Users, including physicians and clinical staff, of Medical Information Systems will need training in adapting to soft-copy images and reports. Most recently trained physicians and clinical staff are familiar with the EHR. However, there are still many physicians and clinical staff that may resist reading reports and reviewing images on monitors.
The following requirements apply for IS / EMR / PACS: unlimited concurrent user support, potentially unlimited long-term and on-demand storage capacity, a proven encryption system.
Suppliers of IS / EMR / PACS are responsible for supporting users in the following methods: 24/7 telephone support, on-site technical assistance within one day, training at installation, remote system monitoring, and remote system updates.
PACS Suppliers offer many software features that add functionality to the systems. In general, a Picture Archiving and Communication System will better serve the facility when it has more functionality.
Some of the important PACS software features include 3D analysis, image manipulation of multiple parameters including magnification and window leveling, to fit study and user needs, workstation-independent user log-ins, administrator-controlled work lists, and automatic notification of prior exams.
A web-based image or report access is another requirement for IS / EMR / PACS, with a variety of image manipulation tools and patient search tools.
Both lossless and lossy compression of images should be offered. It should have GUI-based tools for patient and hardware management, automatic fail-over of critical components, and a UPS standard power backup.
If the IS / EMR / PACS system fails, there should be an automatic alert to IT support.
The database should automatically be backed up at least once an hour .
These systems should be able to interface with other hospital systems. A system should feature broker less and bi-directional interfacing, year 4 IHE, and report dictation interfacing, and the supplier should guarantee uptime of at least 99%.
To facilitate future additions to the network, all newly purchased equipment must be compatible with the current version of the DICOM standard.
Facilities are encouraged to ask DICOM conformance statements from suppliers. These should explain in detail which information objects, service classes, and data encodings are supported by their Image Analysis and Archives systems.
The fact that a system meets the requirements of DICOM, does not guarantee that the data is indeed stored in DICOM format. It is important to remember that when migrating data to a new Image Analysis and Archives system.
Before purchasing a PACS system, facilities should ask suppliers about the issues surrounding data migration in the future.
Buyers should carefully plan the installation of these Image Analysis and Archives systems. Sometimes an entire room may be dedicated to hardware. They should consider airflow and use of floor space and cabling.