IMT decisions back in the hands of the hospitals

The rules of the game have changed. Since the inception of the National Programme for IT (NPfIT) in 2005, the responsibility for specifying, procuring, configuring and deploying major hospital systems has been centralised and the role of local management had become one largely characterised as facilitation. Now though, following a Department of Health review and the announcement in a ministerial statement that the NPfIT is “no longer required”, executive decisions regarding the full breadth of Information Management & Technology (IMT) need to be back on the agenda of board meetings up and down the NHS in England and Wales.
The announcement is that the centralised approach of NPfIT is no longer relevant and IMT decisions should be local, with more modular systems being selected from a plural system of supply. What is more, the tone set in the white paper is continued- that healthcare provision needs to improve, yet the costs need reduce. So providers quickly need to pick up the mantle and take control of how IMT will enable their organisation to deliver this objective.
This new onus on Trust boards brings the need for them to be more tech savvy than they have previously needed to be. Not only are the decisions and responsibility for system delivery back with them, but a plural market requires significantly more expertise, not only in system selection, but also in architecting how more modular systems will be orchestrated to deliver their digital platform. As the Operating Framework for the NHS in England puts it, the approach is about “connecting all” rather than “replacing all”. Integration is the name of the game and the challenge of making a handful of interoperable systems drive an organisation is exponentially more demanding than merely multiplying up the effort of making a single system work.

PACS is dead. Long live PACS

It is my prediction that the days of the acronym "PACS" are numbered. Picture Archiving and Communications Systems are the hospital systems that store all those digital diagnostic images- X-ray, mammogram, MR, CT etc.

They need phenomenal storage capacity (Terabytes) and distributing those images (usually of the DICOM format) from the imagers to radiologists is therefore non-trivial.

When did you last hear an application based IT system have to define itself as a communication system? That's inherent in the fact that it is information technology. It feels illogical to make a big deal out of that, reflects challenges largely in the past and aspires to monolithic systems. I try and use the terms "DICOM Storage", "DICOM Viewer" and "Radiology Writer" to describe the constituent parts and apply as appropriate. Processes are being reengineered such that these elements are being reused in ways the inventing technologists hadn't imagined and the PACS term will itself be reengineered.

There's a lot of inertia in the acronym by virtue of the intellectual capital (deals, research papers, products, implementations) invested in it, so I don't expect a change any time soon... but watch this space

Tags: technology, medicine, medical, health, health care, healthcare, healthcare IT, Health care IT, PACS, Picture Archiving and Communications System, acronym, CT, MR, radiology, etymology, hospital, x-ray, xray, diagnostics