PACS – Renew or Rethink?


Jamie Clifton
PACS – Renew or Rethink?

Many Picture Archive and Communications System (PACS) contracts are coming up for renewal or being renewed now. However, is a straight PACS renewal or replacement contract for another five, seven or ten years with an existing or new vendor really the best solution? Or is it simply perceived to be the easiest route? Or are Trusts really exploring the possibilities available to them?

At BridgeHead, we believe PACS contract renewals present the ideal opportunity for NHS Trusts to take a step back and examine their overall data management strategy. Patient data is, or should be, a strategic asset and should be viewed in isolation from the application that creates it. That’s not to say PACS and other core healthcare systems, such as the Electronic Patient Record (EPR), aren’t critical – they are. But, in our view, healthcare providers need to focus on patient data and its impact on the wider healthcare economy. Then, we believe Trusts will know whether they should simply renew their systems or rethink their patient data management strategy completely.

Feeling locked-in?

So, do the end of PACS contracts truly provide the opportunity to rethink a hospital’s data management strategy? Or is imaging data intrinsically tied to the PACS applications of most Trusts? How many hospitals feel ‘locked’ into their PACS because they do not have a truly agnostic and separate repository for data, such as a next generation Vendor Neutral Archive (VNA) or an Independent Clinical Archive (ICA)? We believe there are far too many hospitals facing the challenge of ‘vendor lock-in’.

Because of this, for many healthcare providers, a change of PACS vendor now or in the future is perceived to be difficult and/or costly. But, rather than migrating data from one PACS to another, by choosing an independent VNA or ICA approach at this juncture, healthcare providers can ensure that this is the last major data migration they ever need to make, whilst creating an environment for enterprise data sharing.

By removing the dependency between the application and the management of the information it creates, Trusts can free themselves from this ‘lock-in’ and have greater choice and flexibility on how they store, protect and share patient data.

We need a 360-degree patient view

What do the various stakeholders in the healthcare market require from their systems today in respect of patient data? Most healthcare providers we talk to say that they want patient information to be stored in a way that makes it easily accessible and available as part of the wider 360-degree patient view. They want to see medical images managed intelligently in a central repository alongside other non-imaging data from a range of hospital departments such as Cardiology and Endoscopy, as well as Radiology, rather than effectively “stuck” in a departmental application.

Many hospitals will have multiple applications across various hospital departments, often with little or no integration. This can make it difficult for clinicians to access the full range of patient data they need (whether that’s medical images, clinical reports or information from any department across the Trust) when they need it, for example, when consulting with a patient or participating in Multi-Disciplinary Team (MDT) meetings.

There is also a growing desire to share images across other departments within a hospital, as well as with other Trusts in a region, especially when we consider Sustainability and Transformation Plans (STPs) and the underlying Local Digital Roadmaps (LDRs). But, is that really possible in a mixed PACS vendor environment? A truly independent VNA or ICA is designed specifically to provide a central access point for patient data available to other hospitals within a region, regardless of whether that data exists in a multi or sole vendor PACS environment.

Why is the management of patient data important?

There are two main themes here – accessibility for a 360-degree view of the patient and the security and protection of patient data.

By maintaining the integrity of patient information in a system separate from the PACS or other core systems, such as the EPR, that fully adheres to healthcare data standards, clinicians can access the full range of patient data (for example, imaging data, as opposed to just Radiology reports). This applies equally to MDT meetings, where the accessibility of the entire patient history will help improve clinical efficiencies and patient care by ensuring that data is available to those that need it, when they need it, and from any location.

In relation to security and protection, we have witnessed the fallout of WannaCry and other data security breaches; the ramifications of data loss or system outage are extremely serious, both from a patient care perspective and the subsequent fines from the Information Commissioners Office (ICO).

Furthermore, in May 2018, the penalties will come into effect from non-compliance with the General Data Protection Regulation (GDPR) legislation. This means healthcare providers will have increased responsibilities for ensuring patient data is appropriately secured. The GDPR demands that any European healthcare facility has robust storage and data security processes. As a next generation VNA or ICA offers a central repository for patient data, it’s easy to enact a Trust’s policies to ensure compliance with GDPR as well as other regulatory or governance requirements.

Patient data is the real asset

In five or ten years who knows what healthcare data will look like? Patient generated data will be included as part of the record (we are already seeing this) and will need to be made accessible to clinicians and patients alike. Analytics will certainly play an increasingly important role. But, does this change how we manage and share data? What we can be certain of is that the importance of, and reliance on, patient data in a healthcare environment will only continue to grow.

At BridgeHead, we believe that patient data is a strategic asset and that an independent VNA or ICA should sit alongside and integrate with the PACS, EPR and other core systems to become a Trust’s single, enterprise-wide repository for all clinical imaging and referenceable patient information. The repository should be capable of ingesting all manner of data formats from a variety of applications and departments to offer an all-encompassing, future proof solution to the management of hospital data. So, before you sign the renewal contract for your PACS, EPR or other system, take a minute to consider your patient data management strategy – it could make all the difference to your organisation.

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