Abstract

What is a PACS-Neutral Archive? Why should one consider a PACS-Neutral Archive? How does an organization achieve a PACS-Neutral Archive? This paper will answer these questions and discuss the challenges and nuances related to achieving this goal.

In an ever changing medical imaging industry, the challenge of implementing a departmental PACS solution has evolved. As more and more healthcare enterprises plan for replacement of their legacy departmental PACS solutions (either with a newer generation replacement sibling from the incumbent vendor or by a solution from a completely new vendor), organizations are faced with tough tactical and strategic decisions.

Tactically, organizations must:

Determine how they can migrate their existing imaging data within a reasonable time frame and at an acceptable cost while ensuring all related imaging data is included (i.e. presentation state, annotations, ROIs, etc).
Ensure the acceptance of the new solution by the end-user community, which often proves to be a difficult challenge.

Strategically, organizations must:

Leverage this moment of change as an opportunity to invest in a solution that will eliminate having to relive this same migration challenge 5 to 7 years into the future when the organization will once again be replacing the PACS which it is now planning to install.
Consider the value of consolidating all medical image archives into one PACS-Neutral archive. It is very rare for one enterprise to have only one PACS. Most have multiple PACS built around the unique requirements of the specialty area (e.g. radiology, echo, cardiology, endoscopy, cath lab, etc). Each PACS has their own unique archive, each requiring a separate archive migration when a PACS change is being considered.
Envision the challenges of image enabling the enterprise EMR application. If medical image data is stored in each PACS domain, the customer must integrate the EMR with each PACS, and train the end users on the unique viewer associated with each PACS. These complications can add substantial time and cost to an EMR deployment. Centralizing image data in a single repository that can integrate with the EMR and present image data with a generic clinical viewer should be a strategic goal.

These tactical and strategic situations are compounded through the ongoing trend of consolidation across imaging centers and the on-going merging hospitals. These change trends further propagate disparate PACS, accentuate the need for strategic medical image archives and raise important questions. For example, how does an enterprise own, share, and provide access to their imaging data across multiple disparate PACS? Most times, the seemingly easy answer is to move forward with a “fork lift” replacement solution and enforce an enterprise PACS design across “all” departments. However, this approach is neither cost effective nor time practical. And it is not likely that one enterprise-wide PACS will satisfy all specialties and prevent future image archive migrations that involve substantially larger volumes of image data.

The reality is that investing in a PACS-Neutral Image Archive is a strategic decision that should be made at either the inception of a new PACS (green-field opportunity) or when a replacement PACS decision is considered. Doing so enables healthcare providers to own their imaging data so they can decide how to share and access their medical image data.

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