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Implementation of a Departmental Picture Archiving and Communication System: A Productivity and Cost Analysis

Macyszyn, Luke MD, MA*; Lega, Brad MD*; Bohman, Leif-Erik MD*; Latefi, Ahmad DO; Smith, Michelle J. MD*; Malhotra, Neil R. MD*; Welch, William MD*; Grady, Sean M. MD*

doi: 10.1227/01.neu.0000431474.49042.5b
Concepts, Innovations and Techniques

BACKGROUND: Digital radiology enhances productivity and results in long-term cost savings. However, the viewing, storage, and sharing of outside imaging studies on compact discs at ambulatory offices and hospitals pose a number of unique challenges to a surgeon’s efficiency and clinical workflow.

OBJECTIVE: To improve the efficiency and clinical workflow of an academic neurosurgical practice when evaluating patients with outside radiological studies.

METHODS: Open-source software and commercial hardware were used to design and implement a departmental picture archiving and communications system (PACS).

RESULTS: The implementation of a departmental PACS system significantly improved productivity and enhanced collaboration in a variety of clinical settings. Using published data on the rate of information technology problems associated with outside studies on compact discs, this system produced a cost savings ranging from $6250 to $33 600 and from $43 200 to $72 000 for 2 cohorts, urgent transfer and spine clinic patients, respectively, therefore justifying the costs of the system in less than a year.

CONCLUSION: The implementation of a departmental PACS system using open-source software is straightforward and cost-effective and results in significant gains in surgeon productivity when evaluating patients with outside imaging studies.

ABBREVIATIONS: DICOM, digital imaging and communications in medicine

EMR, electronic medical record

IT, information technology

PACS, picture archiving and communication system

*Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania;

Department of Neurosurgery, North Shore University Hospital, Manhasset, New York

Correspondence: Luke Macyszyn, MD, MA, Department of Neurosurgery, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104. E-mail:

Received May 2, 2012

Accepted May 2, 2013

Copyright © by the Congress of Neurological Surgeons