Picture archiving and communication systems (PACS) have long been the core engines of health care imaging, particularly within radiology. The functions of a PACS are diverse and include various viewing capabilities (diagnostic, clinical, 3D), short-term archives, lifecycle management, reading worklists, security functions, and more.
However, since their rise in the 1990s, these all-in-one systems have struggled to keep up with today's diverse content storage requirements and greater demand for cross-departmental IT interoperability. There are a host of additional challenges with legacy PACS:
- PACS are often built on proprietary IT that makes data sharing difficult, whether between departments in one site, or across multiple sites within a system;
- PACS migrations are very costly and time-intensive; and
- Advanced modalities are frequently unsupported.
With many PACS reaching the end of their life cycle in the U.S. market, health care organizations are now exploring their options. One of these options is to focus on best-of-breed capabilities, which has been dubbed "deconstructed PACS." This IT strategy uncouples the various components of traditional PACS and reintegrates them with three enterprise-scale applications: a universal viewer, a vendor-neutral archive (VNA), and a workflow engine.
At its core, a deconstructed PACS approach replicates all of the same functions as a legacy PACS, but instead of being an all-in-one solution from a single vendor, the separate parts of a PACS become hardware agnostic. This approach not only removes proprietary barriers, but allows for easier integration with existing IT infrastructure in a standards-based format. The goal of a deconstructed approach is to allow users to view, share, and manage all forms of images and related clinical content across all modalities and specialty departments, without the traditional barriers brought about by older PACS.
Proponents of the deconstructed PACS approach feel that this strategy offers a number of benefits:
Greater efficiency: The enterprise components of deconstructed PACS reduces the number of image viewers and workstations to maintain, which in turn reduces the need for staff training and IT vendor support across different IT systems.
IT consolidation and integration: The deconstructed approach aims to give radiologists and physicians access to the content they need on demand, while also making it easier to extend the viewer, VNA, and workflow functionality to newly acquired IT systems (such as those that might come from a hospital acquisition).
Improved patient care: Through greater access and integration, PACS can now easily share images and other related content to help radiologists and physicians make faster care decisions while also building out a more comprehensive patient record.
Is a deconstructed PACS right for you?
The deconstructed PACS approach is still in its early phase of adoption, so it will take a few years before the industry can see strong examples of how this strategy provides a long-term return on investment.
For now, the majority of deconstructed PACS adoption is focused within radiology departments in larger health systems, which typically undergo extensive merger-and-acquisition activity and interface with multiple vendors across multiple PACS.
If your organization is considering a deconstructed approach, make sure to set realistic goals based on your budgets and IT needs. Many organizations have seen benefits by focusing first on implementing a standard VNA to help consolidate PACS archives and then buying the viewer or workflow solution at a later time. Taking this step-by-step approach could help ease risk-averse organizations into updating their IT infrastructure without changing it all in a single "big bang" implementation.
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