Microsoft Amalga RIS/PACS

Amalga RIS/PACS will be the new member of Microsoft Amalga. Amalga family members include Amalga HIS, Amalga Life Sciences, and Amalga Unified Intelligence System. Another healthcare solution from Microsoft is the Microsoft HealthVault.

Even though Microsoft has always been a pure IT solutions company. Microsoft is relatively new to this field, but that doesn't realy mean a bad thing. Inovation always comes as new !

Recently, news said that Microsoft is finally come up with the PACS/RIS through the Amalga PACS/RIS. Frankly speaking, Microsoft has shaped the way IT solutions outreach to many people and organizations with their verity IT solutions including their MS-Windows OS. So, will Amalga PACS/RIS change the future of Imaging informatics too?

Amalga HIS: Image enabled technology

I have divided my anticipation to the future of this product as positive and negative, advantages and disadvantages to under line such product of such key player in IT industry.

I have put some of these points in humorous way, but that doesn’t mean that Microsoft is a clown! Staytoon and watch for this product !!

“ What will happen when Amalga PACS/RIS is released? ”

Positives · PACS/RIS will be everywhere. Small hospitals off course will get a hacked copy. Just don’t run the genuinity check utility if you have the auto-update running! · PACS/RIS administration will be piece of cake (easy). Authentication using active directory, alerts using process monitors, statistics using excel templates, · PACS/RIS will be easily customizable. Field boxes, check boxes, drop down menus, and macros.. all possible using Visual Basic for Applications (VBA). · Every thing can be done by drag and drop. To reject an image just drop it to the Recycle Bin icon and then you can always change your mind and restore it back. · Integration with other Microsoft products. Lots of smart tags, Web Based using IIS v.7.5,  teaching archive using Sharepoint server. · DB migration is a piece of cake using MS-SQL 2008 migration tools. Just match the field on the UI and click the “GO” Button. · Need help for sophisticated problems? Just login to http://msdn.microsoft.com. · Doctors will be able to do tele-radiology through NetMeeting or Ms-Messenger. With emoticons off course. · You will always blame one company for any problem in the system. Thank you Vin. !! since OS, DB, and Application are from one provider. · First level technical support will be done through a help desk in Banglore, India. If that doesn’t help a service engineer from a service partner will visit the site in just 72 hours. · You can download your frequent service patches from http://update.amalga.com

Negatives · A beta version will be released free of charge and price for the official release will be 50% less than competitor’s. · At the day of the official release, hospital imaging IT personnel will stand in long lines to get their copy. · First Service Patch (SP1) will be released only one week from the release day. · Hospitals have to do a lot of System Reboot. · If problem persists, just format and reload your PACS/RIS.. What about the database ? Don’t worry you will get easy DB recovery tools ! · malware (virus) programmers  will target the new product and lots of them will be coded to replace medical images with personal photos like those of The Simpson’s cartoon characters…

Calculating your PACS storage capacity

I came through a nice table in a presentation from SIIM (society of Imaging Informatics in Medicine) which was showing typical image size and typical full study size for different digital images of different modalities in Radiology. See Table above.
This table will help in estimating the needed PACS storage. From your calculation of No. of exams/day, you can estimate the amount of storage you consume daily and then multiply this by the typical size of each study you will then get the your daily storage consumption (just like the calculation of film consumption in the old days.)
For example, if your department makes 15 CT SCAN cases a day, and by assuming that your study makes 1000 slices per study then each study will comsume around 1GB (assuming your CT is a new one with 1024x1024 image matrix).

Thus, 15 CT cases = 15 GB (per day)
15 GB/day = 15 x (30 working days) = 450 GB / Month
450 GB/Month = 450 x 12 (months a year) = 5400 GB = 5.27 TB

Thus, CT SCAN machine doing 15 cases/day will need a storage of ~ 5 27 TB/year.


Note. PACS admin should anticipate the department growth when using this calculation to estimate the PACS storage needed.

"Your Needs" first step toward your PACS project

Last time...

We discussed lifecycle of PACS projects. Study, Design, Execution. We saw that first two phases usually are implemented by a PACS consultant where third phase is done at last by a vendor.





I don't know my needs !

This is actually a normal case in many projects when healthcare provider doesn't have enough experience. In fact, PACS is limited by IT and storage solution of current technology. Thus, if healthcare provider is not up to date with latest and most effective technology then they may endup with unstable, or outdated technology.


Consultancy Services

In that case, people will hire another body to verify and find there needs. The body who will study your needs is called a "Consultant". There are; infact, many consultants for PACS around the world. For list of consultants for PACS and related field you can refer to
SIIM consultant list, or auntminnie.com PACS Consulting.


Hiring a consultant is too expensive..

Yes !! This is a fact. Consultancy services can cost about 10 to 15% percent of project cost ... a full implementation of PACS can cost up to 1/2 million KD. So, consultancy (study & design) can cost up to 75,000 KD.

Thus, some hospitals will do the study phase themselves. They will study there needs like archive capacity, and fetching throughput to save the expensive cost of hiring a consultant. If hospital decides to do this, they; actually, need to understand their needs first !


Understanding Your needs

It starts with understanding your needs. Very simple: Input and output, it is about the income and outcome of such system. You may never be an IT expert but you can still make the right decision. Keen on the understanding of your needs !

Your pacs vendor may keen on some state of art technology used in his system, but what if non of this works! You can always go back to internet societies to review some technology or some brand name, but there will be no one better than you in understanding your needs..




Put Needs in Writing

Good ! You have been giving thoughts and thoughts about your needs and your work throughput. Later, you started telling your choice vendor about your thoughts and you started negotiating price and might be give up on some parts of your system for the sake of budget limitations. At the end, project accomplished, system starts and then you discover that this wasn't your expectation. The system doesn't meet your requirements and the worst thing that can happen that after few years you find out that your storage archive is FULL !

The big mistake you have done was that you never put your requirements in paper. Your contract was missing the important stuff.

Honostly, in many cases contract was explicit about some requirment; however, all requirement were written in technology specific terms. For example, amount of storage in Tera bytes of storage, type of storage used, servers and H.W used, and no. of client licenses.
In fact, you should state your archive capacity only if you know how much space in Terabytes your center will consume. This is an easy calculation if you study your needs in terms of No. Modalities, Compression rate and etc. Other wise, leave this job to the other party. Of course this will cost you a lot, but I think this is a good solution until we all have a better experience and better sense for our needs.


Request for proposal (RFP)



Now, you decided to call all PACS vendors to submit their offer to supply you with PACS. The invitation letter should; in fact, contain your basic requirments. Those requirments will be your evaluation criteria to decided wich PACS you will buy. The document which will contain your initial requirments is called "Request For Proposal (RFP)" or some times it's called Terms Of Reference (TOR). Down, you can see example of two RFP templates.



1. Georgetown University Medical Center PACS/RIS RFP


2. RFP from David Clunie Website

RFP can have many requirments apart from the system; like, training requirments and integeration services. Project schedule and total period have to be stated there.

Moreover, RFP can have finanical requirments as well. Financial requirments can be some thing like your budget range, your payment policy, and contract penalties.

If you have optional requirments which you think it's good to have but not sure if this will fit in your budget then you should state them as OPTIONAL requirments. Then, you can;first , evaluate (score) all mandatory requirments and later the optional requirments.

Afterwards, vendor can put his/her proposal and then you can score each proposal since all proposals are written based on your requriments


In Summary..


PACS is a full automation solution for imaging departments. Thus, knowing your workflow, and your requirments will lead to a successful PACS implementation. However, not knowing your detailed requirments like storage capacity doesn't mean that you cannot get good PACS. You can still do that by hiring a consultant to do the job or asking vendor to adopt any new requirment which comes in the future. In either way, your requirments should be written in official documents such as RFP. The RFP lists all certain requriments you decided (or consultant decided). RFP gives good way to evaluate different vendor proposal.


Previous Articles..

1. PACS Project lifecycle
2. DICOM SOP
3. DICOM Definition and basic setup