Implementing PACS 1/2
This article has been adapted from a piece commissioned for E Health Insider. You can see the original article here. [external link, opens in a new window].
Over the next three years, every acute trust in England, as well as many in Wales and Scotland, will be changing from conventional film-based radiology systems to a Picture Archiving and Communications System (PACS). This has now been designated a core part of NPfIT – perhaps because it is a quick win for the programme. PACS is one of the elements of the beleaguered National Programme that has universal support – clinicians love its functionality, patients like the more efficient flow through clinics and managers like the impact on radiology waiting times.
Although the government will be funding the actual heart of each PACS solution, there are many other important aspects to consider to ensure a successful implementation of PACS.
Costs
The fact that implementation of areas of the NPfIT may cost more than the initial procurement has been the subject of much press speculation over the last few months; so what are the extra cost to consider in rolling out PACS? Apart from the initial outlay for the actual PACS equipment, software licenses and servers, there are two main areas of expense that Trusts may have to fund – equipment and training.
Equipment
This could include extra computers, new displays (monitors, projectors, etc), storage capacity (either onsite or external), mobile access devices, and printers to provide hard copies when patients are being seen in units where PACS is not yet available. To make the best use of the funds available for procuring equipment, it is important to consider the needs of the users. For example, displays for use by radiologists will differ hugely in price and resolution to those used at clinical workstations throughout the hospital, which will themselves differ to displays suitable for group meetings and operating theatres.
Training
Almost all staff will need training for the new systems – admin staff who have to book tests, radiology and radiography staff, clinicians who will access the images and IT staff who will provide technical support. Trusts should consider whether it may be more cost-effective to prepare an existing member of staff to help champion training or contract out to one of the various providers of on-site training. At the very least, the PACS provider should always provide basic training as part of the package.
But even the most straightforward implementations, if not carried out without training and consultation, could result in difficulty or even put lives at risk. It is important to plan early for the changeover to PACS, and to involve as many as possible of those that are going to be affected by the change. It is particularly important to understand how clinicians work, and how this may be impacted by PACS – when consultation is inadequate, it can lead to trouble - a case study can help demonstrate this.