Clinical experience with a second-generation hospital-integrated picture archiving and communication system

Area of Science:

• Medical Imaging
• Health Informatics
• Picture Archiving and Communication Systems (PACS)

Background:

• A novel second-generation hospital-integrated picture archiving and communication system (HI-PACS) was previously developed in-house.
• This HI-PACS incorporates four unique features not commonly found in existing PACS solutions.
• This report focuses on the clinical experiences and system performance over the past 12 months.

Purpose of the Study:

• To share clinical experiences with the unique features of the in-house developed HI-PACS.
• To evaluate the usage characteristics and user feedback for different HI-PACS components.
• To provide insights and guidance for future in-house PACS development.

Main Methods:

• Described usage characteristics of two workstations (WSs) in neuroradiology reading areas accessing data from CT and MR scanners via ATM network.
• Detailed the implementation and user experiences of an intensive care unit (ICU) server supporting multiple WSs.
• Evaluated physician desktop access to PACS data for over 100 Macintosh users and described the DICOM interfacing process with an ultrasound PACS module.

Main Results:

• Workstation usage patterns in neuroradiology were documented, with user feedback for refinements collected.
• The ICU server successfully supported multiple critical care units, with user requests for improvements noted.
• Physician desktop access demonstrated server performance and user critiques, while DICOM interfacing presented challenges and solutions.

Conclusions:

• In-house PACS development offers significant advantages but also presents inherent drawbacks.
• Clinical experience with the HI-PACS highlights the practical benefits and challenges of integrated systems.
• Three guiding axioms have been formulated based on practical experience to aid future in-house PACS development efforts.