Q&A With Dr. Dan Chernoff: The Formula for a Successful PACS Implementation


Glen Falls Hospital

Glens Falls Hospital and its affiliated private practice radiology group, Adirondack Radiology Associates, needed a way to effectively manage medical imaging and reports across the enterprise. Faced with fragmented imaging records across a wide geographic region and facilities, these providers opted for a Picture Archiving and Communication System (PACS) implementation to create a unified view of patient records and increase clinician productivity and satisfaction.

The Medical Imaging Talk Blog discusses the successful PACS implementation with Dr. Dan Chernoff, radiologist and director of radiology at Adirondack Radiology Associates.

How has the recent implementation of the PACS improved efficiencies and cost savings?
The PACS improves department efficiencies in a myriad of ways, including no lost or misplaced films, images available to multiple users simultaneously, much more efficient soft-copy review of studies compared to film, much better and faster access to prior studies for comparison, and faster turn-around time from imaging to diagnosis.

What reaction have you received from staff and doctors in regards to the PACS implementation?
The response to PACS from staff and clinicians has been overwhelmingly positive. Gone are the days when clerical staff and clinician time was wasted pulling studies from a film library, shuffling through a huge film jacket and discovering films were lost or signed out. Being able to view imaging studies from home has been a god-send not just for radiology calls but also for clinical specialists on call (e.g. neurosurgery, orthopedics).

In terms of introducing staff to the new system, what lessons learned would you offer other hospitals and clinics?
Radiology staff and radiologists were trained directly by McKesson. These radiology super users then trained all others once they were up-to-speed. A lesson I can offer others is to assume that some users will be difficult to train and/or reluctant to change their method of accessing radiology studies. Either accentuate the positive and accept some level of dissatisfaction over change, or have a plan to satisfy “special needs” providers. For example, we did not plan well for PACS in the OR. The mobile carts were not well accepted, and we went back to printing film for the OR until their needs were met.

Can you give some specific examples of how the PACS implementation has affected staff?
The orthopedists, neurosurgeons and neurologists on call were extremely happy that they could review studies at home and do not have to drive in to see every ER patient for whom there is a questionable imaging finding.

For radiologists, we implemented a Master Patient Index, allowing studies performed at the hospital and the radiologist-owned outpatient imaging centers to be contained within a single “virtual jacket” for each patient. This has saved untold hours of trying to get images up from disparate PACS databases for comparison purposes and has probably saved a life on more than one occasion – without for the combined database, a critical comparison would not have been made in the name of expediency.

Were there any surprises during the PACS implementation?
Lack of planning, or more properly lack of thorough consultation, for the OR was one mistake. At the time of purchase, we did not have the resources to fully implement a fault-insensitive system (backup servers, backup network, etc). We are now about 75% there and would like to be at 100%, as PACS is now mission-critical for the hospital.

What risks are there for hospitals that choose not to move forward with a PACS implementation?
Risks to not implementing a PACS include lower department efficiency, higher costs, lack of scalability, slower turn-around time, opportunity to lose images and overall poorer patient care due to limitations of image storage on film.

What do you think will be the next greatest advancement in Radiology Information Systems (RIS)?
I think advances in RIS will include improved data mining tools, more standardization to allow interoperability with other information systems, growth of SAAS or hosted RIS, opening of radiology scheduling to patients and referring physicians, growth and integration of critical results reporting software, and growth of integrated decision-support tools.

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