28 Jun Tips for Choosing a New PACS

A recent Aunt Minnie article titled “U.S. PACS market rides on replacement sales” cites a report from the IMV Medical Information Division indicating that 85% of all PACS sales in 2010 were replacements.  This brought to mind the question, as a Radiology PACS user, why would I want to replace my PACS, and what should I look for when I do?  The answer is certainly complex and will be different for each user, but I will try to summarize.

There seem to be 2  basic categories for reasons why you would replace your PACS:

1. The PACS you have cannot perform the way it was advertised and thus, some requirement of yours is not being met; or
2. Your requirements have changed over time, and thus the PACS you have no longer meets those requirements.

In either case, you will certainly want to be careful when choosing your new PACS to ensure that your requirements will be met.  Here are a few suggestions:

1. Cost is always important, but be mindful to consider your total cost of ownership (TCO), and the time period in which you will use the PACS. A good PACS system that costs a little more may require fewer resources to run. Just as when you buy a car, you may see a higher sticker price, but realize that maintenance in the future will be cheaper and thus your Total Cost of Ownership with a slightly more expensive PACS might actually be cheaper because your maintenance will be less, or you can run it with one less IT headcount. Your vendors will likely help you with an ROI calculation, but make sure you do your own independent analysis as well.
2. Consider your requirements, both today and 3 to 5 years from now. What will your volume be and can the PACS scale? Where will users be located 5 years from now and will I need a web-based PACS?
3. Make sure you not only get the vendor to commit to delivering the features that satisfy your requirements, but test them as well. If the system cannot do what you want today, don’t trust that your vendor will add it later. If they do propose a future addition of a feature you are looking for, make sure you do not pay for that feature until after you get it.
4. 4) Your vendor can likely deploy a test server in your environment.  If you are comparing PACS systems, try to narrow your list to 2 or 3 possibilities, then try to run them side by side in your environment (using a DICOM Router can assist in this test scenario). Before your test, create a list of specifications you will monitor that are important to you (volume of studies in per hour, volume of studies downloaded per hour, hardware resource utilization, ease of use for doctors, ease of use for administrators, etc).  You can create a table in a spreadsheet with each vendor as a separate column, and each feature as a separate row.  Run your test and collect the data; you may choose to share your results (perhaps anonymizing the other vendors depending on sensitivity) with the vendor you will choose.
5. There is no perfect system, but if they know where their shortcomings are, you may get some commitments to fix them as part of the deal. Remember, the moment right before you sign a contract with the PACS vendor is the moment you have the most power to get them to do what you want. Take advantage of that.  Don’t be afraid to ask for what you want. The worst the vendor can say is “No.” However, chances are they will do what they can to make you happy at this stage.
6. Lastly, check references. Find 3 or 4 other customers for that product. If possible, don’t just go with the list the vendor gives you as they will likely give you only their happiest customers. Try to find users that are similar to your business. For example, if you are a 100 bed hospital, try to find another 100 bed hospital that uses that particular PACS.

The above is certainly a generic list, but it is relevent. We have been through 3 different PACS systems, and deal with customers across the country that deal with every major PACS system on the market, many whom have changed in recent years. I think if you follow the above list methodically through your PACS purchase decision, you will be far more likely to pick a winner.