PACS: workflow is the often missed key

When we selected our PACS system we over-emphasized our desire to archive images (“going filmless”).  We failed to really understand the entire radiology workflow.  The paper requisition is such a key today to drive workflow and document information needed by the reading radiologist.  Consequently, films are available for reading, but still sit in the queue waiting for the paper requisition and the hand-written notes.  Furthermore, the techs are still moving that piece of paper all around the department.
We had developed scenarios, but somehow we missed all of these key workflow steps in the process (ouch).  Our PACS system is great at capturing, storing and moving around images.  But we missed out on a host of workflow improvement opportunities.   So, we are busy developing workarounds using other systems and scanning solutions.

6 thoughts on “PACS: workflow is the often missed key

  1. I understand your frustration but you are not alone. I estimate that less than 20% of institutions have a fully integrated RIS/PACS but as we move forward many will be seeking to reduce inefficiencies and lower operating costs by implementing a RIS along with their new PACS purchase. The desire to integrate HL7 and DICOM more fully will power this move. If you want to keep your existing PACS try to get a RIS from that same vendor to smooth the integration curve and reduce any chances for finger pointing.

  2. We went paperless w/ the usage of Carestream’s (Kodak) Sticky Note function.
    All pertinent info is entered by the technologist into the note field, the Radiologists read fron the “Unread worklist”.
    STATs still required physical or verbal prompting, as the Radiologist can read from a STAT folder, but isn’t prompted when it has new items.
    We use Meditech HIS/RIS, but we were previously using McKesson STAR w/o issues.

  3. Indeed workflow is of vital importance. You may be interested to view a demo of the workflow the orthopedic templating and medical imaging software provided by Orthocrat.

    Product name: TraumaCad
    Company URL:

    Demo URL:

    Description:Orthopedic surgical planning and templating software system, without the use of film. Applications include prosthetics, hip replacement, knee replacement, treatment of spinal stenosis, osteotomy and arthroplasty. This medical imaging system has universal PACS integration. Free trial version available.

    Please advise what you think about this software.

    Keep up the good work.

    Paul Glen

  4. The case with workflow is often a vendor trying to conform their product to the customer. However, the customer should have been better advised during the selection process of their system. The evaluation and selection process is not just about price. It is more about finding a product that suits the organization best.

    During your initial site visits to the vendor’s show sites, you should have made workflow observation a huge portion of the visit. I know it is hard when the salesman is pushing you through the site… but you’re spending a lot of capital here, so taking your time is important.

    There are many other aspects of the system that deserve special attention on site visits that will assist you in your selection process, but one that should stand out is picking a qualified Healthcare IT Consultant. Your IT department is filled with great talent, but chances are that non have enough experience with PACS to offer you expert advice.

    You can visit my site and view my resume at

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