I have decided to start my blog with what consumes most of my time currently. One of several big projects I have going on now is the implementation of a new PACS system. PACS systems are used to view MRI, CT and X-Ray images. They can also include images from arthroscope and bone density equipment as well as other types of imaging equipment.
There seems to be two distinct PACS markets – Hospital and Private Practice. Interestingly, the vendors that sell in one market do not typically sell in the other.
I am working with the Private Practice vendors and it has been an interesting process. My client has an older version of software from one vendor and has purchased the latest and greatest from another. The older PACS software owned by the client runs on a Java platform and while it had nice features it seemed to constantly have hangs and lock-ups due to memory leaks on the client side as well as the server side. This older version was bought several years ago by another vendor who has since re-written the software on a much more stable .net platform. My impression of the new re-write is that it has real potential, but like any version 1 or version 2 software it still has some issues that will need to be (and likely will be) addressed in later versions.
My client chose to switch to a more mature product that is also written in .net and so far appears promising in terms of end-user ease of use as well as functionality (lots of bells and whistles!). What is really odd about PACS is that all the players agree to send and receive according to DICOM standards; however, once you have been using one of these systems for some time, you accumulate a lot of large file-size images that have to be stored electronically. This is where the issue begins…the vendors seem to all use their own proprietary methods for archiving these studies. This doesn’t present a problem as long as you stay married to one vendor; however, to divorce one to marry another will cost some alimony in terms of pulling those archived studies back into a format that can be imported into another system! Something to consider when you sign on with a PACS vendor…I would recommend you negotiate in your initial contract that should you (the client) decide to migrate to a new PACS system at a later date there will be no charge for services required to migrate the data (a prenuptial agreement!).