Italian hospital finds that PACS doubles costs

VIENNA - When the radiology department at City Hospital in Legnano, Italy made the move to PACS, it took on a lot of additional costs as well, according to a candid description presented Friday at the European Congress of Radiology.

Dr. Ivo Bergamo-Andreis said the average cost of a single diagnostic exam in his department doubled, going from 6 euros in 1997 to 12 euros in 2003, after the department went digital. The number of exams performed remained roughly constant over that period, at about 170,000 per year.   

Most of the cost increase was fueled by the addition of completely new expenses, mainly the amortization and maintenance of PACS equipment. His department spends about 500,000 euros per year on equipment maintenance, Bergamo-Andreis said.

Back-office personnel costs decreased slightly with the conversion, but physicians continue to print hard-copy films at the institution, undercutting any savings that might have been achieved.

Some 350,000 euros per year could be saved if the department used Web-based delivery of images to the hospital wards and reserved hard-copy films only for outpatients, Bergamo-Andreis said. He estimated that the average cost per exam would be only 8 euros if the department was filmless as well as digital.

The conversion into a digital department was a challenging experience from the start, he noted, requiring nearly a year of effort to overcome resistance from the affected staff.

Equipment from multiple vendors could not be integrated with ease, leading to “some unpleasant bottlenecks causing variable slow-downs,” he reported. The speech recognition system also caused problems, “due to its lack of stability.”

Through his experience, Bergamo-Andreis said he learned that there are really two kinds of digital departments: the perfect and the imperfect. The perfect digital department also becomes filmless at the same time, and doesn’t try to eliminate film in stages, he said.

“It’s mandatory not to proceed step-wise,” he emphasized.

By Tracie L. Thompson staff writer
March 5, 2004

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