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PACS - The verdict is in

August 3, 2008
by jlee
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OK, so I know that it’s been a little while since I posted anything.

The last few weeks have been action-packed. Between finalizing a decision on PACS, beginning implementation, lining up additional resources to help, and other various projects and initiatives, lately “several days have ganged up on me at once…”

The end result of all that is that I’ve not taken the time to post.

I know that I still owe you some thoughts on what qualifies a person as an “IT professional”. I wrote recently about the challenges of finding the ideal educational background. I have been gathering some thoughts about certifications as an indicator of expertise- stay tuned for more on that soon.

Several months ago I talked about the challenges of vendor selection in today’s environment of consolidations, acquisitions and mergers. I illustrated those thoughts with references to our PACS vendor selection, which had drawn out for more than two years- spanning major changes in the vendor landscape.

Since we had been IDX customers for years, the whole Stentor, Philips, IDX, GE, Dynamic Imaging merry-go-round was enough to make anyone’s head spin.

Just in case there’s anyone out there wondering “I wonder what Harvey over at Holzer Clinic ever decided about PACS”, here’s a summary…

We liked the Philips (formerly Stentor) PACS application, and had actually recommended them as the vendor of choice several months ago, when we’d been looking to do a shared system with an affiliated hospital. Even then, though, we had really liked the Dynamic Imaging product- and their people.

Once the aforementioned hospital pulled out of the joint effort and DI joined the GE family, that changed the landscape enough to make us reevaluate.

We ended up giving GE/DI the nod for the PACS application. We are sticking with Philips for the CR equipment, which actually makes up almost half of the total project costs and nearly double the cost of the PACS application.

That sounds a little like splitting the baby, but I think that we made the right decisions for each component of the system.

Truth is that most PACS applications are agnostic to the modalities that feed them. Philips had done some neat stuff with integrations between their app and their CR modalities, but those benefits seemed less important than the promise of future integrations with the GE RIS and PACS platforms.

And while many seem enthralled by the Philips subscription pricing model (which enables you to hide your capital purchases), I’m not all that enthusiastic. If you’re limited in your ability to support your systems internally, you might be able to make a case to pay Philips to do it for you. For me, it just feels like extra expense while we limit our own ability to support and integrate our systems.

The Philips CR equipment had advantages over the other options in the area of mammography readiness and speed. We do have a partnership agreement with them that, combined with the fact that we’ve been buying a LOT of expensive imaging equipment, resulted in attractive pricing for some pretty high-end equipment.

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You know, for me it almost goes beyond the "culture" of a company. These companies have what I think of as a "personality". There are persistent traits of the company that seem to survive personnel changes and even leadership transitions.

The profile of Epic that Anthony did recently uncovered some of those traits in that company.

Compare the "personalities" of Epic, Cerner, McKesson, GE Healthcare, Allscripts, eClinicalWorks. All are successful, but they're all really different.

While I wouldn't say that the company's personality is the most important factor in ing single products, it absolutely plays a role, perhaps more so in determining who ends up on your short list of key vendors.

Other things being equal, we tend to associate with people (and companies) that we're comfortable with.

I've often compared signing a major agreement with a vendor to getting married. That's a little bit of an exaggeration, but you get the point.

By the time you make the investment in time, money, training, integration, etc., getting "divorced" is such a pain it's hardly worth it unless you've REALLY got problems.

So you better make sure she's not just cute.

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