UCSF looks to Agfa to improve PACS network developed in-house

Deal also includes PACS development aspect

Agfa, of Ridgefield Park, NJ, and the University of California, San Francisco, have entered into a partnership for the installation and development of PACS technology. The deal will add Agfa's PACS workstations to a PACS network developed in-house at UCSF, and should also result in new PACS products to be developed cooperatively. Agfa and UCSF announced the partnership with a press conference and open house Sept. 11.

UCSF became an early PACS pioneer when it established its Laboratory for Radiological Informatics in 1992 and set out to develop its own PACS software and network, which went online a year later. The hospital has enjoyed many efficiencies from its efforts in PACS, but eventually realized that in order to grow its network and reach its goal of becoming completely filmless, it would be easier to go with a commercial vendor than to continue to invest in its own PACS technology, according to Dr. David Avrin, an associate clinical professor of radiology and co-director of UCSF's clinical PACS program.

"The barrier we were up against was that we were starting to deploy a lot of workstations," Avrin said. "We were a research lab making the transition to a clinical support group, and we did not want to provide our own in-house seven-day, 24-hour support for radiology clinical workstations."

UCSF began contacting PACS vendors about a possible partnership, and found that Agfa was the company that most closely shared the university's belief that a key component of PACS is the software that enables the movement and distribution of images around an enterprise. Agfa also enabled UCSF to convert to a PACS that supports the DICOM 3.0 standard, which the university's earlier system did not support because it was developed before the standard was ratified.

The two sides began collaborating in April, with Agfa installing a number of workstations that enabled UCSF to expand its PACS network. Agfa also installed archive controllers, a short-term RAID archive, and a long-term optical disk archive, and set up a connection to the UCSF legacy archive that contains the four years of imaging studies collected with the university's earlier PACS network. UCSF also added Agfa computed radiography readers, and connected nuclear medicine and ultrasound to the network. Agfa estimates the value of the UCSF purchases at about $2.5 million.

The agreement is more than just a straight equipment sale, however. UCSF and Agfa will also develop future PACS products, and the university will be able to provide Agfa with valuable feedback on how clinicians are using PACS. On the new product side, the two parties are collaborating on several fronts, such as an effort to add a teaching file database to Agfa's Impax PACS line.

A key to the success of the UCSF network is its use of an asynchronous transfer mode (ATM) backbone to transfer data, which UCSF installed to handle its in-house PACS network. ATM has the bandwidth to handle the transfer of large imaging studies quickly, according to Avrin.

In general, UCSF would characterize its experience with its home-grown system as a success, even though the hospital eventually needed the support of a vendor to go to the next level, according to Dr. Ronald Arenson, chairman of radiology.

"Our in-house system worked remarkably well. We were very happy with it, we've learned a lot from it, and a lot of patients benefited from it," Arenson said. "But we reached that point where to make a change, it became very difficult to handle the cost. My general philosophy has always been 'If you can buy it, do so,' because the cost of development and support can be staggering, especially for academic institutions or other institutions."