PACS in Indian Hospitals

Catching up

Deepak Kumar

Deepak Kumar

Chief Technology Officer Srishti Software, India.


More and more physicians and radiologists have started preferring the PACS systems to hard copies.


How has the response to PACS been?

PACS in India, the response has been very good so far. In fact, there are quite a few hospitals that are fully using the PACS software. The hospitals that we have been targeting have shown very keen interest in PACS. We feel that market is getting mature and is set to boom.

How is the technology likely to evolve in the coming years?

PACS technology has been changing quite rapidly. Initially it was newer and more sophisticated equipment, like good quality CT, MRI, PET/CT etc. These have already allowed clinicians to diagnose with much better accuracy. In future we anticipate that with more development in algorithms and computing power, Computer Assisted Diagnosis based on radiology data will evolve as a feasible technology and will enhance quality of diagnosis to unprecedented level.

What are the basic requirements to implement a PACS across an organisation?

Assuming that a hospital already has a radio diagnosis facility with equipments and radiologists, the following would be additional requirements:

  • Equipments must be DICOM compliant. Some of non-compliant equipments may still be used with additional DICOMisers
  • A PACS server that will receive studies from equipments, store those, allow queries & retrieval, archive, and allow automated routing
  • DICOM workstations that would be used by Radiologists for viewing, processing, analysing, and reporting the studies
  • A good quality network to connect equipments, PACS server and DICOM workstations
  • Storage and backup infrastructure for reliably storing the studies

How have physicians and hospitals responded to the technology, since they have been used to hard copies of X-ray reports for so long now?

That's quite interesting. In fact, we are finding that more and more physicians and radiologists have started preferring the PACS systems to hard copies. Turn around time for modalities connected with PACS is much faster in comparison to traditional films. Further there is no easy way to keep hard copies of 64-slice CT, PET / CT, 4D / 5D etcetera and keeping these digitally remain the only viable option.

What are the benefits of PACS when you look at it from the point of view of the entire healthcare continuum?

IT applications that a hospital uses can be categorized as PAS [Patient Administration System], CAS [Clinical Administration System], EMR [Electronic Medial Records] and ERP [Enterprise Resource Planning]. In order to get complete view of a patient's EMR, one needs complete radiology studies as well, which is maintained in PACS. This makes PACS an integrated part of full patient care applications and workflows.

Does it raise the issue of security of data?

In any form of Medical records, we get privacy and data protection issues. These need to be understood and handled by hospitals that implement PACS. Hospitals needs to additionally understand the security issues and risks involved when PACS is used to enable tele-radiology to allow access of study outside hospital premises.

Does PACS help in providing tele-medicine?

Most of PACS solutions, when implemented properly, will allow out of the box tele-radiology. Enabling studies to be reported by remote radiologists. However there may be additional application required to allow handling of transfer of clinical data, appointments, tele-conferencing, billing etc.

Do you think Indian hospitals are interested enough in Healthcare IT?

All the hospitals we have been interacting are considering IT as their way to improve quality, processes and bring cost down. So we feel that in hospitals India are treating IT as a strategic area and willing to invest.

From your experience in implementing PACS in India, what are issues you came across as a service provider?

In few occasions, hospital may not be clear on human resource needed from their side to maintain and use their PACS environment. For example, to effectively use PACS Radiologists, Clinicians, Operators and PACS administrators must get trained properly. These need to be properly planned and executed; otherwise all benefits from PACS might not be realised. Another set of issues comes when hospital does not have clarity about the duration for which they want to retain studies, making estimation of storage complicated.

Any other comments?

Indian healthcare is fast moving to a stage where hospitals will need to compete more for the same set of patients and in order to do so improve quality while keeping the costs in control. In this regard, many hospitals have started looking or otherwise should look in to way to improve their quality and controlling costs. IT can be a strategic enabler, however hospitals should be careful and engage with a vendor only with proper due-diligence.

Are hospitals in India self-sufficient as far as using this technology is concerned?

Yes, to a great extent. In fact, Indian hospitals are well equipped with the PACS technology. There is good quality support available from various vendors. Additionally number of radiologists, who are comfortable in using sophisticated PACS workstations, is growing and hence pushing the utilisation of PACS infrastructure in hospitals.

How do you view the market for PACS in India?

Quite good. In fact, the market is getting very exciting. Most of the top league hospitals are already using PACS while most other progressive are exploring PACS. Earlier significant high cost of ownership, due to high license fee and hardware & storage costs. However the crashing prices of hardware & storage, combined with reasonably priced solutions from some of the vendors has removed that barrier. Today hospitals of any size can acquire highest quality PACS server and specialist workstation at a price affordable to them.