Since the first PACS was developed in the early 1980s, medical imaging systems have continued to improve. Monitors have higher resolutions for viewing clarity. Images have 3D capabilities. Faster network speeds allow for more efficient image access.
In the 30-plus years since the construction of PACS, healthcare is now seeing its demise — or evolution. In this Q&A, industry consultant and speaker Don Dennison discusses the drive behind PACS’ evolution, what healthcare leaders need to consider and benefits organizations can gain.
Q: What is driving the need to “deconstruct” PACS?
Editor’s Note: This article was previously published on Imaging Technology News and is reprinted here with permission.
OSF HealthCare, an 11-hospital, 52-site, 138-year-old Catholic system based in Peoria, Ill., is recognized among Medicare’s Pioneer Accountable Care Organizations. As such they are constantly looking to improve care quality while reducing costs — all with an eye on transitioning, as all U.S. healthcare providers must, from volume-based to value-based care.
In this case study, Steve Kastelein, manager of diagnostic imaging applications for OSF HealthCare, discusses some of the overarching challenges they are facing.
It’s 1:00am on a Saturday. A patient comes into the emergency room complaining of cough and severe chest pain — hallmark symptoms of pneumonia. The attending physician calls for a chest X-ray. After making a preliminary read of the film, and seeing airspace opacity, the physician says that pneumonia is likely despite the lack of fever. But no radiologist will be available to review the X-ray and confirm the diagnosis until business hours the following day. The patient is sent home with oral antibiotics and instructions to drink plenty of fluids and rest. It’s a common enough story. One that can happen in any emergency department, any night of the week.
It’s never a comfortable moment when you’re trying to make a point and someone’s response is, “Prove it.” Yet that’s the discussion radiologists have been having lately, and the conversation about the value of their work is ongoing.
Proving value is complex — but certainly not impossible. Radiology data is one aspect of that proof; moving radiologists into a more prominent role is another. “We need to become better doctors—real doctors, if you will — who provide real value to our patients, our referring doctors and our hospitals,” said Dr. David Levin, professor and chairman emeritus of the Department of Radiology at Jefferson Medical College and Thomas Jefferson University Hospital in Philadelphia at RSNA 2014. “We’ve let ourselves become the invisible doctors, and that is something none of us are happy about.”
A survey of nearly 500 emergency physicians found that 97 percent have personally ordered diagnostic tests that they knew were medically unnecessary.
The most common reasons they ordered unnecessary tests were:
– Fear of litigation
– To avoid missing a low-probability diagnosis
Unnecessary testing is costly and can lead to negative consequences for patients, such as false positives and unneeded radiation exposure. Healthcare executives should foster cardiovascular imaging best practices among staff to reduce unnecessary testing and patient risks. Promoting the utilization of appropriateness criteria, working toward interoperability and promoting patient awareness will help organizations follow best practices.