AuntMinnie.com: How far has systems integration evolved in PACS? Will RIS functionality eventually be fully married into PACS?
Tucker, Agfa: We believe that the RIS and PACS marketplaces will merge, and it will be a very successful market. In the next 12 to 24 months, any serious PACS will have to have RIS capability built into it. Or, at least, it must be able to fully integrate into an existing RIS. It’s important to acknowledge that the RIS market is fully saturated, so PACS vendors must be able to integrate to the on-site RIS. The general trend is for convergence of these radiology information systems.
In the U.S. market, the RIS market is very well saturated, whereas if you go to Europe, there’s less penetration. So for the majority of business in Europe and everywhere else, there are clear advantages of having a RIS tightly integrated into your product offering. In those other markets, you can’t even play if you don’t have a RIS, whether it’s integrated or part of your PACS.
Mason, eMed: RIS integration has progressed quite far. However, it is still very much a one-way flow of information, from RIS to PACS. This is not ideal. Depending upon the RIS vendor, integration implementation often can be a time-consuming, costly, and painful process for the customer. We look forward to changes in the industry whereby more RIS vendors make integration hassle-free for the customer. RIS and PACS will eventually be fully integrated to improve operational efficiency and billing accuracy. But this is going to take time and will be vendor-specific.
Wanchoo, GE: RIS functionality by default has to be integrated into the PACS workstation, even if you have a standalone RIS at a hospital, which is the case for the majority of healthcare institutions. And this has gone beyond RIS integration to include other tools such as voice recognition, orthopedic templating, dictation, etc. -- to integrating that capability right at the PACS. We’re clearly moving in the direction of RIS functionality being fully married into PACS, whether that’s an integrated RIS/PACS at the desktop or integration with a legacy RIS on the desktop.
Larson, Kodak: Progress has been slow in this regard, but has picked up steam in the past year or two. The logical progression will include collapsing imaging and information systems for radiology, followed by a similar coalescence of imaging and information in clinical and other healthcare information space. The speed of this transition will be driven by a number of complex variables, including how quickly common standards are adopted, such as IHE and HL7. The Web is also driving the speed at which imaging and information systems are able to merge into a single system. Other factors such as the widespread adoption of master patient index systems will help to drive this transition.
Hullihen, Marconi: We’re frequently involved in the connectivity of RIS with PACS. This happens in a variety of ways. Some RIS vendors already have DICOM compliant solutions, so we work quite handily with them. Most other installed base and other provider RIS systems require some kind of interfacing systems. That process works pretty well.
With efforts like IHE, it’s pretty easy to see these technologies and functionalities seamlessly integrated and less interfaced. But in the meantime, many customers have made huge investments in information systems that they’re going to need to make sure they get the right kind of returns over time. This will take some time to unfold.
Primo, Siemens: Only two years ago, interfacing a PACS with a RIS through a so-called PACS broker was state-of-the-art. Today, state-of-the-art integration is performed without a broker. Further, the PACS can now drive the RIS system, or vice-versa. Both applications can share the same PACS workstation, if so desired.
This PACS workstation can also have access to the EPR, for contextual patient info such as lab results, care guidelines, knowledge database, and to resources on the Web. RIS functionality for modality and reading worklists, reporting, and distribution of results will be more and more embedded in PACS, while RIS functions like billing and scheduling will probably shift to enterprise systems such as the HIS.
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