When I first became active in the PACS world, I adopted a goal from my senior partner/mentor: “Sit here, read there”. This was to apply to every site, every examination in our enterprise. Today, we have met that goal, both with our group-owned system, and with PACS provided by the hospitals. I can indeed sit at any site within our realm, and for that matter, at any broadband-connected computer, anywhere, and peek at any particular study that takes my fancy. When you think about it, that is quite an achievement.
All of this interconnection requires, well, a connection! That would be the various networks and portals into the Internet. As I have pointed out in a previous post, aptly titled Disconnected!, when the network is down, thus PACS is down, and therefore the whole department sits idle except for extreme emergency cases.
We are feeling the pressure of the network in another way. One of our hospitals has somewhat suboptimal internet connections to the outside world. We have tossed blame back and forth as to why their web-based PACS can be viewed but slowly at remote sites, and why our web-based PACS (both Amicas, by the way) crawls when viewed from within their walls. Trying to view the Agfa Impax of the other hospital system from within the problematic facility is just that, trying.
As yet, we have no good reason for this to be happening. The IT folks at the institution in question have switched us back and forth on various lines and channels, this one having no net-nanny or port-blocking, that one having X speed, another having yet more different parameters. All we know is that the situation is deteriorating rapidly, and we have to do something. To use the buzz-words that get everyone’s attention, our ability to deliver health-care is being impaired, and this needs to be fixed.
At this point, our main option is to buy our own network. Our system lives in a neutral spot, external to all hospitals. We are on the brink of purchasing Metro Ethernet lines, also called MetroE’s, with point-to-point access for our system. This would also give us direct, very rapid access to our own PACS, and should significantly improve the connection to the hospitals, at least we expect it to do so. At a cost of tens of thousands of dollars per year, we don’t want to do this and see no benefits!
There might be one last option. Our state is participating in the Rural Health Care Pilot Program (RHCPP) which is designed to link under-served primarily rural hospitals with fiber optic broadband. The network-challenged hospital has apparently signed on to this initiative, and anticipates a great boost in service. However, I’m not sure we would qualify to participate:
Palmetto State Providers Network ($7.9 million)—This project will connect healthcare providers to a fiber optic backbone to enhance simulation training, remote intensive care unit monitoring, and medical education in South Carolina.
I suppose we could sign up to read from any rural hospitals that are properly equipped to transmit out to us. That would be a win-win situation.
In the meantime, we’re about to spend a lot of cash for some local bandwidth. At least one part of the economy will be stimulated. . .