Learn how to assess and select the right RIS/PACS solution for your practice.

The current health care environment creates many challenges for providers, and radiology enterprises are no exception. No radiology organization—whether hospital department, imaging center, radiology service provider, or teleradiology group—is immune. Each strives to provide high-quality patient care in the demanding context of changing requirements and winnowing profit margins.

Radiology enterprises are employing creative strategies to overcome these challenges in the current health care climate. Some are expanding their geographic reach, others are developing more subspecialty focus. In all cases, as oppositional as the objectives may appear, achieving maximum efficiency while maintaining high quality is becoming imperative to business success.

In an increasingly technology-driven world, it is no surprise that information technology systems are key contributors to the success of a radiology enterprise. Critical tools for achieving maximum efficiency and the best possible patient care include a Picture Archiving and Communications System (PACS) and a Radiology Information System (RIS). In theory, a robust RIS and PACS will automate manual processes, including scheduling, patient registration, billing, and results delivery. These solutions should reduce turnaround time, increasing radiologist productivity and overall efficiency—and thus contributing to cost reduction.

Of course, theory and reality are often at odds. If all vendors’ claims were true, RIS and PACS technologies would guarantee maximum efficiency and enable every radiology practice to flourish. Instead, many organizations are on an eternal quest to find a better technology solution that more successfully meets their needs.

While there is no shortage of RIS and PACS products, there is a need for more effective solutions to the challenges faced by radiology enterprises. As vendors tout new or existing RIS and PACS products, the radiology market must ask some important questions in order to overcome current and future challenges.

Ed Moore, CEO, United Imaging Consultants

Is a Single-Vendor Solution a Truly Integrated Solution?

There are several hurdles in realizing the full potential of a RIS and PACS to increase efficiency and improve care. The first is integration—the systems must pass data back and forth, working with instead of against each other. In addition, they need to integrate with other systems, such as third-party billing software. While this requirement may be obvious, it is not easily achieved by many vendors.

One clear solution to the integration challenge is to select a RIS and PACS from the same vendor. My experience in the industry shows that a combined, single-vendor RIS/PACS solution is the way to go. But it’s not that simple. Many large vendors in this space offer both solutions, but they do not necessarily work well together. Big companies have swallowed smaller vendors, acquiring their product lines and selling preexisting, stand-alone solutions under the same label. True integration between a single vendor’s RIS and PACS offering may be limited at best, even nonexistent. You must be prepared to scratch below the surface to determine the true extent of an integrated RIS/PACS solution.

Does the Feature Set Meet Your Business Needs?

Critical feature areas for a RIS/PACS solution include patient registration and scheduling capabilities, comprehensive workflow management tools, components for different modalities, effective reporting tools including integrated voice dictation, and flexible results delivery mechanisms. The ability to provide a single, unified worklist supports remote reading and subspecialty services. Ultimately, the solution must perform reliably and securely, while offering an intuitive, easy-to-use interface.

Most importantly, it is necessary to evaluate whether the RIS/PACS feature set meets your operational and business needs. An effective solution will boost staff productivity, reducing manual work and duplicate data entry, and eliminating information loss. That same solution also should optimize resource utilization and volume throughput of patients and imaging. Increasing service levels and referring physician satisfaction leads to increased revenues and profitability—achieving the business success and delivering the premium care that all radiology organizations strive for.

Will Your Solution Evolve with the Market?

Intelerad?s InteleSuite? will round out the company?s established IntelePACS? product with a new, complementary RIS solution, InteleRIS?.

An effective RIS/PACS solution must also evolve with the changing needs and regulations of the market. Take reporting requirements, for example—in our practice, how we report today versus how we reported 5 years ago is significantly different. The requirements of the Healthcare Reform Act will further evolve our reporting methods.

Optimally, a RIS/PACS will evolve with—or ahead of—changing market requirements. A radiology enterprise needs a RIS/PACS solution that facilitates long-term success, rather than just short-term relief. It is impractical and unnecessary to make a hefty new investment every few years.

It is essential to ensure a vendor’s commitment to the continued research and development of its products. The vendor must be forward-thinking and possess extensive market expertise. Optimally, the company will be committed to helping customers achieve meaningful use, while providing opportunities for customers to give input to the product development process. High-quality service and support is also critical to a successful deployment.

An Effective Solution Can Have Far-Reaching Impact

In short, to realize its full potential as a business tool, a combined RIS/PACS solution must provide:

  1. A truly integrated RIS/PACS offering, preferably from a single radiology-focused vendor.
  2. A comprehensive feature set that is capable of meeting current and future business needs.
  3. An evolving solution for which the vendor demonstrates ongoing investment in research and development, as well as service and support.

In a perfect scenario, the impact of a highly effective RIS/PACS solution is far-reaching. It will provide the office staff effective tools for scheduling and patient registration, while making the billing process more efficient, more accurate, and less manual. Workflow will be automated and customized to an organization’s processes—increasing radiologist’s efficiency, more effectively balancing workload, and enabling an increased focus on subspecialty reads. Communication with referring physicians will improve, increasing the timeliness, flexibility, and completeness of the results delivery process.

Ultimately in this perfect world, turnaround times are minimized, the quality of interpretations is enhanced, patient satisfaction increases, and client/hospital contracts are extended and become more stable. If this scenario is realized, a radiology organization is truly enabled to do more with less. With reimbursements per procedure trending lower and lower, every organization seeks software solutions that can have this direct positive effect on the bottom line.

Does the Perfect Solution Exist?

With the potential benefits understood and the decision criteria defined, does the perfect RIS/PACS solution exist? The answer to this question surely varies by individual organization. A better understanding of the questions to ask does not guarantee delivery of the right answers—but it does help to eliminate the wrong solution.

My practice is representative of many. With 32 board-certified radiologists, we read primarily for hospitals and also operate an imaging center. Our locations are spread over a wide metropolitan area; we employ location-based as well as traveling staff. We are currently using a RIS from one vendor, a PACS from another, and a billing system from a third. We interface with different RIS, PACS, and Hospital Information Systems (HIS) at almost every hospital location that we serve. And while it sometimes seems that this wide variety of technology works against us as much as it supports us, we have learned valuable lessons from our struggles.

I am particularly intrigued by the promise of a new, single-vendor RIS/PACS solution recently announced by Intelerad. A smaller but impressive player in medical imaging business solutions, Intelerad is squarely focused on the radiology market. Intelerad knows the business of radiology, and demonstrates an understanding of the ever-evolving needs of health care providers—as evidenced, perhaps, by this latest announcement.

Intelerad’s upcoming InteleSuite™ offering will round out the company’s established IntelePACS® product with a new, complementary RIS solution, InteleRIS™. We adopted IntelePACS in 2006 as the PACS for our practice, and we are very impressed with that product’s feature set, performance, and reliability. Intelerad’s culture is very customer-centric; customers play integral roles in the company’s intensive R&D processes.

In light of the “perfect scenario” outlined above, InteleSuite has great potential. In addition to a well-deserved sterling reputation for service and support, Intelerad has proven expertise in technology integration. Another product, InteleOne®, provides a unified reading environment capable of combining data from disparate PACS, RIS, and HIS solutions. To accomplish this, Intelerad has integrated its technology with that of more than 65 technology providers. This bodes well for the seamless integration of its own paired RIS and PACS solutions.

Structured Approach to Product Selection

Regardless of the specific vendors you may include in a RIS/PACS search, it is important to approach the evaluation process methodically. Because a system change affects everyone, it is best to form a solution review team involving representatives from various parts of your operation—radiologists, of course, but also representatives from IT and contract administration. It is helpful to involve imaging center management, or other personnel who can represent the front desk and patient registration functions. These various perspectives create a more complete picture of the pros and cons of each option.

Allow a few months to identify and properly vet vendors. Plan to test-drive the software. Speak with existing customers to acquire important perspective on how the vendor functions after the sale—how problems are handled, and whether the vendor comes through in a crisis situation. Assess customer service and satisfaction, the delivery of new functionality, and opportunities to provide input to the product development process.

Successfully identifying the best RIS/PACS solution for your business can have a high payoff—not just in patient care and profitability, but also by differentiating yourself in the marketplace. Do not treat the decision lightly. Enable your business to achieve maximum efficiency and revenues, while delivering the best patient care possible.


Ed Moore is the CEO of United Imaging Consultants, LLC, based in the Kansas City area. The group provides diagnostic and interventional radiology services to hospitals and imaging centers.