Costs and Benefits of Picture Archiving and Communication Systems (original) (raw)
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Academic Radiology, 2012
The availability of the Picture Archiving and Communication System (PACS) has revolutionized the practice of radiology in the past two decades and has shown to eventually increase productivity in radiology and medicine. PACS implementation and integration may bring along numerous unexpected issues, particularly in a large-scale enterprise. To achieve a successful PACS implementation, identifying the critical success and failure factors is essential. This article provides an overview of the process of implementing and integrating PACS in a comprehensive health system comprising an academic core hospital and numerous community hospitals. Important issues are addressed, touching all stages from planning to operation and training. The impact of an enterprise-wide radiology information system and PACS at the academic medical center (four specialty hospitals), in six additional community hospitals, and in all associated outpatient clinics as well as the implications on the productivity and efficiency of the entire enterprise are presented.
2010
Intraoperative access to radiographic images is essential for the accurate diagnosis, operative planning and surgical treatment of many musculoskeletal conditions. Traditionally, hardcopy radiographs have been readily available for this purpose. Recently, however, hardcopy radiographs have become less accessible because many hospitals have transitioned to digitally-based picture archiving and communication systems (PACS). Typically, PACS is available in hospital clinics, emergency rooms, and radiology departments but not, as in our institution, in the operating room. The purpose of this study was to determine the merits of implementing and having access to PACS in the operating room.
A methodology for the economic assessment of picture archiving and communication systems
Journal of Digital Imaging, 1995
Most economic studies of picture archiving and communication systems (PACS) to date, including our own, have focused on the perspectives of the radiology department and its direct costs. However, many researchars have suggested additional cost savings that may accrue to the medical center as a whole through increased operational capacity, fewer Iost images, rapid simultaneous access to images, and other decreases in resource utilization. We describe here ah economic analysis framework we have developed to estimate these potential additional savings. Our framework is comprised of two parallel measurement methods. The first method estimates the cost of care actuaUy delivered through online capture of charge entries from the hospital's billing computer and from the clinical practices' billing database. Multiple regression analyses will be used to model cost of care, length of stay, and other estimates of resource utilization. The second method is the observational measurement of actual resource utilization, such as technologist time, frequency and duration of film searches, and equipment utilization rates. The costs associated with changes in resource use will be estimated using wage rates and other standard economic methods. Our working hypothesis is that after controlling for the underlying clinical and demographic differences among patients, patients imaged using a PACS will have shorter lengths of stay, shorter exam performance times, and decreased costs of care. We expect the results of our analysis to explain and resolve some of the conflicting views of the cost-effectiveness of PACS.
Objectives: Meaningful use of picture archiving and communication systems (PACS) can change the workflow for accessing digital images, lead to faster turnaround time, reduce tests and examinations, and increase patient throughput. This study was carried out to identify determinant factors that affect the adoption of PACS by physicians. Methods: This was a cross-sectional study in which 190 physicians working in a teaching hospital affiliated with Tehran University of Medical Sciences were randomly selected. Physicians' perceptions concerning the adoption of PACS were assessed by the conceptual path model of the Unified Theory of Acceptance and Use of Technology (UTAUT). Collected data were analyzed with regression analysis. Structural equation modeling was applied to test the final model that was developed. Results: The results show that the UTAUT model can explain about 61 percent of the variance on in the adoption of PACS (R 2 = 0.61). The findings also showed that performance expectancy, effort expectancy, social influences, and behavior intention have a direct and significant effect on the adoption of PACS. However, facility condition showed to have no significant effect on physicians' behavior intentions. Conclusions: Implementation of new technology such as PACS in the healthcare sector is unavoidable. Our study clearly identified significant and nonsignificant factors that may affect the adoption of PACS. Also, this study acknowledged that physicians' perception is a key factor to manage the implementation of PACS optimally, and this fact should be considered by healthcare managers and policy makers.
Determinant Factors in Applying Picture Archiving and Communication Systems (PACS) in Healthcare
2017
OBJECTIVES Meaningful use of picture archiving and communication systems (PACS) can change the workflow for accessing digital images, lead to faster turnaround time, reduce tests and examinations, and increase patient throughput. This study was carried out to identify determinant factors that affect the adoption of PACS by physicians. METHODS This was a cross-sectional study in which 190 physicians working in a teaching hospital affiliated with Tehran University of Medical Sciences were randomly selected. Physicians' perceptions concerning the adoption of PACS were assessed by the conceptual path model of the Unified Theory of Acceptance and Use of Technology (UTAUT). Collected data were analyzed with regression analysis. Structural equation modeling was applied to test the final model that was developed. RESULTS The results show that the UTAUT model can explain about 61 percent of the variance on in the adoption of PACS (R2 = 0.61). The findings also showed that performance exp...
Design and implementation of a picture archiving and communication system: The second time
Journal of Digital Imaging, 1996
This report describes the authors' experience in the design and implementation of two large scale picture archiving and communication systems (PACS) during the past 10 years. The first system, which is in daily clinical operation was developed at University of California, Los Angeles from 1983 to 1992. The second system, which continues evolving, has been in development at University of California, San Francisco (UCSF) since 1992. The report highiights the differences between the two systems and points out the gradual change in the PACS design concept during the past 10 years from a closed architecture to an open hospitalintegrated system. Both systems focus on system reliability and data integrity, with 24-hour on-line service and no Ioss of images. The major difference between the two systems is that the UCSF PACS infrastructure design is a completely open architecture and the system implementation uses more advanced technologies in computer software, digital communication, system interface, and stable industry standards. Such a PACS can withstand future technology changes without rendering the system obsolete, an essential criterion in any PACS design.
Journal of Health Management & Information Science, 2017
Introduction: Today the use of information technology in accordance with the rapid environmental changes and flexibility acquisition is necessary and unavoidable. Picture Archiving and Communication System (PACS) is one of the medical information technology used in health facilities. PACS provides the images archive and transmission possibility electronically in different units of the teaching and treatment centers. This study aimed to assess the PACS system in teaching hospitals of Shiraz University of Medical Sciences based on a survey of Canadian Infoway. Method: This descriptive cross-sectional study was performed on 53 individuals selected through Two-Stage Stratified Random Sampling. The study population consisted of 156 PACS users in Shiraz University of Medical Sciences hospitals which were equipped with the PACS system in 2015. Data were collected by the valid and reliable customized questionnaire of Canadian Infoway. The reliability was measured by a pilot study on 25 PACS users; Cronbach's Alpha was estimated 0.78. Data were analyzed using SPSS 18. Also, frequency, mean, standard deviation were used. Results: The results are presented in three sections: environment (Background Variables), benefits and challenges of PACS. As to the system availability, 20.8% of the users in the clinic, 75.5% in the diagnostic imaging department, only 3.8% in offices had access to the PACS. As to system accessibility, 49.1% of the users just had access to tests, 5.7% only to the reports, and 45.3% to both reports and tests. With respect to benefits of PACS, the mean was 4.16 (SD: 0.5) (five-point scale 1-5) estimated, and in challenges, the mean was 3.48(SD: 0.5) (five-point scale 1-5). Conclusion: The results showed that although PACS could eliminate many restrictions concerning the use of radiology images and films, there were challenges in this regard. Users are recommended to have access to PACS in all clinics, physicians' offices, and diagnostic imaging department. The majority of users agreed with the PACS benefits. Adequate management measures must be taken to maximize the benefits derived from this system and the utilization of information in order to improve the quality of care. Adequate training and elimination of the deficiencies could affect the use of this system and improvement in the health care services.
Evaluating the digital storage requirements for a partial picture archive and communication system
Journal of Digital Imaging, 1990
The study evaluates the volume of digital images produced in a department of diagnostic imaging, with the primary goal of identifying the requirements of digital storage for a partial picture archive and communication system (PACS). The daily activity of digital units (one computed tomography unit, one magnetic resonance imaging, two ultrasonography, and one digital subtraction angiography), which perform 25% of total examinations in the department, was analyzed to determine the number of images produced by digital techniques. They account for 65% to 70% of the total images. The storage capacity necessary to contain all digital data produced in a 800-bed hospital reaches nearly 100 Gbyte/yr without compression. The study emphasizes that a partial PACS can be economically justified through reduced film-archiving costs. This goal could be achieved through a selection of significant images and examinations, considerably reducing the cost of film reproduction and allowing the amortization of a partial PACS in about 5 or 6 years.
International Journal of Technology Assessment in Health Care, 2000
Objectives: This paper considers the methodological problems that arise in conducting cost analyses in economic evaluations where only observational (rather than experimental) data are available and where the technology being evaluated is diffuse, such that the unit of analysis has to be the institution rather than the patient. Methods: A case study is reported that concerns the application of computer technology in radiology: picture archiving and communication systems (PACS). A range of different approaches were used to estimate changes in running costs, including time series analyses of routine data and direct observation of resource use. Results: The analysis illustrates some of the difficulties involved in costing the introduction of a diffuse technology. Nevertheless, it provides a firm indication that, overall, the introduction of PACS was found to be associated with a significant increase in hospital costs, suggesting that the initial expectations of financial savings were unduly optimistic. Conclusions: The research demonstrates that, using multiple methods, it is possible to estimate cost changes within a single hospital. In addition, the paper discusses the nature of the uncertainties in such analyses and possible ways of representing such uncertainty in terms of confidence intervals.