VIENNA - Turning off the film spigot is the goal of every PACS administrator, but achieving it without repercussions is difficult. Dr. Yu Ting Kuo shut down film in his institution on September 20, 1999. The very next day, an earthquake that damaged several nearby buildings rocked Taiwan.
"The PACS survived and no one said my decision to stop using film was the cause of the quake," Kuo quipped.
In a presentation to attendees at this week’s European Congress of Radiology, Kuo described the results over the past year of a near-filmless PACS implementation at the Municipal Hsaio-Kang Hospital at Kaohsiang Medical University in Kaohsiang, Taiwan.
Kuo and his colleagues began a two-stage facility-wide implementation of PACS in their medium-size (428-bed) general hospital in November 1998. Their first effort was digitizing past films from all modalities except mammography, and then archiving the images.
The group decided to install both a near-term and long-term archive. The near-term archive is a redundant array of inexpensive disks (RAID) system that stores 12 months of images in a 3:1 lossless-compressed format. This compression algorithm provides clinicians with diagnostic-quality images.
The long-term archive utilizes a jukebox of magneto-optical disks (MODs) to store images for up to 87 months in an 18:1 lossy-compressed format.
"We’d prefer to use DVD technology for our long-term media, but DICOM 3.0, as yet, does not support the use of this archive media," Kuo said.
The physicians at the hospital can access all current and prior reports from 40 viewing stations scattered throughout the wards, ICU, and ER. In addition, teleradiology view stations with access to the hospital PACS are available at outpatient clinics.
Kuo shut down the film pipeline nearly 18 months ago, with the exception of mammography. Film use has dropped from a mean of 1.5 films per patient prior to PACS to .06 films per patient since September 1999, a decrease of nearly 300%. During that same period, there was an increase in patient volume of more than 100%.
He noted that physicians at the hospital were particularly impressed with the decrease in time spent retrieving images, from a few hours in the pre-PACS environment to a few seconds via the PACS. In addition, the vast majority of the preliminary radiological reports were available on the PACS and HIS within a single day.
Kuo also reported that the costs of film-related material, file-room personnel, and space were significantly decreased. Referring physicians and radiologists have indicated they are 97% satisfied with the PACS.
Kuo plans on adding transcription software to the system to further reduce overhead and create a more complete electronic patient record.
"We’re looking at a five-year return on investment, a full year sooner than our original projections," he said.
By Jonathan S. Batchelor
AuntMinnie.com staff writer
March 6, 2001
Click here to post your comments about this story. Please include the headline of the article in your message.
Copyright © 2001 AuntMinnie.com
