The Integration Movement

When, back in the 17th century, John Donne famously wrote, “No man is an island, entire of itself; every man is a piece of the continent,” the English poet could easily have been describing the challenges and opportunities built into today's healthcare imaging communications and storage issues. Indeed, as the development of picture archiving and communications systems (PACS) evolves, the issues are becoming both more complex and more interconnected at the same time.

What the leaders of hospitals, medical groups and health systems are trying to forge — and what a small handful of patient care organizations nationwide have achieved to date — is nothing short of a transformation of the ways in which clinicians order diagnostic imaging studies, access diagnostic images, appropriately share those images with one another, store the images, and integrate the use of the images into overall electronic medical record (EMR) systems across entire patient care enterprises. Sound like a daunting task? It is exactly that, say industry experts, CIOs and clinician leaders in the trenches.

What follows is a three-part report that looks at three elements of this critical aspect of clinical care and computing. Our main story examines second-generation PACS development (both in the sense of whole PACS system replacement, and in the sense of the current, more advanced vendor offerings on the PACS market) and PACS/EMR integration at this point in the healthcare industry's evolution, while the second two look at broad PACS vendor selection issues, and the challenges of diffusion and sharing of images across whole communities.