PACS divorce: breaking up is hard to do

Estrangements between PACS customers and PACS vendors may be awkward, but a number of filmless hospitals are finding it necessary to initiate divorce proceedings against their original PACS suppliers.

"We're beginning to see PACS divorces in the marketplace by hospitals facing the decision of whether to upgrade existing PACS systems that are growing obsolete or change PACS vendors," Dr. Bruce Reiner told a SCAR University audience Friday afternoon.

Reiner, director of radiology research at the VA Maryland Health Care System, estimated the average PACS lifetime at five to seven years. Many early adopters are now at that point.

The primary reason for customer discontent with first-generation PACS vendors was disappointing service and support, he said.

Divorce is the fifth stage of PACS marriages that begin with courtship as the customer is wined and dined by the vendor, Reiner said. Next comes the proposal, then consummation (funding), followed by the beginning of what everyone hopes will be a long-term relationship.

PACS relationships are meant to be marathons, not sprints, but issues of functionality and scalability, as well as support and service, cause eventual customer restlessness.

Reiner advised prospective first-time PACS buyers to take safeguards to minimize the negative impact of potential divorce by devising prenuptual agreements that specify opt-out clauses and maximize disposal options.

"One customer leaving Vendor A for Vendor B has an opt-out clause that kicks in if Vendor A ever purchases Vendor B," Reiner said.

PACS database migration is the biggest challenge associated with divorce. It isn't unusual for migration to take 30% of the time it took to acquire the data in the first place.

Expect a cost of between $0.40 and $0.60 per study, and double that if you use a third party, That may be necessary because some contracts restrict Vendor A from assisting Vendor B with data migration.

And don't expect any trade-in allowance, Reiner said.

"There is no PACS aftermarket to date and only limited salvage - strong arguments not to purchase the equipment in the first place," he said.

Also beware of penalties for early cancellation of existing agreements, he warned.

On the plus side, the time and expense of consultants and elaborate requests for proposals are not necessary with second marriages. Many customers already know what vendor is the best fit for them by now.

"People talk, especially about vendors with poor reputations," Reiner said.