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Diagnostic Imaging

Stentor PACS at Children’s & Women’s fixes film chaos

At Children’s & Women’s Health Centre, in Vancouver, B.C., getting an electronic Picture Archiving and Communication System wasn’t just on the want list – it was a high-priority need.

“There’s film literally everywhere,” complained Pamela Berekoff, manager of the radiology department. “It’s a disaster. We can’t clean it up – there’s nowhere to put it.”

Berekoff made her remarks in May during a webcast that was held in conjunction with the hospital’s new PACS vendor, Stentor Inc., of Brisbane, Calif., near San Francisco. The webcast was open to participants across Canada and the United States.

The three-hospital Children’s and Women’s facility (it includes the Sunny Hill Health Centre for Children hospital) performs 100,000 diagnostic imaging exams per year, but only has room to store three-month’s worth on site.

That means rads are at a disadvantage when they want to compare current images with older ones, as they’re left waiting for film files to arrive. Berekoff noted that some staff members are even hiding films, so they have them when required. The upshot, of course, is that when needed by others, they simply can’t be found.

At the same time, the hospital has been acquiring more powerful modalities, including a multi-slice CT scanner and a new MRI machine – both of which dramatically increase the number of images that must be filed. Berekoff showed pictures of staff members squeezing into the narrow aisles of film stacks jammed with files, and file folders spilling across desks and chairs.

“Our clerks are in tears quite often, and the physicians are yelling and screaming,” she said.

Moreover, it’s costly to store film and paper. “Our film storage costs were going up exponentially,” said Berekoff.

With the situation getting out of hand, Children’s & Women’s installed Stentor’s iSite enterprise PACS system in March 2003, on a month-to-month contract basis. In June 2003, it issued an RFP to 10 vendors.

The iSite system worked well – and in February 2004, Children’s & Women’s decided to keep it and expand it. They’ve been in the process of doing just that throughout 2004.

“The time to install was minimal,” said Berekoff. “It’s shocking how fast it was.”

The enterprise PACS, initially available to just some radiologists, but now being fanned out to all rads and across the three sites, as well as to referring physicians, is expected to solve many of the festering film storage problems.

A storage ‘grid’ from Bycast Corp. is being used for Children’s & Women’s new PACS. Jamus Spink, corporate director, technical services, noted that it will be integrated with a storage solution that’s also from Bycast (initially it has been handling storage needs for the BC Cancer Agency.) In this way, the plan is eventually to have all of the region’s images available online.

Neither the hospital representatives nor Stentor wished to comment on the value of the PACS contract. They did say, however, that it includes unlimited licences, which will be of great help when extending the system to referring physicians.

Dr. Gordon Culham, medical director at the radiology department, pointed out that 1,500 referring physicians are connected with Children’s and Women’s, which itself employs 10 radiologists and has two fellows. The hospital makes use of all major imaging modalities – including Computed Tomography (CT), Magnetic Resonance (MR), Computed Radiography (CR), as well as fluoro, nuclear med and ultrasound.

For its part, Stentor is one of the newer players in the PACS world, with offerings that have been commercially available since 2000. It has quickly gained ground, however, and currently has some 250 customers. Most are in the United States, but marketing vice president Matt Long mentioned that four are in Canada.

Currently located in California, Stentor grew out of an initiative at the University of Pittsburgh Medical Center. While the commercial PACS product is relatively new, Long stressed that the original research and development goes back to the early 1990s. “We were one of the first to get into PACS, and one of the first to push PACS outside the radiology department.”