Costs and benefits of picture archiving and communication systems
Journal
J Am Med Inform Assoc
Publication Date
1994 Sep-Oct
Volume
1
Issue
5
Pages
361-71
Summary:
- HIT Description: Picture archiving and communication system (PACS), an electronic and ideally filmless information system for acquiring, sorting, transporting, storing, and electronically displaying medical images. More info...
- Purpose of Study: Introduce the basic components of a PACS and review the PACS cost-analysis literature
- Years of study: 1987-1994
- Study Design: Review published studies
- Outcomes: Direct and indirect costs of PACSs, benefits of PACSs
- Settings: Hospitals
- Evaluation Method: The authors first introduced the four basic components of a PACS system, which includes image acquisition, data management subsystem, display subsystem, and network. Then they reviewed and summarized 12 cost-analysis studies that discussed eight model PACSs Ð some real, some hypothetical. Consequently, they discussed indirect costs and benefits of PACSs including impact on hospital practice.
- HIT System: Picture archiving and communication system (PACS), an electronic and ideally filmless information system for acquiring, sorting, transporting, storing, and electronically displaying medical images.
- Costs: The reviewed cost-analysis studies disagree about the costs and benefits of PACSs. Some studies found PACSs cost-saving, while others found that the systems raises overall annual costs significantly. The reported annual costs of hospital-wide PACSs varied between two and four million dollars. Studies found PACSs may be 12% to 2.7 times more expensive than film systems. The authors discussed several explanations for the differences. One is the fact that the costs of space, material, and personnel included in the studies varied. Another is the purchase prices, maintenance costs, and amortization costs differed.
- Clinical Outcomes: Non-statistically significant 17% relative reduction (4.69/1000 patient days to 3.86/1000 patients days) in preventable adverse drug events. The addition of team changes conferred not additional benefit over CPOE.
- Benefits: The authors cited a few studies to suggest that PACSs will affect physician behaviors, patient management, and radiology department work flows. PACSs also have the potential of time savings among radiologists and file-room staffs. There also was some evidence showing PACS may shorten patients' length of stay, although such effect will not likely be sufficient to produce net savings. Another benefit of PACSs is to reduce radiology-related delays associated with conventional film management within hospital clinicians and among referring clinicians.