We all know that “the perfect PACS vendor” doesn’t exist; however, the market is replete with vendors that will be a perfect fit for you and your organization. As you begin to review vendor demonstrations and read vendor responses to your requests for information, you will arrive at the point where you’ll need to narrow down the number of vendors to two or three. (I strongly recommend that you do not have more than three.) Once you have chosen these top vendors, then it’s time for the on-site visits, which are key in the process of choosing the right PACS for your facility. To completely investigate how well a system will work in your organization with your workflow, you must see the product being used in a clinical environment.
Prior to this point, you already should have decided which of your staff members will be attending the site visits. First, it is very important that the individuals who travel to a site have fully participated in the PACS project’s entire due-diligence process. Second, in determining how many individuals will be attending, there is no set number. Just remember that you will be visiting a clinical environment with patient-care activities; therefore, too large a group can?and will?have an impact on the site that you will be visiting. You will want key stakeholder participation, but you also will want to manage the size. For a single facility, a good number is 4?6 people; however, for a larger multi-facility or multi-radiology group, the participants can add up quickly.
As you are forming your site visit team, remember that the time required for the visits will be one day per vendor, plus one-half day to travel to the first site. (Return travel is normally the early evening of the last site visit.) So, for two vendors, you would need two-and-a-half days; for three vendors, you would need three-and-a-half days. Also, keep in mind the difficulty you most likely will encounter in coordinating the schedules of those who will be attending. You must plan ahead to make sure that everyone who needs to attend is available to invest the time. The sooner you plan these visits, the better, so give yourself 3?5 weeks.
In addition, make sure that the sites you plan to visit reflect a clinical environment that’s similar to yours?it should “look” like your facility in terms of size and clinical issues. Make a list of key clinical priorities. For example, because IT needs to validate the RIS (or HIS) interface, the reference site should have the same RIS (or HIS). Also?and most importantly?you’ll need to see the same version of PACS that you will be buying. In any event, you must drive these priorities, not the vendor. If a facility an hour away is the most convenient but is not a good environmental match, the visit will be a waste of time. Prioritize your requirements, do not make convenience trade-offs, and don’t let the vendor make trade-offs for you. And if the vendor can’t show you what you want to see, let it serve as another point to consider in your decision.
With all of these factors in mind, you still must prepare for the site visit. Your team that attends the site visit should come armed with closed-ended questions from (and for) each department. Prepare in advance what information you will be expected to observe and learn from your visits. Do not ask the persons at the reference site if they like the product. Of course they like the vendor’s PACS, as the vendor would not send you to a facility that hasn’t been happy with the product?shockingly, however, this happens from time to time. Instead, ask the persons at the site questions about actually using the system?for instance, regarding installation, how long it took and what they would do differently if they were to install the system again. The purpose of the questions is to draw the persons at the reference site into a conversation about the PACS. You don’t want to let them off the hook by just saying how terrific the vendor is. You want to gather specific data that will help you make a decision and potentially help you in your implementation.
Prepare a tool to evaluate and document what you see at each site visit. What are the key concerns from IT personnel, radiology administration, radiologists, and the like? Prepare documentation of what to ask and to whom, and then take notes at each visit. Provide input to vendors on whom you want to interview, what clinical departments you want to observe, and any other components of your evaluation tool. These notes will be vital after you and your team have returned from the site visits and begin to discuss what each stakeholder observed and how he or she ranked each vendor.
When you come back from the site visits, you must be prepared to tell your Board of Directors that you saw the PACS work. You want to show the Board that you are not at risk with your vendor of choice.
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Every step of your process is critical to making sure that you select the vendor that is best for your facility and your workflow needs. Watching a product in a clinical environment will tell you one thing: how it addressed the reference site’s workflow needs. You need to make sure that you aren’t wowed simply by not seeing film. Understand how the equipment measures up to what your facility requires to achieve your objectives. Just remember this old adage with regard to your site visits: “If you fail to plan, you plan to fail.”
Michael Mack is VP of business development at the Thomas Group Ltd (Anaheim, Calif). Having more than 20 years of experience in the medical imaging industry, Mack now specializes in PACS planning and implementation.
