| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The digitization of radiology was initiated by a nonradiologist. Godfrey Hounsfield introduced radiologists to the digital world with his invention of CT in 1973. Hounsfield, of course, is not a radiologist; he is a scientist, an engineer trained in electrical and mechanical engineering. He had previously developed the first mainframe computer in England. His employer, EMI Ltd., loaded with monies garnered by recording the Beatles, gave Hounsfield the opportunity to freelance, to explore any and all applications for computers as Hounsfield saw fit—anything that met his fancy. Fortunately for us, Hounsfield fancied radiology because of his beliefs that radiography was inefficient and that there was a lot to be gained if computers were used in capturing information from X rays. And boy was he right! He did it. He designed and built the first computerized axial tomographic machine, the EMI CAT scanner, and published the results in the British Journal of Radiology in 1973 [1]. And the rest, as they say, is history.
MR imaging followed on the heels of CT. MR imaging also required digitization. Radiologists got used to viewing images on a monitor and the more we viewed, the better we liked it. Soon the unthinkable occurred. Some radiologists came to the conclusion that all imaging examinations should be digitized, including radiographs. And computed radiography was born. At first there were many doubters who moaned, "Why do we need to digitize? Plain films have been around for 100 years and serve quite well."
But the innovators persisted; the PACS revolution was launched, and has recently hit full stride. There is no turning back. All previous doubts should be dispelled. For instance, in this issue, Kundel et al. [2] address the issue of the diagnostic quality of PACS versus hardcopy radiographs in the emergency department. Obviously, the possibility that there might be a loss of diagnostic information when using the soft copy alone is a matter of genuine concern. Not to worry, however, because these researchers have found that the diagnostic information on PACS, or soft-copy images, is at least the equivalent of hard-copy radiographs in the emergency department. Check it out!
PACS is better in so many ways than the old hard-copy film system; no darkroom, no file room, no more schlepping of films and film folders, no more paper cuts. PACS is definitely here to stay.
Once your PACS system has been up and running for a few months, you will have all the previous examinations right at your fingertips, likely no more than a mouse click or two away. Film folders are inefficient. The films are likely not in order, and you must sift through the folder to find all the films you need. Of course, you may not find them. They may not be there; films may be lost or misfiled. Or you might feel forced to abandon the search in the interest of time. These potential difficulties mean that your interpretation may be compromised and, as a result, patients are less well-served. PACS is better for all concerned.
With PACS the same examination may be viewed simultaneously at several locations around the hospital. You do not have to tell anyone that you can't look at the films right now because the patient's folder is in surgery, or was checked out by another physician—or worse, cannot be found in the file room or is presently being used in a teaching conference. The latter particularly irritates some clinicians.
With PACS, films are not lost. Examinations do not have to be repeated. And reports of studies can be immediately accessed by a mouse click on the appropriate icon when viewing an examination. Electronic reports cannot be stashed in great piles, unfiled and unavailable, in the hospital medical records department, the way that reports on paper unfortunately tend to be. Patients and referring physicians are certainly better served by PACS.
True, PACS is not nirvana; but most of us, radiologists and referring physicians alike, who have been privileged to use PACS are impressed.
There are a few problems, not the least of which is finding the money to purchase a PACS system in the first place. Many hospitals are strapped for cash. Administrators of other hospitals who might actually have the cash are reluctant to part with the monies necessary to capitalize equipment that has, in their view, such a limited ROI (return on investment). Granted, you can't charge more for examinations when you use PACS. Convenience for physicians and perceived improvements in patient care are unfortunately a tough sell. There are readily identifiable cost savings to be realized: the decrease, if not the total elimination, of film costs and reduction in the number of file room personnel are two obvious budget lines affected by a conversion to PACS. In the end, however, PACS remains a tough sell.
For those who are conversant with the use of computers and are comfortable with the use of a mouse and keyboard, adapting to PACS is not a problem. You are used to wheeling and clicking. However, surprise, surprise, the icons on PACS systems are not necessarily intuitive. If you use computers, you are used to this by now. As with most computer software, maneuvering can be frustrating, but you tend to catch on after a while. The clarity of the images and the convenience of PACS itself are such that any accompanying inconvenience in using the system becomes tolerable.
For the academic radiologist, ready access to images and the capability of downloading images into files for electronic storage or into PowerPoint for presentation is a tremendous boon. The resultant images are so good that it makes your old teaching material look dated and dirty (as it might actually be). With PACS, saving and collecting cases for teaching conferences is also easy and doesn't require sequestering the patient's images from circulation, because the studies remain available online for others to view.
Hounsfield brought radiology more than the CT scanner; he introduced our specialty to the world of digital imaging. We got a lot more than we had bargained for and likely more than even Hounsfield himself had imagined. Hounsfield's introduction of digitization revolutionized the practice of radiology in more ways than one.
References
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
