Planning for a Filmless Hospital

Planning for a 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.ch005
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Filmless hospital is transforming at an unprecedented rate. Physicians, nurses, clinicians, pharmacists, radiologists, emergency departments, local doctor’s offices, operating rooms, intensive care units, and insurance offices all must have instantaneous access to information from CT, MR, and X-ray images to treat their patients. Considering that these individuals could be on different floors of a hospital, across a campus, or scattered over several states, connecting them in real-time and in a cost-effective manner to the information they need is a monumental IT challenge. Detail planning is important in a filmless hospital project.
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In most of filmless hospital projects, the following plans can be identified. They are capacity plan, cost control, backup plan, emergency response plan, and workflow plan.

Capacity Planning

Like other information technology (IT) service, speed, around-the-clock availability, and security are the most common indicators of quality of service of a PACS. Since the design of a PACS varies from a clinic to a hospital, many possible alternative architecture can implement a PACS service. In order to minimize the risk of systems failures, advance planning and preparation are required to ensure the availability of adequate capacity (Dugmore, Lacy, 2006) and resources to deliver the required system performance. Projections of future capacity requirements should be made, to reduce the risk of system overload. The operational requirements of new systems should be established, documented, and tested prior to their acceptance and use (see Table 1).

Table 1
ItemModalitiesSize of
an image
Number of
studies per
year (a)
Number of
images per
study (b)
Size of storage
(Tbyte) (axb)
Total volume of storage required per year

Capacity Planning is the determination of the overall size, performance and resilience of a computer or system. It shall be monitored, tuned, and estimated for future capacity requirements to ensure the required system performance. The detailed components of a Capacity Planning initiative will vary, depending upon the proposed usage of the system, but the following should always be considered:-

  • 1.

    Identification of the total volume of various image data

The total volume of input data should include:

  • 2.

    Identification of the computing power of image archive servers (IAS) (see Table 2)Table 2

  • 3.

    Identification of the database server loading (DS) (see Table 3)Table 3

  • 4.

    Identification of the image storage (IS) (see Table 4)Table 4

  • 5.

    Identification of the Web servers loading (WSL) (see Table 5)Table 5

  • 6.

    Identification of the network bandwidth loading (NBL) (see Table 6)Table 6

  • 7.

    Identification of the image loading requirement (IL) (see Table 7)Table 7

  • 8.

    Identification of the image prefetching requirement (IP) (see Table 8)Table 8

  • 9.

    Identification of the broker loading (BL) (see Table 9)Table 9

  • 10.

    Evaluation of PACS requirement (EPACS) (see Table 10)Table 10

  • 11.

    Regular review of PACS performance

  • PACS vendor should submit half year performance report of the system.

    • 12.

      Regular capacity planning

    Yearly capacity planning should be performed based on the previous performance report of the system. The capacity plan will be submitted to management for discussion.

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