CHICAGO - So you've decided to implement a PACS. Now comes the tricky part: pitching the hospital CEO or CFO on the business benefits -- both clinical and economic -- of a digital image management network.
In a talk during a refresher course Sunday on "Making the Business Argument for PACS", Dr. Bruce Reiner of the Baltimore VA Medical Center (BVAMC) provided some tips for prospective PACS purchasers.
Cost-justification for PACS can be challenging. Financial models available are very complex and idiosyncratic to specific institutions, Reiner said. In addition, very few detailed and rigorous cost-benefit analyses have been performed.
When preparing a PACS proposal, it's helpful to keep in mind benefits that would most influence CEOs, Reiner said. For example, in a survey conducted two years ago by a BVAMC study team, several CEOs reported that their top three most important factors for PACS justification were: cost reduction, access to images and reports, and increased productivity that could potentially lead to staff reductions.
Perceived competitive advantage in the marketplace, making use of state-of-the-art technology, and effect on scheduling were considered to be the three least important factors in PACS justification by the surveyed CEOs.
PACS can improve radiologist productivity, owing to benefits such as ready availability of prior films and fewer interruptions. Of more interest to CEOs, however, are productivity improvements for technologists, Reiner said.
Another BVAMC study discovered that technologist productivity for general radiography increased about 1000 exams per FTE following implementation of PACS. These benefits were likely derived from a number of factors, including the transition from traditional x-ray to computed radiography, Reiner said.
Lost films declined from 8% with film to 0.2% with PACS, while retake rates dropped from 5% to 0.8%. The researchers found that technologist fatigue increased with film, while elimination of film conferred improved workflow advantages.
In addition to cost savings, PACS may also offer the possible of revenue gains through increased utilization of imaging procedures, Reiner said. The BVAMC documented a 43% increase in exams per admission with PACS. During the same two years in the study (1993 and 1996), the national VA utilization of imaging procedures declined 4%. Outpatient procedures climbed 21%, compared with a 19% decline for the national VA system.
The researchers believe the increased utilization is attributable to PACS benefits such as faster report turnaround time and better access to images and reports.
"Utilization seems to be proportional to accessibility," Reiner said.
Ultimately, however, the need for cost justification will likely fade away as electronic medical records become commonplace over the next several years, Reiner said.
"PACS will become the standard of care over the next several years and will be a necessary part of the overall [electronic medical record]," Reiner said.
By Erik L. Ridley
AuntMinnie.com staff writer
November 26, 2001
For the rest of our coverage of the 2001 RSNA meeting, go to our RADCast@RSNA 2001.
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