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PACS - The verdict is in

August 3, 2008
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OK, so I know that it’s been a little while since I posted anything.

The last few weeks have been action-packed. Between finalizing a decision on PACS, beginning implementation, lining up additional resources to help, and other various projects and initiatives, lately “several days have ganged up on me at once…”

The end result of all that is that I’ve not taken the time to post.

I know that I still owe you some thoughts on what qualifies a person as an “IT professional”. I wrote recently about the challenges of finding the ideal educational background. I have been gathering some thoughts about certifications as an indicator of expertise- stay tuned for more on that soon.

Several months ago I talked about the challenges of vendor selection in today’s environment of consolidations, acquisitions and mergers. I illustrated those thoughts with references to our PACS vendor selection, which had drawn out for more than two years- spanning major changes in the vendor landscape.

Since we had been IDX customers for years, the whole Stentor, Philips, IDX, GE, Dynamic Imaging merry-go-round was enough to make anyone’s head spin.

Just in case there’s anyone out there wondering “I wonder what Harvey over at Holzer Clinic ever decided about PACS”, here’s a summary…

We liked the Philips (formerly Stentor) PACS application, and had actually recommended them as the vendor of choice several months ago, when we’d been looking to do a shared system with an affiliated hospital. Even then, though, we had really liked the Dynamic Imaging product- and their people.

Once the aforementioned hospital pulled out of the joint effort and DI joined the GE family, that changed the landscape enough to make us reevaluate.

We ended up giving GE/DI the nod for the PACS application. We are sticking with Philips for the CR equipment, which actually makes up almost half of the total project costs and nearly double the cost of the PACS application.

That sounds a little like splitting the baby, but I think that we made the right decisions for each component of the system.

Truth is that most PACS applications are agnostic to the modalities that feed them. Philips had done some neat stuff with integrations between their app and their CR modalities, but those benefits seemed less important than the promise of future integrations with the GE RIS and PACS platforms.

And while many seem enthralled by the Philips subscription pricing model (which enables you to hide your capital purchases), I’m not all that enthusiastic. If you’re limited in your ability to support your systems internally, you might be able to make a case to pay Philips to do it for you. For me, it just feels like extra expense while we limit our own ability to support and integrate our systems.

The Philips CR equipment had advantages over the other options in the area of mammography readiness and speed. We do have a partnership agreement with them that, combined with the fact that we’ve been buying a LOT of expensive imaging equipment, resulted in attractive pricing for some pretty high-end equipment.

Rounding out the dance card, we’ve engaged a PACS-knowledgeable consultant from Hayes to serve as our “internal” project manager. (OK, I know that she’s not “internal”, but we’re still trying to build our PM expertise, and she is at least the one slated to represent our interests as we work with the vendor.)

We’re buying add-0ns from TraumaCad for orthopedic templating, from Barco/Voxar for 3D rendering, and from Peervue for some QI tools. There are other miscellaneous odds and ends that I won’t list.

We’re not jumping straight into digital mammography. Maybe next year.

In a nutshell, this was a long, drawn-out process, that probably involved more politics than science. I’m satisfied that the end result was as good as we could have hoped for. Now all we need to do is have a successful implementation.

We’re working under a time crunch for part of this, as we’re opening a major new facility in a couple of months that has no allowances made for processing film. Our track record of doing things quickly is spotty at best, so we’re hoping for better things this time.

Early returns on the resources from both GE/DI and Hayes are excellent. I’ve been especially impressed with the quality of documentation that GE has delivered. (No reflection on GE one way or the other, but everything I’m seeing is clearly legacy DI material.)

Although my plan is to continue to be involved in the executive steering committee for the PACS project, we’ve asked another of our administrators to serve as the Executive Sponsor of the project, since he’s got direct responsibility for most of the affected areas in the organization. Better coming from that direction than coming from the IT guy. We’ll see how that goes.

I’m leaving tomorrow for the Allscripts national user conference in Chicago. I promise to share what I learn as the week progresses.

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Comments

great post. love to hear from your Hayes consultant, perhape Pete (Rivera) can get her to weigh in.

Your post makes me wonder - when it comes to buying something like a PACS or RIS, how much is it about the product and how much is it about the culture and values of the company you are buying from? I would think that the bigger the product, the longer the relationship, the more important it is to consider who you're buying from as opposed to just what you're buying.

People come and go, so you can't base it on a relationship with a rep, but culture takes longer to build and usually longer to change (both positive and negative change), so it may be a better measure of compatibility

You know, for me it almost goes beyond the "culture" of a company. These companies have what I think of as a "personality". There are persistent traits of the company that seem to survive personnel changes and even leadership transitions.

The profile of Epic that Anthony did recently uncovered some of those traits in that company.

Compare the "personalities" of Epic, Cerner, McKesson, GE Healthcare, Allscripts, eClinicalWorks. All are successful, but they're all really different.

While I wouldn't say that the company's personality is the most important factor in ing single products, it absolutely plays a role, perhaps more so in determining who ends up on your short list of key vendors.

Other things being equal, we tend to associate with people (and companies) that we're comfortable with.

I've often compared signing a major agreement with a vendor to getting married. That's a little bit of an exaggeration, but you get the point.

By the time you make the investment in time, money, training, integration, etc., getting "divorced" is such a pain it's hardly worth it unless you've REALLY got problems.

So you better make sure she's not just cute.