Feature | February 10, 2010| By Jeffrey A. Breall, M.D., Ph.D.

Tips When Looking for the Ideal Cath Lab PACS

Systems should offer connectivity, data-mining and increased efficiency.

The latest Horizon Cardiology version 12.1 from McKesson integrates barcode inventory management. Supplies used in the cath lab are scanned during the procedure and immediately recorded for inventory and billing purposes.

Infinitts Cardiology PACS offers templates for 14 procedures and allows cardiac catheterization quantitative coronary analysis. It includes a coronary tree that can be annotated, which auto-populates text for in the final report.

Most cath lab PACS/cardiovascular information systems integrate data from the hemodynamic monitoring system to create a more complete patient record.

FUJIFILM Medical Systems new Synapse Cardiovascular 4.0.4 allows users to access a variety of third-party applications from a single workstation.

In today’s market, many vendors have very good cardiovascular picture archiving and communications systems (PACS). One needs to only hit the exhibit floor for a short time at the Radiological Society of North America (RSNA) or the American College of Cardiology (ACC) before it becomes apparent that there is a myriad of systems available right now that are excellent and fairly user friendly. They are capable of storing and retrieving high-quality images in just seconds.

So how does one choose if all of the PACS give crisp clean images that are easily retrievable? Start by asking yourself the following questions: Can the PACS system readily tie into your centralized patient information system? How easy is this connectivity? Can information flow forward and backwards? In other words, at the completion of a study, can all of the information be readily “dumped” into your central patient server? When initializing a study can information be downloaded from your central patient server to the PACS to avoid duplication (such as patient demographics)? These issues are of paramount importance when choosing a CV PACS.

A PACS should allow you to see your images with excellent clarity, allow you to manipulate the image and do quantitative analyses without having to read a 400-page user manual. You may also want to be able to pull up old studies at a moment’s notice with no lag time, and add the ability to store and retrieve and manipulate digital subtraction images for your peripheral vascular studies in an ideal system, However, there are deeper issues to consider, such as connectivity, the ability to mine data and using technology to increase efficiency.

PACS Need to be Interoperable

While many major vendors have image storage and retrieval systems, they have a very closed architecture that makes it difficult, if not impossible, to “talk” to other information units in a hospital. This lack of interoperability may include systems in the cardiac catheterization lab itself. This offers a financial advantage for a given vendor, as it forces hospitals to purchase all of its individual components to insure the best connectivity.

However, it is unusual for a given vendor to have the “best” of everything. Clinicians prefer different vendor systems because the image quality of one cath lab is preferred over another. Some hemodynamic monitoring systems are also more intuitive for technologists and nurses to run. It is important to have a PACS that integrates with the clinicians’ preferred devices.

Auto Report-Generation Saves Time

It is also important the system has automated report-generation. In the current era, there is little reason to not be able to complete a study and have the report 80-90 percent completed and waiting. A physician should only need to spend an extra three to five minutes to finalize things. Dictation is so 1960’s. The ability for information to automatically transfer from the image acquisition system and the hemodynamic monitor to the PACS system is crucial. This also allows for automatic population of a nearly completed report. Remember saving time is a critically important feature to the interventional cardiologist.

The flow of data is not simply one-way into the PACS, there needs to be two-way communication. Data acquired in the cath lab must be sent to a central hospital information system, and IT communication is key for any system under consideration. This transfer of information might come in several forms, such as a finalized cath report.

Data-Mining Is Needed

The ability to easily program the PACS to pluck out data elements of interest that are subsequently collected and sent it to another repository is also quite helpful. It might be useful to know how many cases were successful vs. those that were unsuccessful; how many drug-eluting eluting stents were placed vs. bare-metal stents; or how many complications occurred and what was the precise nature of said complications. This information is requested on a regular basis by national data registries and quality assurance organizations. Furthermore, third-party payers are now demanding to know this information regularly. Reimbursement (both physician and hospital) is often tied to providing this information in a timely fashion. A hospital may have two, three, four or more full-time employees laboriously combing through charts to get this information. Alternatively, pre-specifying what data elements are sent automatically to a report from a PACS is worth its weight in gold.

At the conclusion of any given case, an optimal PACS has the ability to provide the operator with a report that is 90 percent complete and provide the operator with images that are easy to review and can be ultimately kept in storage. The system should also provide data elements that go to a central repository for later distribution to a quality assurance committee, national data bank registry, or any third-party payer as deemed appropriate by the hospital.


Obviously, inherent in this discussion is my belief that any PACS worth investigating is one that offers an open architecture. In other words it must be vendor-neutral. It must be able to easily communicate with whatever systems are either present in the cath lab, or are to be brought into the cath lab at a later date. It must be able to communicate with the overall hospital information system as well. This allows you to have a system as described above. The technology is moving and evolving in a fast and furious manner. My advice is to do your homework on any system and do not to rush into purchasing a system. This will pay off in the end.

Editor’s Note: Dr. Breall serves on the Editorial Advisory Board of Diagnostic and Invasive Cardiology. He is a professor of clinical medicine, director of the cardiac catheterization laboratories and head of interventional cardiology for Indiana University, Krannert Institute of Cardiology. He is also medical director of the cardiac catheterization laboratories for Clarian Health Partners in Indianapolis. He recently researched and purchased a cardio PACS for one of his facilities.

Related Content

Philips IntelliSpace cardiovascular information system (CVIS)

The Philips IntelliSpace is an example of the newer generation of cardiovascular information systems (CVIS) that can consolidate all cardiology department data sources into one location.

Feature | Cardiac PACS| October 04, 2017 | Dave Fornell
Consolidation of data in one location to improve efficiency and enable data analytics, as well as smooth integration
Medical Metrics Taps Digisonics Cardiovascular Information Systems for Clinical Trials
News | Cardiac PACS| October 03, 2017
October 3, 2017 – Medical Metrics, an experienced core laboratory for multi-center clinical trials, has implemented t
ScImage and Invia Partnership Announced
News | Cardiac PACS| September 19, 2017
ScImage Inc. and Invia Imaging Solutions recently announced formation of a joint partnership at the American Society of...
Healthcare cybersecurity concerns have increased dramatically as EMRs and medical devices become more digitally connected.

Healthcare cybersecurity concerns have increased dramatically as EMRs and medical devices become more digitally connected.

Feature | Cybersecurity| August 18, 2017 | Dave Fornell
August 17, 2017 — Cybersecurity has become a growing concern in healthcare as patient data, medical systems and impla
ScImage Awarded U.S. Government DIN-PACS IV Contract
News | PACS| August 16, 2017
ScImage Inc. was recently awarded a new DIN-PACS IV (Digital Imaging Network/Picture Archiving and Communications...
The Centricity Cardio Enterprise (CCE) Interactive Guide offers information on GE's cardiovascular information system (CVIS)
News | Cardiac PACS| July 28, 2017
July 28, 2017 — GE Healthcare has released the eight-page...
WVU Medicine Deploys Enterprise PACS from ScImage
News | Cardiac PACS| July 24, 2017
ScImage Inc. recently announced West Virginia University Health System has partnered with ScImage to utilize ScImage’s...
Innovative Cardiovascular Ultrasound Solutions Showcased at ASE 28th Annual Scientific Sessions
News | Cardiovascular Ultrasound| June 01, 2017
June 1, 2017 — More than 50 companies and organizations will display their latest products and services at the Americ
Memorial Hospital of Gulfport used a McKesson, Change Healthcare, cardiovascular information system (CVIS) to improve workflow efficiency

Memorial Hospital has increased efficiency using a single cardiovascular information management database. 

Case Study | Cardiac PACS| May 23, 2017
Located along Mississippi’s Gulf Coast, Memorial Hospital at Gulfport is a nonprofit, 445-bed facility originally est
News | Information Technology| May 11, 2017
McKesson Imaging & Workflow Solutions, an industry leader in providing healthcare IT and imaging solutions, is...
Overlay Init