When a 63-year-old man with lower abdominal pain visited his family doctor, the physician referred him to the radiology department of a local hospital for a CT of the abdomen and pelvis. Eight days and many repeated phone calls from the physician later, the results of the scan had still not been reported to the physician. Attempts to track the whereabouts of the information or report seem to have broken down, with no clear tracking mechanism ensuring that the CT scan was taken, read, and reported.

The delay may have contributed to tragic results. When the man was rushed to the emergency room, hypotensive, tachycardic, and in acute back and abdomen pain, he was found to have a dissecting aneurysm of the abdominal aorta. Though the patient was rushed into emergency surgery, the AAA had ruptured, and he died on the operating table. Much later, the patient’s widow filed suit against the hospital, the radiology department chair, the CT section chair, and the family physician, alleging gross negligence in failing to provide CT results in a timely manner. She sought damages of $750,000, and the case settled for a combined total of $500,000 from the hospital, radiology department, and family physician.

Some three months before the events, the hospital had installed a new radiology information system (RIS) and a new picture archiving and communications system (PACS). The RIS tracked the procedure through completion and interpretation, and then the images were stored on the PACS. In this case, the patient’s CT scan was listed as complete in the RIS, but there was no evidence of storage of images on the PACS. It was up to the radiologist to note which cases remained uninterpreted and to be sure that correct information was transmitted to the PACS. With no formal or technological mechanism in place to double check, an examination could slip through the cracks as it did here — and with disastrous results. And many believe that a tighter integration between PACS and RIS systems could prevent such instances from occurring, while simultaneously improving workflow efficiency and providing more complete patient information to all involved parties.

RIS has achieved a market saturation of about 80 percent, says Amith Viswanathan, senior industry analyst for market research firm Frost and Sullivan (San Jose, Calif.) and author of a late 2001 study of the RIS/PACS market. The study predicts a zero growth curve for RIS products alone; Viswanathan declares the market to be “tapped out.” The salvation for this market is that “the PACS market is growing exponentially,” says Viswanathan. His report predicts that PACS products will see a total growth of revenues of 18 percent for 2001-2002.

Please refer to the February 2003 issue for the complete story. For information on article reprints, contact Martin St. Denis