What kinds of factors drive the selection of PACS solutions? One of the chief elements, those interviewed for this cover story package say, is clinician workflow.
“Our hospital performs 10,000 surgeries a year, and the images were not in the right places at the right times,” says Wilfried Schroeter, head of medical technology at the 631-bed Celle Hospital in Celle, Germany. He and his colleagues ultimately chose a PACS solution from Germany-based Siemens because of the potential for optimizing clinician workflow for the hospital's physicians and nurses.
Like others involved in vendor selection, Schroeter and his colleagues looked at several vendors (five), and did site visits (10). Schroeter's advice to anyone involved in PACS vendor selection? “PACS is not isolated in the hospital; it is part of the whole IT system. And the hospital information system plays a big role in workflow in the hospital. So you must look at the workflow across the enterprise.”
Among the criteria involved in the vendor selection at Celle was the requirement that the vendor have already done projects in Germany, where the clinical workflow is somewhat different from U.S. hospitals, for example.
Another major factor CIOs and clinician leaders should consider, says Michael Sutter, is the whole issue of storage, particularly in light of the explosion in diagnostic imaging activity in the past few years (see main story).
Sutter, CRNA, M.S.N., director of clinical systems and network services and telecommunications for both the 300-bed Carle Foundation Hospital and the Carle Clinic Association (its physician group partner) says, “You certainly want to know what type of storage architecture a vendor presents with. For example, with some storage vendors, they'll store the images offsite for you; it's like an ASP model, where you only keep the pertinent images onsite and the rest are offsite. But you are going to pay for that offsite storage.”
Interfacing issues between the PACS vendor and any potential separate storage vendor should be looked at as well. At the same time, preparation for implementation must include a thorough examination of network infrastructure, in order to optimize clinicians' use of the PACS solution.
Of course, all these factors are something of a moving target in the current vendor marketplace, says Cary Negley, president of Negley, Ott & Associates Inc., a Savannah, Ga. firm providing clinical consulting support to hospitals deploying clinical information systems.
In the evolving market, Negley says, “EMR vendors have come to realize that they can't live without pictures anymore; as a result, the majority of the large core clinical vendors have either integrated pictures and image objects into their EMR packages, or have created or attempted to create seamless interfaces for users.”
As PACS and EMR systems both evolve, CIOs and other IT executives and clinician leaders will have to follow the market closely in order to get a sense of how both types of IT solutions are changing, and will have to use that market awareness to make optimal vendor selection decisions, he says.
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