Picture Archiving and Communication System By Gloria Martin James Madison University NSG 460: Nursing Informatics

Because everything is cuter and more interesting if there is a Baby involved

What is a Picture Archiving Communication System (PACS) ? “Comprehensive networks of digital devices designed for acquisition, transmission, storage, display, and management of diagnostic studies” (Hood & Scott, 2006) Where a “traditional analog department is transformed into a highly functional, efficient, digital environment” (Kapoor, 2010) Basically, it is a computer system that takes digital studies and provides ways to manage, store, transfer, and retrieve the images

The Principle of PACS

History and Development of PACS Originally developed to increase efficiency for radiologists interpreting images (Faggiono, Nero, Castellana, Caramella, &Bartolozzi, 2010) Increased efficiency for radiologists over 40%, technicians 20-60% (Faggiono et al., 2010) Physicians reported fewer lost images (You, Yun, & Tu, 2008) PACS now used outside of traditional radiology Cardiology, teleradiology, Computer assisted diagnosis, and education (Faggiono et al., 2010; General Electric Company, 2013; Mildenberber, Brüggemann, Rösner, Koch, & Ahlers, 2010)

Out with the old, in with the new Below is a video clip showing radiology workflow at a community hospital before and after implementation of PACS Workflow before and after PACS

Benefit for Healthcare Professionals Images available for immediate review and old images easily available for comparison Reports linked to images for easy accessibility Able to transmit patient images to outside facilities Images immediately available at any workstation for quick preliminary read by clinician (ex. x-ray to check ETT or central line placement for patients in ICU) Faster readings equals faster intervention times

Benefit for Healthcare Institutions Efficiency One radiologist group can interpret images at multiple off site locations Increased productivity results in cost savings Less staff time spent repeating lost images Less time spend processing and searching for films

Benefit for Patients EMR’s contain comprehensive patient data Images, not just reports Quicker discharge times for patients who are awaiting results Faster and more precise treatment r/t ease and study comparison Referral visits more time efficient because consulted physician has had time to review images prior to appointment time More accurate monitoring and treatment of conditions such as heart disease, aneurysms, or tumors

Conner’s Story Below is a short news clip showcasing how PACS expedited treatment for a small child. Conner's Story

Cons Systems not always fully utilized to capability Multiple IT vendors for different departments create barriers to full integration (Faggiono, et al., 2010) Requirements can be cost prohibitive for small institutions and clinics `Large data storage and backup infrastructure Ability to interface with electronic medical record systems Workstations Digital Imaging Communication compliant servers

Conclusion PACS plays a vital role to the informatics of healthcare Provides benefits to all stakeholders Essential component of a comprehensive EMR Technology advances will continue to improve accuracy and efficiency for clinicians Increases safety, satisfaction, diagnosis and treatment for patients

References Hood, M. N., & Scott, H. (2006). Introduction to Picture Archive and Communication Systems. Journal of Radiology Nursing, 25(3), 69-74, doi: 10.1016/j.jradnu.2006.06.003 Faggiono, L., Neri, E., Castellana, C., Carmella, D., & Bartolozzi, C. (2011). The Future of PACS in healthcare enterprises. European Journal of Radiology, 78,253-258. doi:10.1016/j.ejrad.2010.06.043 General Electric Company (2013). Centricity Radiology Mobile Access. GE Healthcare. Retrieved from http://www3.gehealthcare.com/en/Products/Categories/Healthcare_ IT/Medical_Imaging_Informatics_-_RIS-PACS-CVIS/ Kapoor, D. (2010). Picture Archiving and Communication Systems (PACS) A New paradigm in Healthcare. Apollo Medicine, 7(3), 181-184. Retrieved from htpp://www.sciencedirect.com/science/article/pii/S0976001611601026 Mildenberger, P., Brϋggermann, K., Rösner, F., Koch, K., & Ahlers, C. (2010). PACS infrastructure supporting e-learning. European Journal of Radiology 78, 234-238. doi:10.1016/j.ejrad.2010.05.006