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Advanced enterprise pacs system to speed up all radiological workflow

In the most recent years, huge investments have been made by Azienda Ospedali Riuniti di Trieste towards renewing the radiological equipment with most advanced and digital platforms, thus creating the conditions to implement and take benefits from a PACS for image archiving and distribution.

In 2005, owing to the financial effort of the Regional Administration, and partly to a private grant from the Fondazione Cassa di Risparmio di Trieste, Azienda Ospedali Riuniti di Trieste has acquired from EBIT AET the first PACS in the Friuli Venezia Giulia Region, completely integrated with the hospital systems and adherent to the most advanced international standards.

The system, that allows for image archiving, preserving, reporting and distribution, is conceived as a single enterprise system that collects exams performed at the radiology units of its two networked hospitals, i.e. Cattinara and Maggiore, as well as exams performed at the Cardiology, Nuclear Medicine and Gastroenterology units. Because of its scalability, any other image modality of current and future acquisition will be connected to the PACS. Today, the PACS already includes 5 Computer Radiology, 3 CTs, 2 MRs, 3 Angios, 6 Ecos, 1 Gamma camera, 1 Mammo, 2 portable C-arm, covering nearly 100% of the radiological and cardiological activity in the hospitals.

The professionality of EBIT AET and that of the entire hospital staff involved in the project, together with the enthusiasm and the effiort -in terms of human resources- put on field has allowed to reach the start-up of the project just after a few months from the beginning of the installation, that to give an idea of the size, includes a dozen of servers that manage a 13.5 TeraBytes Storage Area Network, 38 primary reading workstations and 11 CD/DVD printer systems for CD patient.

The deep integration of the the PACS system with the Insiel G2 Hospital Information System allows an optimal workflow at the clinical departments, as the patient worklists are directly routed to the modalities eliminating any typo and patient mismatch error. Once the exam is performed, images are then routed to the PACS and read by the radiologist for reporting. Images and reports are immediately available at the clinical departments, thus eliminating film and paper circulation.

On the one hand, physicians have therefore more time available for their patients, minimizing also patient displacement around the hospital. On the other hand, cost savings due to film reduction start to give a return on investments. In the period July 06 - June 07 film purchasing will be reduced by 70%, while forecast for the two following years will bring down to a 5% of current expenditure the money spent for films.

A such innovative and integrated project has been possible at the Azienda Ospedali Riuniti di Trieste owing to a daily innovation pushed as a strong hospital policy: from the high-speed network reaching all corners to the complete digitalization of the diagnostic equipment; from the great number of PCs, spread at any clinical department to bring such information technology culture, to the design and development of a single integrated hospital information system, for the ultimate goal of powering the hospital system as a whole and improving the efficiency and efficacy of the clinical services to the citizens.