The other day a friend of mine forwarded to me a link to the Imaging Technology News eNews web site. My friend encouraged me to look on the left bar of the web page and find the invitation to participate in their current survey. The question was “Will PACS/RIS meet the meaningful use criteria to qualify for incentive dollars?” If the survey is still running, you can check out the current results here.
Last time I checked, 33% thought that PACS/RIS would meet the criteria and another 30% thought that there’s a good chance it will.
I’d love to see the demographic of the survey participants, and I’d love to see a list of their assumptions.
I’m among the 30% that responded with a solid “no”, convinced that the PACS/RIS as we know it will not qualify for Meaningful Use, because it simply doesn’t have what it takes, and most likely never will.
If the survey participants gave serious thought to the question, they should have realized that the most critical component of what it takes to sustain Meaningful Use will be “ease of use”. Most physicians are far too busy to learn and remember how to use more than one image viewer. Most physicians are far too busy to switch back and forth between multiple viewers to assemble a montage of all the relevant clinical information in a single viewing window. That’s exactly what will happen if we continue on the present path of developing individual URL links between the Physician Portal and the data elements being stored in each of the specialized departmental PACS, and using those department PACS viewers to view the data. This approach shouldn’t make sense to IT, and it won’t make sense to the physician users. So the participants must have been assuming that an all-encompassing Enterprise PACS will emerge, a single PACS that will embody all of the specialized department PACS requirements and thereby become the Uni-PACS.
In my opinion, it is highly unlikely that a current generation Radiology or Cardiology PACS or any other departmental PACS for that matter, will evolve in the next few years into an Enterprise Data Repository capable of managing the patient’s longitudinal record of all clinical information. I seriously doubt that they will be able to manage all of the image information, much less all of the non-DICOM and non-image data objects.
Managing all of this clinical data is probably the easier part. The harder part will be providing all of the expected display and processing applications that are specialized for each of the contributing imaging departments. This is not to say that some of the larger vendors won’t try to become an all-encompassing enterprise PACS, or at least claim to be the Whopper of PACS, but I don’t see that happening.
In my opinion, the more likely scenario will be the Enterprise Neutral Archive fulfilling the role of the Enterprise Data Repository, and the (interfaced or embedded) UniViewer will provide the unified set of viewing tools that the physicians will use to access and view all of a patient’s clinical information, both the image and the non-image data being managed by that Neutral Archive.
Today, more and more Health Care organizations are “getting it”. They see all of the advantages of separating the “archive” data management applications from the departmental PACS. And it’s a natural to add a viewer to this new generation Archive. Sooner or later, each of the PACS vendors will “get it”, and at that moment the push will be on in their R&D groups to further differentiate their department PACS products with the specialized applications unique to that department. Their PACS will have to become an even better, specialized tool for each department, because the Neutral Archive will have already become the tool of choice for the Enterprise. Meaningful Use will be much easier to achieve if the physicians know they only have to go to one repository and only have to use one viewing application to assemble all of the relevant clinical information in a single viewing session. Get it?