The following is a brief synopsis of our Webcast featuring John Evers and Herman Oosterwijk that was broadcast on Sept. 17, 2009. Click here if you'd like to view the complete presentation.
The majority of PACS systems are running at a sub-optimal level due to a lack of re-engineering for IHE profile implementations. Proper IHE implementations can eliminate unnecessary steps and can greatly increase the data integrity and efficiency of your PACS.
A poll held during our Webcast found that only 4% of our audience used the DICOM Modality Performed Procedure Step (MPPS) for all modalities. The MPPS communicates the exam status, number of images and procedures changes from a modality to the PACS and RIS. We also discovered that only 28% used MPPS for some modalities, while 65% had not yet implemented this feature.
This seems to demonstrate that nearly two-thirds of PACS implementations still do not use the IHE scheduled workflow capabilities to their fullest extent. Based on our poll, it’s a safe assumption that there are quite a few practices using unnecessary steps and actions, as well as inefficient workflow scenarios, to manage their PACS.
Apparently, full integration of RIS and PACS still has a ways to go.
At a time when many users are switching PACS vendors, or considering moving to a new system, issues with poor integration might not be due to a lack of functionality on your current deployment, but rather a lack of understanding of the full potential of your RIS/PACS integration. I have visited institutions where the department had paid for integration using the IHE workflow profile capabilities, but never switched it on; worse, they did not even know they paid for this functionality.
How can you ensure that your RIS/PACS are fully integrated and optimized? First, map the current workflow, and identify the potential bottlenecks. Second, look at the workflow as described by the IHE Use Case scenarios. These scenarios not only detail standard department operations, but also show how to deal with unscheduled exams, patient updates, procedure updates, multiple orders for the same procedure (such as a chest-abdomen-pelvis CT) and other "exception" cases.
The next step is to make an inventory of the current IHE support and capabilities of all your modalities and the PACS and RIS, which can be verified by the IHE integration statements of these devices. It is very likely you’ll find that you have some devices that do not have MPPS, or even Storage Commitment, configured. Your final step is to make a plan to upgrade the devices that are lacking these features, and then roll out the workflow changes. I know this is quite a bit of work, but the results of having a much more efficient operation will be worth it.