Your PACS Should Store More Than Radiology: One Patient, One Imaging Record.

OffSite Image Management, Inc. | Healthcare Imaging Insights

For decades, PACS has been closely associated with radiology.

X-rays. CT scans. MRIs. Ultrasound. Mammography. Nuclear medicine.

That made sense when most digital medical imaging originated inside the radiology department.

But that isn’t the hospital of today.

Images are now being created throughout the healthcare organization – in departments that may have little or nothing to do with radiology.

An ophthalmologist captures retinal images. A gastroenterologist records a procedure. An orthopedic surgeon captures arthroscopic video from inside a knee. Pathology produces digital slide images. Cardiology generates ECGs, EKGs and other diagnostic information. Dental departments create their own imaging. Wound-care teams take clinical photographs. Operating rooms generate still images and video. Endoscopy produces cine loops and complete procedure recordings.

Yet in many healthcare organizations, each department still manages that information independently.

Radiology images live in PACS. Cardiology may have another archive. Ophthalmology may have its own system. Endoscopy has another. Pathology has another. Some clinical photographs may be attached to the EHR. Others may remain inside specialty applications.

The result is an organization producing enormous amounts of clinically valuable visual information without having a truly centralized imaging record.

We believe an enterprise PACS should change that.

PACS Should Be an Enterprise Resource

The word enterprise gets used frequently in healthcare technology. But enterprise imaging should mean more than allowing several radiology departments to use the same PACS.

A truly enterprise-wide imaging environment should be capable of managing visual clinical information produced throughout the healthcare organization. That can include traditional DICOM studies such as CT, MR and X-ray, but it should not stop there.

• Radiology studies and cardiology images.
• Ophthalmology and retinal imaging.
• Digital pathology and laboratory slide images.
• Dental imaging.
• Endoscopy images, cine loops and complete procedure video.
• Arthroscopy and surgical video.
• Wound-care and dermatology photographs.
• ECG/EKG-related documents and diagnostic records.
• Scanned clinical documents and other provider-generated visual content.

The technology should adapt to the healthcare organization rather than forcing every department to maintain its own isolated archive.

The Patient Doesn’t Have Separate Medical Histories

From a technology perspective, healthcare departments are often divided into separate systems. From the patient’s perspective, they aren’t.

A CT examination, retinal photograph, endoscopy image, pathology slide and surgical video may all document different aspects of the same patient’s care.

Why should those images exist as unrelated islands of information?

The long-term objective of enterprise imaging should be to create a more complete visual medical record. That does not necessarily mean every physician needs access to every type of image. Permissions, workflow and specialty viewers remain important.

It means the organization should have the ability to centrally manage its imaging assets while making the appropriate information available to the appropriate users.

Specialty Systems Can Create Imaging Silos

Healthcare organizations frequently acquire technology department by department. A specialty application solves a particular clinical problem, and that application may include its own storage. Then another department purchases another system.

Over time, the hospital may accumulate numerous imaging repositories. Each can introduce another server, another database, another backup requirement, another disaster-recovery concern, another upgrade cycle and potentially another data-migration project when the application is eventually replaced.

The individual solutions may work perfectly well. The problem emerges at the organizational level.

The hospital ends up maintaining multiple islands of clinical images because each specialty application was designed primarily around its own workflow.

What if the healthcare organization treated clinical images as an enterprise asset rather than a departmental asset?

Centralization Does Not Mean Eliminating Specialty Workflows

A centralized imaging strategy does not require forcing every department to use the same viewer or workflow.

An ophthalmologist may need specialized ophthalmic tools. A pathologist may need capabilities designed specifically for digital pathology. A cardiologist has different requirements from a radiologist. A gastroenterologist reviewing endoscopy video needs a different experience than a physician reviewing a chest CT.

Those specialized tools can remain. The archive underneath them, however, does not necessarily have to remain fragmented.

The enterprise imaging layer can become the common infrastructure connecting those environments. Specialty systems can continue doing what they do best while the organization gains a centralized strategy for managing its visual clinical information.

One Place Changes More Than Storage

Centralization is not simply about reducing the number of storage systems. It can change how an organization thinks about its information.

A centralized environment can provide a more consistent approach to retention, security, backup, disaster recovery, access controls, auditability, data migration and long-term ownership of imaging information.

Instead of asking each department how its images are being protected, the organization can establish an enterprise strategy. That becomes increasingly important as medical imaging continues expanding outside radiology.

The Next Generation of PACS Is Hospital-Wide

PACS originally solved a radiology problem. Film needed to become digital. Images needed to be stored. Radiologists needed to retrieve and interpret them.

That mission has evolved. Today’s healthcare organization produces visual clinical information almost everywhere. The infrastructure responsible for managing those images should evolve with it.

At OffSite Image Management, we believe PACS and enterprise imaging should ultimately provide a centralized home for the healthcare organization’s imaging information – not simply the images generated by radiology.

Radiology. Cardiology. Ophthalmology. Pathology. Dental. Endoscopy. Surgery. Clinical photography. Documents. Video. And whatever comes next.

Different departments may create the information. Different specialists may interpret it. Different applications may display it.

But the healthcare organization should have the ability to manage its images as one enterprise.

One patient. One organization. One imaging record.