Collaborative Picture Collaborative Picture Archiving & Communication Archiving & Communication

System (PACS) ProjectSystem (PACS) Project

SISU Medical SystemsSISU Medical Systems

July 17, 2006July 17, 2006

“I have traveled the length and breadth of this country

and talked with the best people, and I can assure you that data processing is a fad that won't last out the year.”

The editor in charge of business books for Prentice Hall, 1957

Acronyms & DefinitionsAcronyms & Definitions

PACS – Picture Archiving Communication PACS – Picture Archiving Communication System. Defined as a system that enables System. Defined as a system that enables the capturing, storage and retrieval of the capturing, storage and retrieval of digital images.digital images.

SAN – Storage Area Network. Defined as a SAN – Storage Area Network. Defined as a high-speed sub-network of shared storage high-speed sub-network of shared storage devices.devices.

HCIS – Health Care Information System.HCIS – Health Care Information System.

RIS – Radiology Information SystemRIS – Radiology Information System

Overview of SISUOverview of SISU

Non-profit information technology Non-profit information technology consortium for hospitals & clinics.consortium for hospitals & clinics.

Currently 14 members throughout Currently 14 members throughout Minnesota.Minnesota.

Shared technology and I.T. staff.Shared technology and I.T. staff. SISU is SISU is NOTNOT a vendor! a vendor!

Typical Rural Radiology Typical Rural Radiology EnvironmentEnvironment

The patient’s perspective:The patient’s perspective: May have to wait for a May have to wait for a

radiologist consult while image radiologist consult while image is couriered to the radiologist.is couriered to the radiologist.

In general, is at the mercy of In general, is at the mercy of delays related to the physical delays related to the physical media being shuttled between media being shuttled between multiple locations.multiple locations.

Patient may be transferred as Patient may be transferred as an end result.an end result.

Typical Rural Radiology Typical Rural Radiology EnvironmentEnvironment

From the radiologist’s From the radiologist’s perspective:perspective:

Delay in reading films in Delay in reading films in emergency situations.emergency situations.

Difficulty in meeting customer Difficulty in meeting customer expectations.expectations.

Typical Rural Radiology Typical Rural Radiology EnvironmentEnvironment

From the hospital / clinic From the hospital / clinic perspective:perspective:

Stuck in the middle between the Stuck in the middle between the patient and the radiologist.patient and the radiologist.

Images not always where they are Images not always where they are needed, when they are needed needed, when they are needed resulting in inefficiencies.resulting in inefficiencies.

Costs associated with film, storage, Costs associated with film, storage, courier services, etc.courier services, etc.

Every healthcare organization Every healthcare organization could build its own PACS could build its own PACS

solution, but…solution, but…… they would miss the opportunity to share the they would miss the opportunity to share the

risks and costs associated with maintaining risks and costs associated with maintaining common elements of a PACS environment.common elements of a PACS environment.

… they would need to build their own they would need to build their own methodology for connecting the radiologist to methodology for connecting the radiologist to their site.their site.

… the radiologist would likely have multiple the radiologist would likely have multiple means of accessing multiple locations and means of accessing multiple locations and need to learn multiple PACS environments.need to learn multiple PACS environments.

… the radiologists would likely miss the the radiologists would likely miss the opportunity to share resources such as on-call opportunity to share resources such as on-call duty with other radiologists.duty with other radiologists.

“A pessimist sees the difficulty in every

opportunity; an optimist sees the opportunity in

every difficulty.”Sir Winston Churchill

NS ACentralized

Archive System

Image Cache / DICOM

Broker / Web Access

Modalities

Diagnostic Workstations

HCIS / RIS

Internet

T-1 or bette

r

VPN VPN

Clinical Workstations

VPN

Network Configuration

Medical Facility

Radiologist Office

Radiologist Home

Shared PACS Network - Current Shared PACS Network - Current StatusStatus

Seven hospitals have already purchased jointly from Seven hospitals have already purchased jointly from our selected vendor: Grand Rapids, Crosby, Aitkin, our selected vendor: Grand Rapids, Crosby, Aitkin, Ely, Bigfork, Deer River, Detroit Lakes.Ely, Bigfork, Deer River, Detroit Lakes.

Five hospitals are in the process of installing Five hospitals are in the process of installing computed radiography in preparation for PACS. This computed radiography in preparation for PACS. This project was assisted by a joint state grant. These project was assisted by a joint state grant. These hospitals include Grand Marais, Cook, Cloquet, hospitals include Grand Marais, Cook, Cloquet, Moose Lake, and Mora.Moose Lake, and Mora.

Integrating our healthcare information system with Integrating our healthcare information system with the PACS for five of our facilities. This interface will:the PACS for five of our facilities. This interface will: Pass ADT information to the PACS.Pass ADT information to the PACS. Pass radiology order information to and from the PACS.Pass radiology order information to and from the PACS. Allow the users to call up an image from within our Allow the users to call up an image from within our

enterprise medical record system.enterprise medical record system. Pass transcription to the PACS.Pass transcription to the PACS.

Shared PACS Network – The FutureShared PACS Network – The Future

Four additional hospitals are evaluating Four additional hospitals are evaluating and preparing to purchase PACS and preparing to purchase PACS technology - Cook, Cloquet, Mora, technology - Cook, Cloquet, Mora, Hastings, Hutchinson and Moose Lake.Hastings, Hutchinson and Moose Lake.

Likely begin the integration between Likely begin the integration between our healthcare information system and our healthcare information system and the PACS for the remainder of the the PACS for the remainder of the hospitals.hospitals.

Continue enabling access to HCIS / Continue enabling access to HCIS / PACS environment by remote PACS environment by remote radiologists & physicians.radiologists & physicians.

Advantages of Working Advantages of Working CollaborativelyCollaboratively

Negotiated pricing with our PACS vendor.Negotiated pricing with our PACS vendor. Shared hardware costs.Shared hardware costs. Reduced maintenance costs.Reduced maintenance costs. Reduced interface costs through standardization.Reduced interface costs through standardization. Data resides in at least two locations at all times Data resides in at least two locations at all times

allowing member sites to go film-less.allowing member sites to go film-less. Reduced pricing on computed radiography (CR).Reduced pricing on computed radiography (CR). Ability to contract jointly for radiology services.Ability to contract jointly for radiology services.

Examples of Shared Examples of Shared ExpensesExpenses

Centralized Long-term Archive:Centralized Long-term Archive: HardwareHardware LicensingLicensing MaintenanceMaintenance

Potential savings in “like” modality Potential savings in “like” modality interfaces.interfaces.

Savings in “like” HCIS vendor interfaces.Savings in “like” HCIS vendor interfaces. Shared information technology staffing for Shared information technology staffing for

archive and network maintenance.archive and network maintenance. Shared internet / VPN access expenses.Shared internet / VPN access expenses. Reduced on-going training expenses Reduced on-going training expenses

through shared vendor training sessions and through shared vendor training sessions and sharing of expertise with other members.sharing of expertise with other members.

NS ACentralized

Archive System

Modalities

Diagnostic Workstations

HCIS / RIS

Clinical Workstations

Current PACS Configuration

Medical Facility

Less ResilientLower Cost

Highly Resilient

Higher Cost

DICOM BrokerImage Cache

Server

Web Access Server

NS ACentralized

Archive System

Modalities

Diagnostic Workstations

HCIS / RIS

Clinical Workstations

Even Lower Cost

Configuration

Medical Facility

Less ResilientLower Cost

Highly Resilient

Higher Cost

DICOM BrokerImage Cache

Server

Web Access Server

Thank You!Thank You!

Sisu Medical Systems / SolutionsSisu Medical Systems / Solutions5 W 15 W 1stst St, Suite 200 St, Suite 200Duluth, MN 55802Duluth, MN 55802

(218) 529-7900(218) 529-7900(218) 529-7920 / Fax(218) 529-7920 / Fax

www.SisuNet.orgwww.SisuNet.org