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For other articles and previous issues click here. September 5, 2005 Taking
the Leap — Smaller Hospitals Want PACS Scaled to Their Needs
and Budgets As the PACS market has shifted from the early adopter phase into a more mature market, more smaller rural and community hospitals and stand-alone imaging centers are seeking a PACS solution. They want this solution on their terms. “They want something that is less expensive and easier to install, maintain, and operate; something that fits within the constraints of their budgets and their relatively small IT departments,” says Eric Pearce, marketing manager of imaging and information solutions for GE Healthcare of Waukesha, Wisc. PACS developers are responding to this demand by designing and manufacturing scaled-down versions of PACS targeted to these so-called “independent” facilities. The organizations seek the same benefits their larger brethren enjoy from PACS: enhanced delivery of high-quality patient care, improved imaging services, increased productivity, reduced film and chemical costs, and less space for film storage. Working Around Constraints To meet that need, GE offers Centricity SE, which aims to address the needs and logistical and financial parameters of smaller customers. The price tag is more affordable and installation is less complex. “We’ve taken all of the things we’ve learned over the past 13 years experience with PACS and rolled them into a package designed specifically for [the] smaller and independent type of hospitals,” says Pearce. “This has provided us with all of the functionality of the bigger PACS units,” says Linda Martinez, director of medical imaging at Katherine Shaw Bethea (KSB) Hospital in Dixon, Ill., where the Centricity SE has been implemented. “We have all of the beefiness of PACS in a small package.” Flexible Storage The CLARiiON AX100 provides networked storage-consolidation, automation, and advanced data protection. Specifically geared to small and mid-size customers, the AX100 includes 12 serial ATA (advanced technology attachment) drives in a 3.5-inch rack-mountable cabinet. It can provide up to 2.2 terabytes of usable storage, and more. “It is easily expandable,” says Pearce. “When the first 2.2 terabytes purchased becomes full, you simply buy another tray and pop it in.” According to EMC, storage for a typical enterprise PACS system can amount to hundreds of thousands of dollars, while its own storage solution costs approximately $35,000. Total cost for the Centricity PACS SE is roughly $700,000 per system. Larger institutions can pay anywhere from $2 million to $20 million for their PACS. “The price is lower because the price tends to scale with the size of the implementation,” explains Pearce. “At a modestly sized organization, the price scales appropriately.” Easy Installation No custom integration is required, which contrasts to larger site installations. Indeed, customization wouldn’t be suitable for the “independent” market. “At some of the larger academic hospitals [that] have large IT departments, we can customize our Centricity Enterprise to run in their current IT environment,” says Pearce. “But Centricity PACS SE is designed to be a streamlined installation. Much of the custom configuration and custom design capability is probably not going to be appropriate for smaller markets.” Usually, installation for Centricity PACS SE can be accomplished in one day, with studies delivered the same day as installation. Full enterprise PACS systems can take up to three months to install, according to Pearce. GE began shipping Centricity PACS SE in fall 2004. Since then, the penetration rate at independent hospitals has been in the 20% to 25% range, according to Pearce. One of GE’s pilot sites was KSB Hospital. 40,000 Imaging Procedures The hospital implemented Centricity PACS SE in October 2004. Three main goals drove the decision to purchase the system: freeing storage space, enhancing patient care, and improving radiologist workflow. The department wanted to use its film storage space to better advantage. As with any hospital, space comes at a premium at KSB, and Martinez is confident that the PACS installation will eventually enable them to accomplish this goal. The task will be considerable, as it will involve the scanning and loading of studies to reduce existing files. Patient care can be enhanced, Martinez believes, by speeding up the distribution of images and reports throughout the hospital. Centricity PACS SE is already making this possible at KSB. “From a quality standpoint, we need PACS to distribute images to clinicians in the timeliest manner possible,” she explains. “With Centricity in place, we have image availability within minutes after the completion of an exam.” One main concern in the area of radiologist workflow was the large number of images produced by the hospital’s recently installed multidetector CT scanner, which can produce up to 200 images per patient study. “We needed something to help manage the large amounts of images produced,” says Martinez. “The SE made it possible to have the images produced be accessible online.” Improving Workflow “For instance, we were doing quite a few MRI exams a day,” she says. “Each one included at least 13 to 20 sheets of film, but now the technologists don’t have to worry about hanging the films and putting everything together for the doctors and radiologists to look at. That was necessary, but it was a waste of time. Now, just a couple of minutes after finishing the exam, the technologist can be finished and the radiologist has everything right there to read.” The decision to implement PACS was followed by considerable research. Martinez gave careful consideration to vendor offerings targeted to small and mid-sized facilities. “Ultimately, we selected GE’s Centricity PACS SE because it offers the power and functionality of an enterprise system, yet scaled to our needs,” she says. The GE sales and service team worked with the hospital throughout the process to ensure a smooth installation. However, the scope of the project wasn’t as large as anticipated. “I think that members of the GE team themselves were surprised at how easy it was to install,” recalls Martinez. “I think they thought it would be a much lengthier process.” She adds that GE’s team worked closely with the hospital, focusing on the IT infrastructure, physical planning, financial considerations, and the hospital’s project timeline. Also integral to the smooth implementation was the collegial support from the hospital’s IT department. KSB’s IT infrastructure didn’t require any significant adjustments. However, members of the IT department shouldered a great deal of responsibility in the process. “We couldn’t have done it without them,” says Martinez. “They made sure that the network was in place, including all of the necessary hubs and switches. In fact, the guts of the PACS unit sit in the IT department.” Successful implementation also entailed the same elements required with enterprise implementations at larger sites. These included providing the radiologists a sense of ownership in the project as well as engendering support from the administration. “The cooperation of the radiologists and administration was tremendously helpful, especially the support of the administration,” Martinez points out. “Even though we are a small hospital, our administration is very much in tune with keeping up with the latest technology. That is something any site needs.” Quick Acceptance As expected with new technology, KSB faced technological acclimation—or “growing pains,” as Martinez termed it. Staff needs time to adjust to new technology. “We were used to having film and paper in hand and bulky jackets, so it took some getting used to,” she says. “Also, we had to get the initial configuration set up for the radiologist, so that each exam displays in the specific way that they want. But once that part was all set, and we were good to go, everyone fell in love with it.” She also indicates that the more referring physicians got used to the new system, the more they liked it. Such reactions aren’t a surprise to Pearce. “Once you start seeing the expected and significant reduction in film, and significant reductions in report turnaround time, you tend to see greater radiologist satisfaction,” he says. “That can turn out to be very important when you consider that many of these small sites may be in rural locations, where it may be hard to attract radiologists.” — Dan Harvey is a freelance writer based in Wilmington, Del., and regular contributor to Radiology Today. |
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