Installing a hospital-wide PACS network all at once can yield cost savings, according to an article published online in the Journal of Digital Imaging.
"With low initial capital outflow and a sufficient number of examinations, a hospital-wide PACS with carefully controlled expenditures brings the advantages of computer technology and has a favorable economic impact," the authors wrote.
To determine the cost differences between film-based radiology and a hospital-wide PACS network, researchers from Taipei City Hospital-Heping Branch and National Taiwan University in Taipei, Taiwan, measured cash flow and operating costs of PACS and film-based operations over an eight-year period (JDI, June 14, 2006).
The government-owned hospital decided to convert to a filmless operation all at once to avoid running costs of dual systems and to reduce the cost of laser film. PACS was implemented between January and March 2004.
As part of the transition, the hospital purchased three high-capacity computed radiography (CR) processors and one autochest CR reader. The initial capital expenditure for PACS was $699,457. Maintenance for the first two years was included in the contract, according to the authors.
Following full PACS implementation, two of the five full-time film library employees were dismissed, with the remaining three switched to handling registration and scheduling. After installing PACS and educating users, the hospital was able to achieve a 100% reduction in film within two weeks, with the exception of the mammography and remote fluoroscopic units.
The authors found that the estimated net present value (NPV) for PACS operation from 2004-2012 was $1,598,698, offering savings of $485,157 compared with $2,083,856 for film-based operation. Payback for PACS will be realized by four years, they noted.
In other findings, the costs of CR and image plates accounted for 40% of the initial capital expenditures in PACS, followed by computer hardware (29.8%), workstation software (8.9%), storage (8.3%), servers (7.8%), Web access (4.3%), and network (0.9%).
The cost of film, chemicals, and film jackets made up 58% of the total costs of film operation, with film processor costs contributing 22%. Wages for film library clerks made up the remaining 20%.
The study showed that implementing PACS all at once produces net savings, according to the authors.
"For hospitals intending to go filmless soon, this study offers evidence, obtained through differential cost analysis, in support of PACS implementation," they wrote.
However, the authors acknowledged several risk factors with this implementation approach.
"Acceptance by clinical physicians; a user-friendly interface for registration employees, technicians, radiologists, and physicians; and integration of HIS-RIS and PACS are the most difficult components," they wrote.
Cooperation between IT and radiology departments and general agreement in the workforce may be easier to achieve for small and medium-sized hospitals, according to the authors.
"Larger medical institutions may face more difficulties from resolute physicians who wish to adhere to traditional film viewing," they wrote.
By Erik L. Ridley
AuntMinnie.com staff writer
June 15, 2006
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Consumer LCDs fare well for radiography reading, April 29, 2006
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