Application service providers: an alternative approach to PACS implementation

Several impediments have delayed the adoption of filmless imaging by the majority of radiology practitioners. These factors include concerns for technology obsolescence, limited available capital, and lack of existing information technology (IT) infrastructure and experienced personnel. Application service providers (ASPs) have begun to emerge as an alternative approach to the more traditional acquisition of picture archiving and communication (PAC) systems. This approach offers the prospective PACS customer the opportunity to outsource hardware, software, and IT services to a vendor on a fee-per-use basis. The ideal candidates for such an approach would be small to medium-sized hospitals with limited existing IT infrastructure. Using the ASP model, prospective PACS customers can purchase services unique to their needs and upgrade or expand these as needed. As ASP vendors increase their customer base, there is the potential for customers to achieve unique economies of scale not available through traditional financing means. This report discusses the economic and operational issues associated with ASPs, as well as potential limitations and future implications of this phenomenon.