); however, people never though that demand will grow for imaging procedures. Electronic systems Are No Magic! Historically, imaging departments had their own policy & procedure in the manual workflow. After introduction of PACS people though that IT will automatically do this for them. Unfortunately we still need those policies. We still need human intervention. Learning from mistakes Through out two+ decades of PACS we have seen many incidents of PACS disasters and data loss. Did we take preventive action against those failures?! Imaging IT is way behind ! History has shown us that PACS is way behind consumer IT. It’s time to bring IT staff inside the imaging department specially when considering the era of open-source solutions. However, those IT staff should be trained to appreciate medical services. (See also Eyes Wide Open, Herman Oosterwijk, 2010) Evolution is part of our human nature... PACS is the same ! Evolution of PACS has shown us that radiologists gave up many things. For example, number of viewing heads (monitors) which have gone down (see DRC movie). That means that radiologist who were trained on some hanging protocol can adapt to new ones. This message is both for vendors and for radiologist who should adopt new technology based on evidence not habits. USER & VENDOR Marriage. When you sign agreement with your PACS vendor make sure that your agreement is written and is inclusive.. It’s like your marriage.. Both parties should be clear.. Marriage certificate should be issued.. It’s a long term relationship.. In worst case scenarios: divorce is their.. But it’s painful.. in PACS/RIS terms, You will require the most painful process which is DATA MIGRATION.. Radiologists are doctors in the first place? Some radiologists are loosing their insights and imagination. Through out history of imaging goal was to acquire best image quality for human anatomy of physiology to help diagnosing with bare eyes. Now days, a new direction is coming up .. Computer aided detection, virtual reality (i.e. volume rendering, virtual colonoscopy, etc..). Radiologists should maintain their role as physicians not as image interpreters only .. some one will take that role soon !! PACS in the enterprise. PACS historically was a XRAY, CT, MRI. Today we see multimodality PACS not only as the archive destination but as reporting stations as well. Tomorrow, vendor-neutral PACS will be hub for all healthcare imaging. PACS is getting more attention. I don’t thing we will have more territorially PACS.. Interconnectivity in PACS is key. Through out history of technology, vendors started their innovations independently in some lab some where on earth. However, most current breakthroughs are not those standing alone. For inter-connectivity between different technologies we need standards such as TCP/IP, Bluetooth, IrDa, DICOM and HL7. Giving up those standards will not happen and should continue to spread. Thus, those standards have to be part of our Techs education.
Further Readings    ·  Early RFP (Year 1990):  MDIS RFP           ·  PACS History Project:     http://www.pacshistory.org