PACS in a "digital hospital": preliminary data from phase III evaluation of the experience with filmless operation at the Baltimore VA Medical Center

Abstract

The operation of the radiology department and hospital was analyzed prior to and afer the installation of a hospital-wide Picture Archival and Communication System (PACS). Significant improvements in radiologist productivity, timeliness of imaging reports, and film retake and film loss rates were recorded Preliminary economic analysis suggests that capital depreciation and maintenance costs are matched by savings in film costs and personnel. The use of the PACS may also increase the efficiency of clinicians and other hospital staff which could result in substantial savings on a hospital-wide basis. Further savings may be achieved by sharing the PACS among multiple medical centers. Clinicians expressed a preference for PACS over film, typically utilized the system 3-5 times per day, taught themselves how to use the PACS rather than take the formal training course, and indicated that their rate of consultations with radiologists had not changed or that it had decrmtd &er the transition to filmless radiology.

Work practice changes caused by the introduction of a picture archiving and communication system

“…The introduction of the PACS has affected the work practices of many users, including radiologists, radiographers, nurses and doctors. A literature study [1][2][3][4][5][6][7] indicated that understanding work practice changes and clinicians' acceptance of the changes is critical for the successful integration of a PACS into clinicians' work practice. The rapid delivery of X-ray images to clinicians is critical for timely diagnoses and treatment.…”

“…The rapid delivery of X-ray images to clinicians is critical for timely diagnoses and treatment. Siegel et al 5 reported that the rate of film loss can be reduced from 8% in a film environment to less than 1% using a PACS.…”

Evaluating the Implementation of Picture Archiving and Communication Systems in Newfoundland and Labrador—a Cost Benefit Analysis

“…Several studies report the number of acute care beds as an indicator of imaging volume, 5,9,22-25 whereas others use the actual volume of exams. [26][27][28] An earlier study by Bauman et al 29 went as far as to state that a large PACS installation required a minimum of 20,000 examinations per year to ensure the feasibility of PACS, whereas 7 years later, Siegel and Reiner 27 reported the cutoff was at 39,000 exams. In classifying sites, Cartier 30 carried out a study in a "small" hospital that produced 15,000 exams a year, while Hayt et al 31 carried out a study in a "large" hospital that produced 116,000 exams per year.…”