Considerations when consolidating PACS archives into a third-party archive

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When I meet with hospitals that are considering consolidating PACS archives into a single VNA, they’re usually looking to do so for one of two reasons (or both if they fit). First is the simple financial motivation to reduce the cost and complexity of managing multiple, disparate archives. The second reason is clinical and their desire to give access to patient data across departments. For example, allowing the cardiology department with a first-time patient to see previous studies done by the radiology department, like a 2-view chest CR.
If you’re considering PACS archive consolidation, here are a few things to think about as you get started that can help you architect the right solution for your organization.

1. Do your current PACS applications support third-party systems?

This is an easy question to answer (just ask your PACS vendors if you don’t know), but a big roadblock if any of them don’t support a third-party archive. If any of your current PACS don’t support a third-party archive, your journey to consolidation needs to start with a PACS upgrade or potential other workarounds.

2. How do you want data to be shared…or not shared?

When you consolidate PACS into a single archive, you can choose to have data in different PACS to be “sharable” or you can choose to have the data from the separate PACS available only to the PACS that it came from. Depending on your situation, one approach will make more sense.

Making the data sharable, where the cardiology department can view images from radiology in my example above, makes great sense from a patient care perspective when the department or hospital PACS archives that you’re consolidating have a high degree of cross-pollination of patients. In that case, patient care can be greatly improved by enabling different departments to access records from the same patient.

In other situations, sharing data across PACS really isn’t necessary nor would it improve patient care. For example, if your hospital is part of a large system that spans multiple states and it’s rare that a patient would visit more than one hospital in the system. 

3. What’s your patient naming schema?

A third question to ask early on, especially if you’re part of a larger hospital or hospital system, is how does your organization assign patient identifiers and how will those identifiers let you find patient data in a consolidated archive.

In some hospitals, I’m assigned a MRN as a patient and regardless of where I go in the hospital or hospital system, I always have the same identifier. In other hospital systems, I’ll get a new MRN if I visit another branch.  If you decided in question #2 that you want patient data to be sharable across PACS and your different departments or hospitals have different identification schemes for patients, you’ll need a strategy to normalize your data before it goes into the third-party archive, or leverage an EMPI (enterprise master patient index) to reconcile the patient but keep the same MRN schema.  EMPIs are expensive, but very helpful in long-term plans. On the other hand, if you decided in question #2 that data doesn’t need to be shared, the different identification schemes may not be an issue.

There are many other questions when it comes to PACS archive consolidation. What’s at the top of your list? We’d love to see your suggestions in the Comments box below.

Originally posted on: 7/22/2013 1:42:04 PM

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