In Maine, several hospitals share a PACS

A disparate group of hospitals in Maine has been sharing a PACS for five years, achieving the same results as newer systems with advanced technologies such as XDS, according to a presentation Wednesday at the RSNA meeting.

The Maine Medical Center, MaineHealth, and the medical center's radiology information system have successfully integrated 10 different business entities into a single, tightly integrated combination RIS/PACS/Dictation system, said Dr. Matthew Ralston, a radiologist, and Bob Coleman, radiology informatics director at the hospital.

Key technology solutions for the system involved capturing remote data in the hospital RIS and then subjecting it to an integration engine before it reaches the PACS, Coleman said. Another key element was the use of an electronic patient index feature that unites data from patients with different identification numbers from outside facilities.

Using the multi-institutional capabilities of the medical center's PACS and RIS, along with custom-built interfaces to the RIS systems at the remote sites, the hospital was able to combine data from different imaging centers and hospitals into a single, unified archive, they said. Any radiologist at any participating site has automated access to pertinent prior studies of the same body part from anywhere else in the system.

Sharing images across different institutions has been highlighted at this year's RSNA meeting. A demonstration project involving 16 different vendors shows how a new standard for sharing imaging data, XDS-I, developed under the RSNA's Integrating the Healthcare Enterprise initiative, allows rapid sharing of imaging and report data among different PACS and facilities.

The experience at Maine Medical Center illustrates the advantages and challenges of this approach. Radiologists have access to prior images and reports that may have been collected at another, unrelated facility, making them more efficient. But the system must link competing institutions, overcome bandwidth concerns, involve multiple stakeholders, and unite separate patient identification systems.

Elements of the system include a small PACS at each site connected by wide area networks that feed into the central PACS at Maine Medical Center. The system is operated on a nonprofit basis with a small per study fee to cover costs.