PACS: implementation in the U.S. Department of Defense

Anna K. Chacko MD, Ronald Wider, John Romlein, Michael A. Cawthon DO, Rob R. Richardson, HowardWm. Lollar, Jay F. Cook MD, Harold L. Timboe Ml), Thomas G. Johnson MD, Douglas W. Fellows MD.Medical Research and Material Command, Ft. Detrick, MD.The Department of Defense has been a leader in Radiology re-engineering for the past decade. Effortshave included the development of two landmark PACS specifications (MDIS and DIN-PACS), respectivevendor selection and implementation programs. A Tn-Service (Army, Navy and Air Force) Radiology re-engineering program was initiated which identified transitioning to digital imaging, PACS andteleradiology as key enabling technologies in a changing business scenario. Subsequently, the systematicadjustment ofprocurement process for radiological imaging equipment included a focus on specifyingPACS-capable-digital imaging modalities and mini-PACS as stepping stones to make the hospitals andhealth clinics PACS-ready. The success of the PACS and teleradiology program in the DOD is evidencedby the near flimless operation of most Army and Air Force Medical Centers, several community hospitalsand several operational teleradiology constellations. Additionally, the MDIS PACSystem has become thecommercial PACS product for General Electric Medical Systems. The DOD continues to forge ahead inthe PACS arena by implementing advanced configurations and operational concepts such as the VRE(Virtual Radiology Environment), the negotiation of Regional Archiving and Regional PACS MaintenancePrograms. Newer regulations (HIPAA, the FDA approval ofdigital mammography) have beenpromulgated impacting the culture and conduct of our business. Incorporating their requirements at thevery outset will enable us to streamline the delivery of radiology. The DOD community has embraced theinformation age at multiple levels. The Healthcare portion ofthis community with these initiatives isintegrating itselfinto DOD's future. The future holds great possibilities, promises and challenges for theDOD PACS programs.Keywords: PACS, MDIS, DIN-PACS, DOD, Virtual Radiology Environment, VRE, TARAThis paper does not represent the opinions ofthe United States Department of Defense.