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PACS as an Essential Tool for Healthcare Informatics and Communication Technology (HICT)

By Frans Dhaenens


Introduction: PACS has evolved from a technical difficult and expensive radiology based business towards the main driver in digital diagnostic imaging in healthcare. Emerging countries will not repeat this evolution but have to jump on the bandwagon of enterprise PACS the motor behind healthcare informatics. PACS will use rather of-the-shelf technologies like internet1+2, commercial storage and communication solutions than special "homemade" technology. PACS will evolve from a local image-data center towards a regional and even countrywide medical imaging expertise and knowledge network. This will increase the role of the organ-based specialized radiologists in the diagnosis and treatment of patients."nDevelopments: There exist 3 levels of PACS deployment with increasing technical complexities. At least all of them require a minimum of RIS and HIS to make them useful."n• Modality based PACS: supported by modality vendors and of increasing importance by the new 3-4D image processing. Here all processing and storage is located around the MRI and CT. It has value for the radiologist but is not helping clinicians and it is costly because it has to be repeated for every modality and every vendor. "n• Departmental PACS: integrates all modalities into 1 type of workstation, storage and communication, but communication towards clinicians and other hospitals is based on film, CD ROM or a kind of simple LAN. This has a very high cost and only helps the radiologist. The use of DICOM standards is mandatory."n• Enterprise PACS is the imaging part of a hospital-wide informatics strategy (called HIS) leading to an EMR (Electronic Medical Record), EPR (Electronic Patient record) or EHR (Electronic Health record), where neither paper nor film is used. All medical specialties (including the image-rich cardiology) are integrated into one system, improving treatment speed and quality. The main decision-takers are governments, health authorities, health insurances, and hospital chains. It is often used as a competitive and marketing advantage. HL7 is now the dominant standard. Several enterprise PACS can be integrated into a multisite-PACS (even on remote distances) allowing doctors and patients to go wherever into the system. This approach requires new standards like the Master Patient Index (MPI) and a lot more intelligence and integration of the (multi-vendor) systems. The final goal of enterprise PACS is to look for knowledge, EBM and use of the semantic web in order to improve the treatment of patients even in remote locations."nConclusions:"nFinally all PACS levels have to evolve towards enterprise PACS, integrated in a HIS, and images will be part of a kind of EPR. Modality and departmental PACS must be upgraded towards a hospital-wide PACS in a cost-efficient way without compromises about speed and capacity. Internet technology, database are integral parts of the solution."nCompanies offering PACS should have this approach in their roadmap, rather than short term throw-away offers. RFPs have to written in respect to future upgrades towards enterprise PACS just to avoid dead-end streets and costly disappointments

Topics: Medical physics. Medical radiology. Nuclear medicine, R895-920, Medicine (General), R5-920, Medicine, R, DOAJ:Internal medicine, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Kowsar Corporation
Year: 2007
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