Posted: May 25th, 2022

Picture Archiving and Communications System

PACS

Business Case Study: Budget Proposal and Justification for Adoption of a Picture Archiving and Communications System (PACS)

Picture Archiving and Communications Systems (PACSs) are increasingly replacing traditional film and other media printing techniques in medical imaging. PACSs benefit patients, physicians, and administrators through improved turnaround times between imaging and result deliveries and ultimately through cost savings to the medical institution. All key stakeholders, namely those listed above as well as investors/operating boards of the medical institution, will ultimately benefit from the adoption of this technology. The objectives of this service are reduced costs and increased efficiencies of medical image creation, transmission, and review, which will also improve the efficacy of care available.

The initial cost of implementing this technology will be considerable, and will also vary depending on the current technological assets and capabilities of the medical institution. Academic literature provides scant concrete information as to the cost of these systems, but estimates of approximately two-and-a-half million dollars appear to be reasonable budgetary targets for the initial adoption of this technology. Ongoing costs will also be incurred through updates to the technology, but these must be measured against the cost savings that the adoption will begin to create immediately. The key risk involved in this proposed technology adoption is the increase of long-term costs, over which the institution will have little control or predictive power, but again the savings will more than offset these costs.

The management of the suggested service will be handled primarily by the IT department/personnel already in existence at the medical institution, along with physicians and other staff that utilize the various medical imaging technologies. These personnel can make recommendations to the proper procurement officials as changes and equipment are needed. The other changes that will need to be made to the institution and its other practices are minimal; the PAC system will essentially replace the existing print technologies by which medical images are currently produced and analyzed, but will require few if any changes outside of these procedures. Dedicated equipment and space for this equipment will need to be created, but this can likely be created through the removal or the adjustment/reconfiguration of current image reading rooms at the institution.

Introduction

The purpose of this business case study is to propose the adoption of a picture archiving and communications system, or PACS. These systems, which have become increasingly common and increasingly reliable since they first began development a decade ago, provide methods for the production and analysis of medical images taken through a variety of different technologies and techniques without the use of specialized films or other printing needs. Instead, PACSs allow for the digital creation and transmission of images, with equal and often greater precision, detail, and clarity than traditional film techniques, and with a much lower per-image cost than older technologies, as well.

This paper will provide a detailed assessment of the initial and ongoing costs of the proposed PACS adoption, as well as of the cost savings and other benefits that this technology will provide. The case for change will be clearly laid out, with the improvements to service and increased cost efficiency of using such systems forming the primary basis for the recommendation made herein. An overall analysis of the proposal and the practicalities of actually achieving his adoption in different budget scenarios will also be provided, along with an assessment of the risks that are an inherent part of any significant change in a medical situation, and those risks that are specific to the adoption of a PACS itself. Management techniques for this technology adoption will also be described, and final recommendations for the implementation strategy will be the ultimate provision of this proposal.

The Case for Change

Changes in technology have made it possible to achieve better and cheaper results from medical imaging techniques (Rath 2010; Jackson & Langlois 2005; Hoffman 2008; Slomka & Baum 2009). While there are several possible alternatives to the traditional production of medical images from MRIs, X-rays, and other similar technologies, the most cost effective method for image generation and transmission as well as the method that provides the greatest clarity and accuracy in the images produced is found through the use of PACSs (Maydell et al. 2009; Hoffman 2008; D’Asseler et al. 2000). Adopting this technology will produce significant long-term cost savings and improve efficacy and efficiency of treatment (Cannavo 2005; Tan & Lewis 2010).

The cost savings is one of the key benefits that is expected as a result of the proposed adoption of PACS technology, with initial outlays being recouped within four to six years of implementation and cost savings totaling half a million U.S. dollars or more within a decade of moving from traditional film technologies to a PACS according to current estimates (Hoffman 2008; Rath 2010). Other benefits include a greatly increased rate of production and transmission of medical images, both of which can occur at a near-instant level with a PACS as opposed to significant delays that often arise with the need to print images, and backlogs that occur in many institutions and processing organizations that deal with high volumes of input and large workloads (D’Asseler et al. 2000; Maydell et al. 2009; Slomka & Baum 2009). The benefits of implementing the proposed system, then, are both financial and medical in nature.

This proposal has not yet been brought to any of the major stakeholders that would be affected by the implementation of this system, or those whose approval would be required before the adoption and implementation of this technology could be permitted to proceed. There is a great deal of evidence, however, that physicians, administrators, and patients would all sign off on this proposal if given the opportunity to witness the technology in action (Jackson & Langlois 2005; Cannavo 2005; Shakeshaft 2010; Tan & Lewis 2010). The benefits and simple changes inherent to this system compared to traditional imaging techniques directly impact each of the above-defined groups of stakeholders through cost savings, improved speed and accuracy of care, and the increased portability of medical images.

Analysis of PACS Adoption

The primary objective of any major change in medical practice is and must always remain the improvement of the care offered to patients. There are many ways to achieve this improvement in care. Better health outcomes, more cost-effective procedures that do not lose any efficacy or may in fact increase it, and increased accuracy and/or speed of diagnosis and care plan determinations all form parts of this larger objective, and all are also brought about by a transition form traditional image production to techniques to a PACS (Rath 2010; Shakeshaft 2010; Jackson & Langlois 2005). The primary alternative to PACS adoption are remaining with traditional techniques or transition to paper- rather than film-based hard copy image production; the former represents no change in practice with no benefits or risks and will lead to a lack of competitiveness, while the latter introduces a less significant cost savings while also producing images of poorer quality, in some cases unacceptable (Maydell et al. 2009).

Up-front costs for the adoption of these technologies is considerable, amounting to approximately two-and-a-half million dollars for an average-sized hospital organization (Hoffman 2008). This cost covers only the initial purchase of equipment and integration with existing institutional infrastructure; other ongoing technology costs will also be incurred and training and adaptation costs that cannot be directly measured must also be acknowledged (Cannavo 2005; Kalyanpur et al. 2009). Given the cost savings that these systems represent over film-printing techniques, however, the long-term cost savings of these technologies are well wroth the substantial up-front fees (Hoffman 2008; Rath 2010).

Most of the major effects of the adoption of a PACS are largely if not entirely quantifiable, with cost savings, improvements in turnaround for image creation and analysis and the making of decisions all measurably different with such systems than in traditional image production techniques. There will also be an enormous though unquantifiable environmental benefit, however, as there are very little or no physical materials involved in the rendering of each image in such systems, and certain benefits to patients and physicians such as easier transmission and increased portability are also difficult to quantify (D’Asseler et al. 2000; Kalyanpur et al. 2010; Shakeshaft 2010). It is through cost savings and the improved efficiency and efficacy of care that stakeholders will derive the largest benefit from adoption of this technology, however.

It is difficult to provide concrete numbers as to the costs and savings that will be presented by adoption of a PACS, as technology costs are fairly volatile. They are following a general downward trend, however, and could thus be considerably lower than the estimated two-and-a-half million dollars of the most recent estimates that can be founding the literature (Hoffman 2008). Other ongoing costs are associated with maintaining and updating serves and connected image viewing equipment, as well as with hardware and software upgrades that often take place every five years and annually, respectively (Cannavo 2005). These maintenance costs will run an estimated four hundred-thousand dollars per year, averaged out over each five-year period and following the initial outlay for equipment purchases, which initially seems to present a great deal of excess expense (Cannavo 2005).

Estimates of cost savings from the reduction in film costs as well as through reduced work hours needed for the creation of images and the reading of images by physicians will lead to an average annual cost savings of between five hundred- and seven hundred and fifty-thousand dollars a year, leading to an overall cost benefit of one hundred- to three hundred and fifty-thousand dollars a year compared to traditional film production techniques (Hoffman 2008; Rath 2010). A ten percent reduction in costs could be achieved through increasing the competitiveness of a the bidding process amongst companies that produce the technologies necessary for a successful PACS, as well as through reducing the time and personnel involved in training programs. This latter is not especially advisable, however, as indirect costs will likely be created though reductions in the efficacy of the adoption and a reduced improvement in treatment efficiencies and speeds (Kalyanpur et al. 2010). At these rates, breakeven points typically occur within a decade of adoption, with immediate benefits to cash flow apparent for most institutions (Hoffman 2008).

Risks

Given the degree to which these technologies have been vetted and supported in the literature, the risks of PACS adoption are minimal. There is some possibility of decreased cost benefit and prolonged breakeven periods due to unforeseen costs, and there are also risks associated with the safety and reliability of digital storage systems for medical images (Cannavo 2005; Kalyanpur et al. 2010). The management of initial costs and providing the necessary for funds for system maintenance and archival processes will mitigate these risks to a large degree, however.

Service Management

The governance of this project will fall primarily to the administrative and medical heads of the radiology and/or imaging department(s) at the identified medical institution, as it in is this/these departments that the changes will be implemented. Staff physicians and other personnel that utilize medical imaging equipment will need to be apprised of the changes, though the actual job functions for many individuals will not be impacted. Equipment procurement will be handled by appropriate administrative staff under the guidance of lead physicians/medical department head(s), and IT staff will be brought in to ensure compliance with existing technological standards. These standards are primarily important to ensure compatibility with other institution equipment and with the equipment and software that exists in other offices and institutions to ensure portability and communicability.

Though there are many complexities that will result out of the transition from traditional film-production imaging and reading techniques to the utilization of a PACS, the steps necessary to achieve this transition are actually few and relatively straightforward. Purchasing and installing the equipment, while dismantling and disposing of obsolete film-based equipment, is the initial step in this transition process; training is really the only other step that needs to occur prior to completing the transition to this technology. The ease of use of this technology once basic steps are mastered will allow for a very quick increase in the efficiency of use, leading to practical benefits from the transition almost immediately.

Change Management

Despite the relative ease of this transition, there will of course need to be some explicit measures for change management put into place in order to ensure that there is no interruption in the provision of medial services in the medical institution. Personnel training can take place concurrent and even prior to the purchasing and acquisition of equipment, limiting the practical difficulties that can arise for physicians and technicians and increasing the positive aspects of the user experience (Kalyanpur et al. 2010; Tan & Lewis 2010). Department heads will manage the transition of operations from the traditional mode of image processing and reading to the use of the new technologies, while administrative staff and IT personnel will handle the practicalities of actually obtaining and installing the necessary equipment and software and ensuring compatibility with other institutional equipment and processes.

Conclusion

PACSs require a significant amount of upfront expenditure, though these costs are in no way prohibitive to most medical institutions of medium size or larger. The cost benefits that they provide over the long-term lead to a breakeven point between five and ten years after initial adoption of the technology, however, and continued savings on a significant basis beyond this point. The benefits of added clarity and hugely increased efficiency and portability of the images produced are also major assets of this technology, and represent indirect cost advantages as well.

References

Cannavo, M. (2005). “The new PACS puzzle: Cost and technological change.” Imagining economics (July). Accessed 20 October 2010. http://www.imagingeconomics.com/issues/articles/2005-07_04.asp

D’Asseler, Y.; Koole, M.; Van Laere, K.; Vandenberghe, S.; Bouwens, L.; Van de Walle, R.; Van de Wiele, C.; Lemahieu, I. & Cierckx, R. (2000). “PACS and multimodality in medical imaging.” Technology and health care 8(1), pp. 35-52.

Jackson, P. & Langlois, S. (2005). “Introduction of picture archiving and communication system at The Townsville Hospital.” Australasian radiology 49(4), pp. 278-82.

Kalyanpur, A.; Singh, J. & Bedi, R. (2010). “Practical issues in picture archiving and communication system and networking.” The Indian journal of radiology & imaging 20(1), pp. 2-5.

Hoffman, T. (2008). “Beyond Film.” Computerworld 42(19), pp. 32.

Maydell, A.; Andronikou, S.; Ackermann, C. & Beuidenhout, A. (2009). “Comparison of paper print and soft copy reading in plain paediatric radiographs.” Journal of medical imaging and radiation oncology 53(5), pp. 459-66.

Rath, P. (2010). “The cost effectiveness of implementing picture archiving and communication systems (PACS) in the operating room.” Current orthopaedic practice 21(1), pp. 89-93.

Shakeshaft, J. (2010). “Picture Archiving and Communications System in Radiotherapy.” Clinical oncology 22(8), pp. 681-7.

Slomka, P. & Baum, R. (2009). “Multimodality image registration with software: state-of-the-art.” European journal of nuclear medicine and molecular imaging 36, pp. 44-55.

Tan, S. & Lewis, R. (2010). “Picture archiving and communication systems: A multicentre survey of users experience and satisfaction.” European Journal of Radiology 75(3), pp. 406-10.

---

Get Professional Assignment Help Cheaply

Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?

Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.

Why Choose Our Academic Writing Service?

• Plagiarism free papers
• Timely delivery
• Any deadline
• Skilled, Experienced Native English Writers
• Subject-relevant academic writer
• Adherence to paper instructions
• Ability to tackle bulk assignments
• Reasonable prices
• 24/7 Customer Support
• Get superb grades consistently

 

Online Academic Help With Different Subjects

Literature

Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.

Finance

Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.

Computer science

Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!

Psychology

While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.

Engineering

Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.

Nursing

In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.

Sociology

Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.

Business

We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!

Statistics

We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.

Law

Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.

What discipline/subjects do you deal in?

We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.

Are your writers competent enough to handle my paper?

Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.

What if I don’t like the paper?

There is a very low likelihood that you won’t like the paper.

Reasons being:

• When assigning your order, we match the paper’s discipline with the writer’s field/specialization. Since all our writers are graduates, we match the paper’s subject with the field the writer studied. For instance, if it’s a nursing paper, only a nursing graduate and writer will handle it. Furthermore, all our writers have academic writing experience and top-notch research skills.
• We have a quality assurance that reviews the paper before it gets to you. As such, we ensure that you get a paper that meets the required standard and will most definitely make the grade.

In the event that you don’t like your paper:

• The writer will revise the paper up to your pleasing. You have unlimited revisions. You simply need to highlight what specifically you don’t like about the paper, and the writer will make the amendments. The paper will be revised until you are satisfied. Revisions are free of charge
• We will have a different writer write the paper from scratch.
• Last resort, if the above does not work, we will refund your money.

Will the professor find out I didn’t write the paper myself?

Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.

What if the paper is plagiarized?

We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.

When will I get my paper?

You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.

Will anyone find out that I used your services?

We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.

How our Assignment  Help Service Works

1.      Place an order

You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.

2.      Pay for the order

Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.

3.      Track the progress

You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.

4.      Download the paper

The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.

PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET A PERFECT SCORE!!!

---