Conventional X-ray reports are pass©. With technologies like Radio Information System (RIS) and Picture Archiving and Communication System (PACS), modern healthcare is approaching more towards smarter infrastructure that not only benefitting the users but the  patients alike. A closer look!

By Sharmila Das, ENN

The market for RIS-PACS solutions in India is price sensitive. The focus of RIS-PACS solution is ease of use, price-performance and virtualisation of patient image records. RIS-PACS virtualisation solution ensures collaboration between specialists at different locations. This helps in having multiple faculty consultations in remote locations especially in cases involving multiple organs injury. By integrating RIS, PACS to Operation Theatre (OT) cameras, live OT images can be streamed live for cross consultations. We all know the benefit of virtualisation. It enables referring doctors to view the same images that the remote doctor is viewing. The RIS-PACS solution makes life of a PACS administrator a lot easier, as there is only one server to maintain.
The best feature is that it enables patient x-rays and other images to be digitally attached to patient electronic medical record and be sent outside or within the hospital to consultants/ experts for second opinion within minutes.

Adopting RIS & PACS

Mostly Indian urban hospitals have adopted RIS and PACS efficiently. However, larger acceptability is still a constraint because Indian hospitals and healthcare industry normally is price sensitive. Hence, the key requirement is that the solution should be cost competitive. Other than that it is also necessary that the solution should have interface with third party applications, it should offer ease to use for end users and it must conform to global standards of healthcare. These solutions store images electronically thus  hospitals can save a lot on operational costs. With RIS-PACS, hospitals can vastly improve their efficiency. Since these solutions enable attaching patient medical records and report electronically to their files, it is easier for doctors to send them within the hospital to experts / consultants for second opinion. They can also store for their record and reference. Also, electronic storage of data enables healthcare institutions to store the images in their archive and can be revisited by them at any point later for reference without the fear of physical damage to reports.

Arup Mukherjee,
COO, Binary Spectrum

An integrated PACS viewer works to eliminate the emphasis on where a test is performed, since all results are shared electronically with other facilities

RIS-PACS solution can be completely integrated with external Hospital Information System (HIS) solutions. Implementation of RIS / PACS sometimes requires integration with third party solution. Appropriate technical support from the vendors is required. Any inadequate support and coordination leads to delay in the implementation time line and would create a possible risk to the project.
Sunder Natrajan, CEO, Ashva Technologies shares, The RIS/PACS marketplace is evolving globally and in India the adoption of IT is in high gear. These are very exciting times both for the RIS/PACS vendors and adopters of the technology. The productivity gains and improved patient care by technology adoption is well documented.
Ashish Dhawad, Founder & CEO, Medsynaptic Pvt Ltd says, Today we see a lot of hospitals opting to deploy a PACS because the advantages have been clearly demonstrated by the previous generation of users. Hospitals can derive both financial and non financial advantages by deploying PACS. Reduction of spending on consumables and film provides a direct and real ROI for the hospital recovering the cost of the solution itself in a short span of time. Improved workflows, better staff management, 24 X 7 tele-radiology, data mining, academic research and higher equipment utilisation are some of the other benefits that a hospital can get from installing a PACS. Finally all of the above lead to customer delight and higher quality of patient care which is the final goal ofany hospital.

Arup Mukherjee, COO, Binary Spectrum says, An integrated PACS viewer works to eliminate the emphasis on where a test is performed, since all results are shared electronically with other facilities. A PAC web viewer is a perfect example of how information can be shared through the Internet. Radiologists, referring physicians and clinicians can access a chronological view of a patients radiology history. It also slashes costs related to the managing of film and tests previously affected by lack of access to relevant priors, or lost films.

Dr Suresh Munuswamy,
Faculty for Health Informatics, Senior
Lecturer, Indian Institute of Public Health – Hyderabad

Public Health Foundation of India says, The availability of Indian Health Care Professionals (HCP) is a state of plenty and poverty depending on the location. RIS and PACS if implemented can link and rationalise the availability of HCPs

Dr Suresh Munuswamy, Faculty for Health Informatics, Senior Lecturer, Indian Institute of Public Health – Hyderabad, Public Health Foundation of India says, The availability of Indian Health Care Professionals (HCP) is a state of plenty and poverty depending on the location. RIS and PACS if implemented can link and rationalise the availability of HCPs. However, even the availability of basic imaging services for X-ray, CT Scan, MRI, Ultrasound etc in India is patchy and not dependable. Digital medical imaging services need digital diagnostic equipment, support infrastructure and screening algorithms to make the best use of RIS and PACS systems.

Innovations on RIS & PACS In days to come we are surely going to see a lot of improved RIS and PACS solutions. As per the industry experts the existing RIS will get better resolution images. Bhavesh Thakker, VP, Chowgule Mediconsult Pvt Ltd feels, Innovations are currently focusing on RIS and PACS which is propelling growth. Improving image quality and resolution on one hand and speed of data transfer on the other hand are the aspects under focus. Image analytic space is also seeing a lot of interest and activity as it adds a lot of value to the end user. Coming years should see clinical data capture, apart from images, secure transfer across platforms and interoperability as the key drivers of growth.

Dhawad says, Technology is a fast changing business and vendors need to innovate continuously to ensure that the customers get the best solution. PACS technology has also evolved tremendously in the last couple of years. Lot of interesting innovations are happening and I see most of the hospitals now prefer to go for a fully web based PACS. Apart from that I see a lot of new technologies being deployed like a) integrated advanced visualisation, b) cloud PACS sharing the same infrastructure between group hospitals, c) zero foot print viewer, d) tab and mobile based viewing of images, e) full workflow integration.

Dr Munuswamy says, Innovations may result in three outcomes; reduction of size of imaging devices, continuous imaging in real time and continuous analysis in real time.

Sunder Natrajan,
CEO, Ashva Technologies

The RIS/PACS marketplace is evolving globally and in India the adoption of IT is in high gear

Natrajan says, The single most important technology and innovation happening today is the advent of cloud computing infrastructure. Cloud computing is remaking the RIS/ PACS technology in many ways. Major impact can be seen in the cost of ownership, significant increase in adoption rates, efficiency and productivity, anywhere, anytime access to data on demand. Combined with the penetration of the Internet to rural India, there would be a significant increase in access to good healthcare for the entire population.

Supporting factors
It is not that the popularity for RIS & PACS processes has taken place over a day or night. The demand was there already. Mukherjee says, As per the analyst, healthcare service providers eagerness to be competitive in the market, improve their facility and better manage their imaging is a huge boost to the RIS-PACS market. There is a significant increase in the number of patients, while there is not enough medical staff to attend to them. This scenario has encouraged hospitals to automate their functions to ease the burden on their medical personnel. The proliferation of sophisticated medical devices compels hospitals to deploy advanced PACS to enable the seamless exchange of information. Furthermore, there is a rapidly rising demand for storage, as more devices produce images in the digital format.

Market dynamics
Market grows as per the demand. Although there is no authentic data available on the market size of RIS & PACS, the demand curve for adopting more such solution is surely on the rise. Dhawad informs, The RISPACS market has started maturing in last few years and will continue to grow substantially in coming years. The market is big enough to sustain

Ashish Dhawad,
Founder & CEO,
Medsynaptic Pvt Ltd

24 X 7 teleradiology, data mining, academic research are some of the other benefits that a hospital can get from installing PACS

many players both Indian and foreign. Companies which ensure good quality develop new technologies and maintain high levels of service will gain more market share and revenues. At the same time companies like Medsynaptic are taking a leap into the international market and have been successful in several countries across the globe.
Mukherjee says, Declining costs of RIS-PACS encourage their adoption by low and mid-tier hospitals. RIS-PACS used to be adopted exclusively by the top-tier hospitals in the 1990s because they were prohibitively expensive to the smaller ones. However, with the decline in costs and advancements in applications, smaller hospitals have begun to implement them in various medical disciplines such as cardiology, dentistry, and orthopedics.
RIS & PACS have answered many issues relating to delays in diagnostic procedures. However, in days to come, with newer developments these solutions will just get better in serving healthcare.

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