Many rad departments still lack PACS-EMR integration, but improvement may be on the way

Integration between PACS and electronic medical records (EMRs) is still lacking for many radiologists, but there are reasons to believe it could improve in the near future, according to a recent study published by the Journal of the American College of Radiology.

Pablo R. Ros, MD, MPH, PhD, Case Western Reserve University and University Hospitals Case Medical Center in Cleveland, Ohio, and colleagues explained that it was vital for radiology departments to have as many of their IT systems working together as possible.

“Integration, here defined as the ability of two IT systems to exchange information with each other, has since the introduction of digital imaging and various data systems within radiology been of utmost importance to both ensure and improve the efficiency of radiology workflow,” the authors wrote. “Initially, digital images could be viewed only at dedicated modality workstations, but as PACS evolved and it became possible to view images from multiple modalities at a single workstation, PACS quickly became a pivotal IT system for radiologists and integral in the radiology workflow. As such, the need for integration between PACS and various imaging modalities, and between PACS and other IT systems, increased and became a critical factor for any successful radiology practice.”

To investigate the current state of PACS integration across various academic radiology departments (ARDs), Ros et al. surveyed members of the Society of Chairs of Academic Radiology Departments (SCARD), asking them a total of 29 questions about their departments.

The answers revealed that integration of PACS with dictation systems is more than 90 percent, while integration of PACS with radiology information systems (RISs) is 82 percent. PACS integration was much lower with EMRs (47 percent) and critical notification systems (15 percent).

The number for EMRs is low, but the authors said there are numerous factors that suggest it could be skyrocketing in the near future.

“The number of ARDs with PACS-EMR integration is likely to increase significantly in the future, not only because of widespread adoption but also because literature suggests that improved PACS-EMR integration will increase the perceived value of the radiology service and as indicated by the participants’ responses regarding where they foresaw the greatest potential for future workflow efficiency improvements,” the authors wrote. “This is further supported by Imaging 3.0, as suggested by the ACR, where from the perspective of the radiologist in the image value chain, access to a patient’s clinical information is of great importance to increase the impact of the final end product of the radiology workflow, an actionable report.”

Ros and colleagues added that the high percentage of ARDs with integration between their PACS and dictation software showed significant progress for the profession.

“Integration between PACS (and/or RIS) and dictation software was an early integration issue and, as confirmed by these results, for most ARDs has been resolved,” the authors wrote.

The authors did say their study had multiple limitations. The response rate from SCARD members, for instance, was just 26 percent, which was lower than originally expected. In addition, participants were given the option of skipping questions, which made the results harder to interpret.