PACS Replacement Market Heats Up: In Search of Bigger, Better, Faster

Medical information technology (IT) users and users of consumer IT have at least one thing in common: they both have a fascination with the next big thing.

Consumers’ gaze always seems pointed toward the next big thing, needed or not. Over the years, interest has shifted from desktop computers to laptops to tablets and mobile devices.

The situation in medicine is not so unidirectional. In fact, right now, attention appears focused on an old, invaluable favorite: the picture archiving and communication system (PACS).

According to a recent report from market researcher KLAS, the PACS replacement market seems to be gathering momentum.

Large hospitals are leading the parade. Of hospitals and health systems with more than 1,000 beds, nearly one in six told KLAS they are in the planning process of replacing their PACS.

One of the reasons that the PACS replacement market is heating up again: The early PACS were strictly radiology systems. They were used to store, access, and distribute digital imaging files.

The current PACS generation encompasses radiology information systems (RIS) and cardiovascular information systems (CVIS), too. A RIS is a computerized radiology database with functions that include results reporting, patient tracking and scheduling, and image tracking. Interfaced with PACS and in many cases a hospital information system (HIS), the RIS plays a central role in radiology workflow, from radiology practices to hospitals. In a similar way, a CVIS is a workflow solution for cardiology departments and practices.

But the large hospital/health system decision makers who responded to the KLAS survey don’t want just any PACS/RIS/CVIS. They said they wanted innovative technology from a new PACS vendor with in-depth clinical and radiological expertise. They demand reliability, scalability, interoperability, mobility and accessibility, as well. Finally, they want their vendor to be a strategic partner.

Those are not unreasonable expectations. In fact, they are all qualities, according to KLAS voters themselves, of the company they chose as 2011’s top PACS vendor in the large hospital category: DR Systems (San Diego) (a Dowling & Dennis client).

Besides DR’s industry-leading technology, KLAS voters cite the company for working extremely well with customers. A PACS is not – or at least should not be– be an off-the-shelf product. Customers should have access to executives and product designers at the vendor company so they can customize and even help evolve the product to better fit their needs.

Which is why we think hospitals may be better off purchasing from “best of breed” companies like DR Systems, rather than from large corporate vendors that have a medical division but also divide their attention among many other divisions.

While it’s mainly large health systems that are planning PACS replacements now, it probably won’t stay that way. The KLAS analysts believe the wave the big institutions are starting will eventually envelop smaller hospitals, too.

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Cloud Brightens Radiology

While healthcare reform will make immediate changes in the medical landscape, one aspect of care is still evolving only slowly. The problem: Most patient information remains on paper, stored away in files. Even most electronic patient information remains in silos – and is often not readily accessible, with appropriate privacy safeguards, to caregivers who need it.

Radiology, which generates most of the information in an electronic health record, has traditionally relied on proprietary picture archiving and communication systems (PACS) to store and transmit patient info. While PACS will remain central to radiology, much of this information will eventually migrate to the “cloud” of digitalized info that can be uploaded and downloaded remotely – again with privacy safeguards – to and from websites and servers.

This month has seen the official commercial launch of eMix (“electronic medical information exchange,” It’s the leading new application for sharing radiology images and reports, but it certainly won’t be the only one.

eMix solves a problem that has vexed medical imaging: how to securely share radiology data between proprietary PACS and other IT systems that don’t “talk to each other.” The solution: Use cloud computing to make data sharing as easy as sending and receiving email. The service was created by DR Systems, a client of Dowling & Dennis PR.

As RHIO’s (regional health information organizations) evolve into HIE’s (health information exchanges), they’ll have to figure out how HIE members can easily and inexpensively share patient information. Given how hard this is to do institution-by-institution or state-by-state, it seems inevitable that HIE’s will look to the cloud for the solution.