Establishing benchmarks for creation of a pro-forma economic model to evaluate filmless PACS operation

The purpose of this study was to establish data points (benchmarks) to incorporate into a pro-forma cost analysis model, comparing film-based and filmless modes of operation. Prospective data were collected over a 6-year period at the Baltimore VA Medical Center (BVAMC) immediately before and after implementation of a hospital-wide PACS. These data were in turn compared with local and national VA centers during comparable time periods, to establish reference data between manual film-based (without PACS) and filmless operations (using PACS). Benchmarks utilized for the study fell into 2 broad categories: operational costs and revenues generated. Factors contributing to operational costs include space requirements, equipment, supplies, personnel, and maintenance. Factors contributing to revenues generated included examination volume, modality mix, and reimbursement rates. Collectively, these data points were incorporated into a pro-forma model that allows prospective PACS customers to compare total cost of ownership for film-based and filmless operations dependent on the unique variables of the respective institution.