Procurement

Evaluation of the current environment and understanding where industry is headed constitute an important aspect of any enterprise. With the introduction of technology into healthcare organizations, we are presented with opportunities that had not been available before. Consider this hypothetical situation. We may start with a certain highly structured radiology department that possesses commendable human-powered processes and optimized workflows in every facet of the radiology business and provides a delivery service to an institution. This radiology department may have already had a very low percentage of film loss. The department may have already had an outstanding turnaround time in the despatch of reports to clinical peers, by having placed a transcriptionist next to a radiologist during dictation and ensuring swift film distribution to clinical practice. Perhaps each radiologist had a specific area to serve in for a specific period of time, where he/she worked with a technologist to sustain volume from specific modalities in clinical practice. However, perhaps as the department moved toward reading with greater specialization, it was recognized that those specialists that were most qualified to read certain exams may not have been in the correct location. New modalities started to produce significantly larger data sets and impeded our ability to sustain

our attempt at emulation of the printed film model of professional interpretation and clinical distribution of radiological studies. Our ability to consult with colleagues was constrained by geographical proximity. Moving toward the electronic era had become inevitable. A good start for an evaluation of the current environment is a review of the state of modalities such as CT, MRI, CR, and so on and the assessment of their compliance with industry standards with regard to the modality work-list, data, and image communication. The next step is to proceed with evaluation of the environmental readiness. This is a perfect opportunity to review current reading and control rooms and examine as to how they can be altered to accommodate the new digital environment and workflows that will be in place postPACS deployment. Validation of sufficient cooling, of appropriate illumination, of the sound-proofing of reading areas, and so on is essential. Furthermore, one should proceed with evaluation of the network infrastructure not merely in terms of the endpoint workstation’s connection but with regard to the overall network requirements of the PACS system of choice, ranging from the scanners to the data centers, workstations, the final archives, and clinical distribution of the images. Some systems have distributed architecture and some have central architecture. Each system topology has its advantages; more important is the fact that each system requires a different network infrastructure and reliability.