You and your colleagues have been discussing PACS for years; now, you’re finally moving forward. You’ve selected a vendor. You have money budgeted and approved for acquiring the technology. But now comes the period for preparation and implementation. As I’ve discussed in previous editions of “Informatics Report,” simply having the best product is not enough. Without proper execution or implementation, the success of your PACS project will negatively impact the best plan or best product.
After you have cut your purchase order, it will typically take 90?120 days for your vendor to build your system, install it, and take you “live.” This time frame is very short and will require an intense period of preparation for the facility and medical community. Key activities include:
- determining the location and handling the installation of all the network drops and power outlets;
- building and testing the interface/integration of RIS to PACS;
- testing and certifying modality DICOM readiness;
- creating current workflow documentation and post-PACS redesign; and
- communicating to the radiology staff, hospital staff, referring community, and power users of film about the upcoming change in radiology.
And, if you haven’t already done so, hiring a PACS administrator (PA) will now be required. Proper and timely preparation will have a direct impact on your “go live” timing and success.
During the first step of this preparation and implementation period, your vendor will designate a project manager from its company who will be the “quarterback” for the vendor, their resources, and the project plan. This project manager (PM) should work very closely with your PA.
A couple of quick points about project management should be noted here. Several vendors include the project-management aspect of the PACS project in their proposal; some do not. I would not advise going it alone. Many vendors include the travel and living expenses for the PM in the project; some do not. Go in with your eyes open to avoid surprises. Whether a vendor has two PMs or 200 PMs, I would encourage you to realize that not all PMs are created equal, and some are much better than others. Additionally, vendors are being challenged to meet increasing installation volumes. A doubling of their business does not necessarily mean a doubling of resources.
The PM’s first priority should be to coordinate and set up an on-site kickoff meeting. Remember that up to this point, only your PACS committee, the vendor’s salesperson, and your PA have been involved in the PACS project. The newly appointed PM has no history. At this kickoff, the PM needs to get up to speed on your project.
On the front end of the implementation, you will want to review and discuss the actual site preparation for each piece of PACS hardware for the complete system across your entire enterprise. Where do you need network drops, power outlets, mounting hardware for workstations, and placement of racks for archiving equipment? Essentially, ask what needs to be placed where, both optimally and realistically.
Also, this kickoff is a good time to begin preparing and planning your new workflows. I recommend benchmarking your current workflows for inpatient, emergency department, and outpatient for all modalities, plus the film file room. Once you have properly documented these workflows, you will need to begin making decisions on how that workflow will look post-PACS. What will happen to old films and reports? What will be your digitization protocol? How do you achieve consensus on what the workflow can be or should be? What about downtime procedures? The capabilities of the PACS configuration you are purchasing also must be considered. Consistent workflow is critical to your preparation, which is why I recommend building from your current procedures and modifying them for a filmless environment. You will want your employees to follow consistent workflow procedures so they are both responsible and accountable for their work.
Additionally, if you haven’t done so already, you must meet with your marketing team/person and begin preparing an internal marketing communication plan to be extended across your medical community. In my experience, the most effective method to spread the word and keep it visible is to develop a plan that provides everyone with an initial announcement that is followed later by a reminder news flash. You also will want to send a very targeted message to your referring community. During this time, determine who are your power users of film?those users who are placing the majority of the orders for originals or copies of film being taken out of your department. Keep the message very positive, upbeat, and informative.
With all of these activities taking place, your PM should provide a project plan that highlights all the activities that will occur over this implementation period, whether driven by the vendor or not. He or she should set up a weekly conference call to review the progress of the action items and go-live timing. It is up to you to hold the vendor accountable for its part in the implementation process and to ensure that nothing outside of the vendor’s responsibility falls through the cracks. Remember, proper planning and execution will make your implementation a success. Good luck!
Do you have a question for Michael Mack that you’d like to see answered here in “Informatics Report”? Email your questions to .
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.