A brighter future for PACS?

Healthcare IT industry calls for national framework to aid procurement of next-generation PACS solutions

Healthcare solutions experts are calling for a national framework to be introduced to allow trusts to procure next-generation PACS technology and to open up the UK market for suppliers.

In an interview with Building Better Healthcare (BBH), Peter Harrison and Ronan Kirby from Siemens Healthcare said the expiry of PACS contracts delivered via the much-criticised NHS National Programme for IT (NPfIT) would help to open the market to genuine competition, benefiting both customers and solutions providers.

Harrison, divisional director of imaging and therapy, said: “The national programme and the local service providers (LSPs) were quite a disruptive influence on the market. PACS represented the low-hanging fruit within the scope of NPfIT, as the programme was struggling and PACS was relatively easy to deliver. As a result, where PACS was installed, it is being used, unlike some of the electronic patient record (EPR) systems, which have not been fully delivered or embraced.”

Post NPfIT we have seen the market opening up to ourselves and other non-LSP PACS providers, and that’s of great benefit to end users

Under the NPfIT, Siemens was not selected as a PACS provider by the local service providers and, as a consequence and like many other companies, found the market in the UK largely closed for the best part of a decade. In this time the company was nevertheless active overseas and continued to develop its solutions.

Harrison said: “Post NPfIT we have seen the market opening up to ourselves and other non-LSP PACS providers, and that’s of great benefit to end users.”

He added that said some LSPs had offered discounts for PACS contract extensions. But he challenged the value of such offerings, telling BBH: “How can trusts be assured they are obtaining value if they have no alternative reference point? The best way of testing value is clearly by going to the market and an open market will ensure value by virtue of open competition. It is a good thing for trusts and suppliers that are seeking to re-engage the NHS market in England.”

And he supported calls for a national framework to be introduced specifically for PACS, which would pre-select vendors capable of providing effective solutions, and enable trusts to call-off PACS solutions. This would provide access to latest generation technology confident that vendors have been subject to stringent pre-qualification.

“What has been happening in the last few months is that individual trusts have been coming to the market with their own needs, which are typically very detailed,” said Harrison. “However, there is a lot of commonality of requirements among these trusts. With PACS procurements, there is a lot of work involved for purchasing managers and the supply community alike. If there was a framework agreement then this could facilitate lower cost and more agile procurements - to everyone’s benefit.”

While the national programme showed that a one-size-fits-all approach did not work, there are calls for suppliers to provide systems that can be universally integrated.

Harrison said: “The national programme failed to provide an appropriate sharing solution. The imaging exchange portal provided something of a sticking plaster. It does its job well, but ideally what we want is a national solution that is a bit more functionally rich and which has been planned according to standards, ensuring that solutions from multiple vendors share a common interface.”

Where PACS was installed, it is being used, unlike some of the electronic patient record (EPR) systems, which have not been fully delivered or embraced

Kirby, Siemens’ syngo PACS solution business manager, added: “Vendor-neutral archiving and transfer is a key need and something for which we think there should be new standards, ensuring that anyone who provides PACS can connect to a central portal.”

These standards and the framework would provide a springboard for the introduction of next-generation PACS systems, which are rapidly seeking to provide healthcare organisations with an end-to-end imaging collection and storage system.

Kirby explained: “With hindsight there are a lot of things we can do better this time around.

“As an industry we need to do more around image sharing and following patient pathways. We also need to look at the integration of different imaging modalities across a hospital. Because all imaging is done digitally, people are thinking about the need to have other imaging data in the same place, for example movies, endoscopy and pathology information. They want all imaging data on a patient available to everyone with the relevant security.

“These advancements provide a streamlined workflow environment for radiologists, which improves throughput and provides patients with a better service.”

The best way of testing value is clearly by going to the market and an open market will ensure value by virtue of open competition. It is a good thing for trusts and suppliers that are seeking to re-engage the NHS market in England

Harrison added that remote access for PACS would also be a key advancement, telling BBH: “The patient wants to know that images are going to be delivered and reported on ASAP and the radiologist is very busy and wants the convenience of being able to access studies from wherever they happen to be. They want the information that will be of most use. They want PACS technology that will help prepare images and allow them access in the most effective manner.

“The benefit of newer technology is that historically PACS would have been accessed from a dedicated computer workstation in a particular location. Now radiologists can access studies from different work stations in different locations, and this can even be extended remotely. That’s really important for radiologists, but also for patients. This is key enabling technology to ensure prompt reporting, so that the most effective therapies can commence without delay.”

PACS can further be complemented by Computer Aided Diagnosis whereby the radiologist can be supported by additional analysis of image data.

With these improvements in mind, Siemens has recently signed the first UK deal for its syngo.plaza PACS solution, which in conjunction with its syngo.via advanced 3D visualisation technology is providing a next-generation image reporting solution for Russells Hall Hospital in the West Midlands.

With PACS procurements, there is a lot of work involved for purchasing managers and the supply community alike. If there was a framework agreement then this could facilitate lower cost and more agile procurements - to everyone’s benefit

Replacing its existing Siemens solution as part of a managed equipment service contract (MES), the hospital’s 2,500 PACS users will now benefit from fast image reading on any workstation. The system stores user preferences, organises images based on individual clinicians’ needs and offers a fast overview of a patient’s history. It also assists in complex clinical challenges, using post-processing applications as required, and will enable the hospital to expand functionality as its requirements change.

Stephen Cotton, the hospital’s IT manager, said: “syngo.plaza is the next-generation PACS and will allow us to stay ahead of the game and provide the best quality imaging to patients. Users will have the same functionality from whatever workstation they use, allowing them the flexibility to view images in 3D and merge a number of images into one. The solution will also allow us to maximise the up time of the system so we can deal with patients more efficiently.”

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