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The cost effectiveness of implementing picture archiving and communication systems (PACS) in the operating room

Rath, Paul A.a; Gugala, Zbigniewa; Swischuk, Leonard E.b; Lindsey, Ronald W.a

doi: 10.1097/BCO.0b013e3181b84245
Original Research

Background Intraoperative access to radiographic images is essential for the accurate diagnosis, operative planning and surgical treatment of many musculoskeletal conditions. Traditionally, hardcopy radiographs have been readily available for this purpose. Recently, however, hardcopy radiographs have become less accessible because many hospitals have transitioned to digitally-based picture archiving and communication systems (PACS). Typically, PACS is available in hospital clinics, emergency rooms, and radiology departments but not, as in our institution, in the operating room. The purpose of this study was to determine the merits of implementing and having access to PACS in the operating room.

Methods All hardcopy radiographs generated solely for use in orthopaedic surgery cases at our institution were prospectively tracked for 3 months. The annualized costs associated with these hardcopy images (film, production, storage, technical time) were compared with the projected cost of acquiring, mounting, and maintaining PACS monitors in the orthopaedic surgery operating room.

Results Comparative cost analysis determined that the initial 12-month cost for orthopaedic surgery PACS in the operating room would be realized at 9 months after implementation; the projected PACS net savings for our institution would be approximately $500,000 at 10 years after implementation.

Conclusions In addition to improved efficiency in patient care, a clear cost benefit exits of implementing PACS in the orthopaedic surgery operating room.

Departments of aOrthopaedic Surgery and Rehabilitation

bRadiology, The University of Texas Medical Branch, Galveston, Texas

Correspondence to Zbigniew Gugala, MD, PhD, Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0165

Tel: +409 747 5760; fax: +409 747 5715;


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