Last month, while covering an industry conference, we explored the notion that mobile health might be dead. The sense from the mHealth + Telehealth World event was a resounding no.
This week, while covering an industry conference, radiology-focused newsletter AuntMinnie.com explored the notion that picture archiving and communication systems (PACS) in their current form may be dead.
The sense from a keynote speaker at the Society for Imaging Informatics in Medicine‘s annual conference was that it was impending, according to an AuntMinnie.com commentary (registration required). The same goes for an assesment by an unnamed journal that it was time to “start planning the funeral for PACS,” according to the author of the commentary, Michael J. Cannavo, a consultant known as the PACSMan.
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That assessment is incorrect, and “used solely for shock value,” Cannavo said. “PACS is very much alive and well, and it will be for quite a long time.”
While vendor-neutral archives are helping to break down some of the data silos that hospitals have created with PACS and other health IT systems, Cannavo said that it is time-consuming and expensive to migrate existing imaging and data to VNAs. He explained:
While eliminating the various data silos that are attached to each individual clinical system is one of the ultimate goals of a VNA, having a single data repository for an entire hospital’s data also has its technical and operational limitations as well. That is why a PACS that incorporates a VNA is often configured so that less than 10 percent of all queries need to retrieve images from the VNA, and why many employ a strong prefetching algorithm as well. There also needs to be a strong disaster recovery plan for the VNA if it is to be the central data repository for all hospital data.
Cannavo then picked apart three arguments some cite for indicating the fall of PACS: the movement away from fee-for-service reimbursement; wide adoption of electronic health records; and consolidation of healthcare providers.
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While these market forces seem to favor the VNA approach, Cannavo knows how slowly healthcare changes, particularly at the enterprise level. He compared working with PACS to raising children.
“I’ve been living with PACS for 30 years and with my kids for over two decades. Nothing prepared me for the wild ride I have had with either,” Cannavo wrote. “Every now and then, PACS needs a swat on the backside, and we need to revisit our plan for raising it so it continues to becomes a productive member of the hospital enterprise. The future is in PACS and will be for quite some time.”
Photo: U.S. Navy
