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Providers Illuminate PACS Enterprisewide


By Beckie Kelly Schuerenberg, Senior Editor June 2007
Three years ago, executives at Mercy Health Partners decided to reevaluate how the seven-hospital delivery system manages clinical images. Images were playing a larger role in patient care, so executives wanted all types of images, including those from cardiology and pathology, to be integrated into a single system so they could be available to all locations.

To do so, Mercy Health Partners planned to install a picture archiving and communication system at three rural Ohio hospitals to enable those facilities to share images with Mercy's four Toledo-area hospitals.

But enabling enterprisewide access to images required more than a shift in strategy. The delivery system had to increase the bandwidth to its rural facilities to 15 megabits per second from 6 Mbps to enable large image files to be transmitted quickly.

Mercy Health Partners also purchased an enterprise information management system to create a separate centralized storage area network for the delivery system's PACS and customize all images for viewing. Both systems are from Rochester, N.Y.-based Eastman Kodak Co., which is selling its health division to Toronto-based Onex Corp. under a deal expected to close during the first half of 2007.

The delivery system also required physicians to use authentication tokens from RSA Security Inc., Bedford, Mass., to access the PACS.

"We wanted our rural locations to have a broader reach to images," says Jim Albin, CIO. "But that also included images that weren't included in the PACS, such as cardiology and pathology images."

Enterprisewide clinical imaging has become a strategic priority for many hospitals and group practices. Physicians of all stripes are the drivers of the strategy, because they increasingly are relying on clinical images to devise treatment regimens. Enterprise image access also is part of the movement toward centralized information access, industry experts say. Many facilities, for example, already offer centralized access for lab, medication and other clinical data and want to do the same for images.

But as Mercy Health Partners discovered, various technological and workflow issues must be addressed before images can be made available enterprisewide.

In addition to evaluating network bandwidth, storage and security, provider organizations also must ensure each clinician can view an image at the resolution they need for their specialty of care, says Gary Reed, president at Integration Resources Inc., a Lebanon, N.J.-based imaging consulting firm.

Also, an enterprisewide clinical imaging strategy often requires providers to integrate a PACS with other clinical software, such as a laboratory, radiology or hospital information systems, so physicians can access various types of patient data with images, he adds. Further, offering all physicians access to a PACS means they must be trained to use the system as well as kept abreast of future enhancements.

"The role of the medical image has gone well beyond the radiology department. It now serves the entire hospital and wide area community," Reed says. "But hospitals need a realistic implementation strategy to make sure they have the human resources and infrastructure in place to support this use. They shouldn't take on too much too fast."

Three years after Mercy Health Partners began its enterprisewide clinical imaging initiative, it's just beginning to see returns. So far, its four Toledo hospitals are connected to the PACS storage area network, which was jointly developed by Kodak and EMC Corp., Hopkinton, Mass. Mercy expects to have one rural hospital on board this month, with the others going live by the fall, says Albin, the CIO.

When an electronic image is created, one copy is stored on the local hospital's PACS, and the enterprise image management system sends two copies over the delivery system's network to the SAN at Mercy's flagship St. Vincent's Mercy Medical Center.

When physicians log into the PACS-either from the network or via a portal-the image management system retrieves their requested images from the SAN.

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