Splitting With Your PACS Vendor

CHICAGO - In many ways, your relationship with your PACS vendor is like a marriage: good times when the system works well, bad times when it needs maintenance. There’s no doubt, though, that you’re relatively stuck together, and splitting is both painful and hard.

Changing your PACS vendor isn’t a decision to make lightly. You’ll face significant challenges to making the switch, but it can be done, Steven Horii, MD, the director of medical informatics in the University of Pennsylvania radiology department, told a group at this year’s RSNA annual meeting.

Your biggest problem, he said, is the several terabytes of data currently sitting in your existing PACS. All that information must be migrated over to your new system.

“Look at what it will take to transfer your data as far in advance as possible,” he said. “We put DICOM images in there, but the problem is that vendors don’t store our data that way. They use proprietary database tables and reassemble an image into DICOM format when you ask for it. It’s not as simple as going to the archive, putting in a flash drive, and pulling out your data.”

To get the best result, you should begin the migration with at least the past one to two years. That should cover roughly 80 percent to 90 percent of your studies, he said.

With that much stored information, though, there will be mistakes. Patients could have multiple record entries under slightly different names, studies could have been entered with incorrect request numbers, or you could have records for dead-end or orphan studies. It will take time to fix these errors, Horii said, and you will either need to do them manually or with additional software.

The time it takes to migrate your data can also present difficulties. Horii recommended you have a frank conversation with your new vendor about a realistic time frame for how long it will take to make the switch. Many times, new vendors provide time estimates based on having 100 percent to your PACS system. Unless you intend to shut down your practice until your new system is functional, that’s not a feasible option. Determine how much access you can give them each day to accurately pinpoint when your new PACS will be ready to work.

If your new vendor misses that migration deadline, you can encounter problems, especially if your old PACS is running low on storage space. In these cases, Horii said, negotiate a reduction in the migration fee so you are compensated for the added stress and delay.

In addition, you could benefit from having a “pre-nuptial” agreement with your new vendor. If your system malfunctions for any reason during the migration process, someone needs to be responsible for fixing it. Not discussing this possibility beforehand can leave you without a working PACS for a period of time.

“Your old vendor is no longer under contract to service your PACS, and the new system vendor is not likely to be enthusiastic about paying for maintenance or expanded storage in the system they’re replacing,” he said. “If you run into this problem, it’s good to know what your plan is ahead of time.”

Going into the process of switching PACS vendors having considered all the possible problems and contingencies will help you navigate the situation with as little stress as possible. Most importantly, Horii said, don’t wait until the last minute to prepare for this change.

“If you want to reduce the pain of moving to a new vendor, the most important thing you can do is plan thoroughly,” he said. “Start getting ready as far in advance as you can go.”