Implementation of Filmless Hospital

Implementation of Filmless Hospital

Carrison K.S. Tong (Pamela Youde Nethersole Eastern Hospital, HK) and Eric T.T. Wong (Hong Kong Polytechnic Institute, Hong Kong)
DOI: 10.4018/978-1-59904-672-3.ch007
OnDemand PDF Download:


A PACS has tremendous benefits (Bryan, Weatherburn, Watkins, Buxton, 1999) and values outside of radiology as well as internally. The biggest benefit derived from a PACS is breaking the physical as well as time barrier for information exchange. The other benefit from PACS implementation is not the decreased operating cost in Radiology. The radiology cost benefit, while significant, does not compare with the system wide benefits of networking images throughout the hospital and physician offices. All PACS implementations should start with a business plan. This is the summation of many small plans and also summarizes the global goal. The plan should be segmented into smaller separate plans for cost justification, risk assessment, capacity planning, and the last consisting of an implementation plan.
Chapter Preview

The Business Plan

A business plan (Lemke, Niederlag, Heuser, & Pollack, 2001) for setting up a filmless hospital is required for a successful project. The first thing in the plan is to define a clear objective for the project which is fully understandable by the whole healthcare organization from front line staff to senior management. The detail business plan should include the followings:

Cost Justification

This covers the area of hard and soft cost reductions and revenue enhancement (Reilly, Avrin, 2005).

  • Hard cost reduction should include low skill labour costs in the darkrooms, film libraries, film management, and film cost. However, in real situation, the Full Time Equivalent (FTE) of the labour costs may be reduced but the net cost associated with this will most likely be offset by the higher paying job of a PACS network administrator either within radiology or Information Systems.

  • Soft cost reduction will include decreased film waiting time for clinicians, no film transportation is required, improved infection control as less physical interaction is needed, and thus leads to increased productivity of staff.

  • Revenue enhancement can be experienced by setting up new services for the radiologists and clinician as a profit sharing venture. This can be realized because there is no longer the physical boundary of geographic location. Services such as providing remote medical consultation for small hospitals are now possible.

Risk Assessment

This includes an inventory checking and assessment relating to the risk of filmless hospital operation.

  • Evaluate medical equipment or imaging modality that need integration including their upgradability.

  • Evaluate personnel needs and technology education level of all users.

  • Compile a list of imaging equipment, computer equipment, network equipment, vendors, and training capabilities.

  • Check with local networking and internet service providers regarding services available in the area.

Capacity Planning

  • Set up a methodology to evaluate the needs and resource requirement.

  • Assess and evaluate the existing resources and if they can meet the current needs.

  • Determine what current resources can be utilized.

  • Assess the future needs.

  • Integrate available resources, present a plan that incorporates future resource needs.

Complete Chapter List

Search this Book:
Table of Contents
Chapter 1
Introduction  (pages 1-27)
Carrison K.S. Tong, Eric T.T. Wong
Picture archiving and communications system (PACS) is a filmless and computerized method of communicating and storing medical image data such as... Sample PDF
Chapter 2
Carrison K.S. Tong, Eric T.T. Wong
The protection of information for a healthcare organization, in any form, while in storage, processing, or transport, from being available to any... Sample PDF
ISO 27000 Information Security Management System
Chapter 3
Carrison K.S. Tong, Eric T.T. Wong
PACS disasters can, and do, appear in a variety of forms including storage hard disk failure, file corruption, network breakdown, and server... Sample PDF
High Availability Technologies for PACS
Chapter 4
Carrison K.S. Tong, Eric T.T. Wong
Fundamental to ISO 27000 (ISO/IEC 27001:2005, 2005) is the concept of an information security management system (ISMS). The information security... Sample PDF
Implementation of Information Security Management System (ISMS)
Chapter 5
Carrison K.S. Tong, Eric T.T. Wong
Filmless hospital is transforming at an unprecedented rate. Physicians, nurses, clinicians, pharmacists, radiologists, emergency departments, local... Sample PDF
Planning for a Filmless Hospital
Chapter 6
Carrison K.S. Tong, Eric T.T. Wong
More rapidly than any technological advance in medical history, filmless hospital is changing the clinical and business aspects of radiology... Sample PDF
Design of a Filmless Hospital
Chapter 7
Carrison K.S. Tong, Eric T.T. Wong
A PACS has tremendous benefits (Bryan, Weatherburn, Watkins, Buxton, 1999) and values outside of radiology as well as internally. The biggest... Sample PDF
Implementation of Filmless Hospital
Chapter 8
Carrison K.S. Tong, Eric T.T. Wong
As PACS gains widespread use, the importance of Quality Control (QC), Quality Assurance (QA), and Business Continuity Plan (BCP) in PACS is rising.... Sample PDF
Quality Control, Quality Assurance, and Business Continuity Plan in PACS
Chapter 9
PACS Quality Dimensions  (pages 140-153)
Carrison K.S. Tong, Eric T.T. Wong
A large number of studies have attempted to identify the factors that contribute to good PACS quality, such as that shown by Reiner et al (2003).... Sample PDF
PACS Quality Dimensions
Chapter 10
Customer Oriented PACS  (pages 154-169)
Carrison K.S. Tong, Eric T.T. Wong
During the early development phase of PACS, its implementation was mainly a matter of the radiology department. This is changing rapidly, and PACS... Sample PDF
Customer Oriented PACS
Chapter 11
Carrison K.S. Tong, Eric T.T. Wong
Nowadays it is hard to think of any applications in modern society in which electronic systems do not play a significant role. In aerospace and... Sample PDF
Design for PACS Reliability
Chapter 12
Carrison K.S. Tong, Eric T.T. Wong
There are some medical errors for which preventability is rarely questioned. These include medical errors such as wrong site surgery, wrong... Sample PDF
PACS Failure Mode and Effects
Chapter 13
Carrison K.S. Tong, Eric T.T. Wong
Economically speaking, it is interesting to see that over the years, the question as to whether PACS is cost-justifiable has not been easier to... Sample PDF
PACS Network Traffic Control
Chapter 14
Human Factors and Culture  (pages 225-243)
Carrison K.S. Tong, Eric T.T. Wong
Human factors engineering (HFE) is the science of designing systems to fit human capabilities and limitations. These include limitations in... Sample PDF
Human Factors and Culture
Chapter 15
PACS Monitoring  (pages 244-263)
Carrison K.S. Tong, Eric T.T. Wong
The present study advocates the application of statistical process control (SPC) as a performance monitoring tool for a PACS. The objective of... Sample PDF
PACS Monitoring
Chapter 16
Carrison K.S. Tong, Eric T.T. Wong
To illustrate the benefits of implementing QM in PACS, a successful case based on the Six Sigma approach is given below. It involves a project... Sample PDF
Quality Management Benefits
Chapter 17
Epilogue  (pages 288-297)
Carrison K.S. Tong, Eric T.T. Wong
Today’s filmless radiology through PACS provides greater speed and superior image quality. However, when workflow is encumbered by inefficiencies... Sample PDF
Appendix A
Appendix B
Appendix C
About the Authors