By: Chris Meenan and Paul Nagy, PhD
Buying a PACS is a long-term commitment. The partnership between you and your vendor is much like a marriage, with both parties entering the relationship with certain assumptions and expectations. Over time, however, shared values and direction may diverge, making you wonder if it's right to stay together. The relationship you have with your vendor can mean the difference between an innovative, always-on system with happy users or a system that fails to meet your user's expectations. The Baltimore-Washington area ClubPACS users group came up with this list of "top 10 signs it's time to consider changing your PACS vendor."
10. Continuous substandard service and poor support:
The service relationship is a key differentiator with any PACS company. While the sales department often establishes the initial contact, it is typically the service organization that continues to manage the relationship after the sale is made. Once the sales group collects its fee, is the love gone? A responsive service organization is the key to keeping your system up in the event of any issues that arise.
9. Poor vision for the future:
If your vendor is just announcing it is decommissioning NT 4, it could be a sign of trouble. It is key to understand where your vendor is heading from a strategic perspective and that it has a strategy for continually embracing innovative technology and not just fork lifting architectures every five years. You need to enjoy the market benefits of hardware advancements and reductions in cost. Moore's Law states that storage should be twice the size every 18 months for the same market price. If your vendor seems unconcerned about the single points of failure or has no strategy to handle disruptive innovations like archiving thin slice data or supporting new imaging modalities, it might not be the right vendor for you.
8. Your vendor keeps getting bought out:
If your sales rep calls you and asks for a job referral, you should be somewhat concerned. It's often preferable for technology companies to have a solid roadmap for their products that spans a multi-year horizon. Ask yourself why the company was bought out in the first place. Companies that are dealing with a merger or acquisition can become distracted from their true mission, which is providing innovative technology products. If you have more than three business cards with different company logos for your sales rep, you might want to start worrying.
7. Lack of open standards and interoperability:
When reviewing a vendor's technology solution it's important to understand how the various components can be put together. Over time, the ability of a system to integrate with other hospital systems becomes more and more desirable. Proprietary solutions for storage or other systems architecture can force you into a complex configuration that requires multiple vendors and a high cost to sort out. Vendors that commit to open standards understand the value in flexibility and interoperability as you migrate and integrate systems over time. Proprietary interfaces mean higher cost, vendor lock-in and an inflexible environment for any changes.
6. Confining licensing model:
It is difficult to expand and grow the use of your PACS if your vendor is still in a per-user fixed seat license mode. Your vendor should be well aware that PACS is popular and that any model that restricts your ability to roll it out could damage your department's reputation. Solid vendors offer cost-effective alternatives, such as site licenses, so that you can add users and grow over time. The days of being tethered to workstations should be over by now.
5. Internal vendor chaos:
Does it seem like your vendor is confused depending on which company representative you talk to? Lack of corporate alignment may prove to be a good reason to shop the market. If it appears as though the engineering department is not talking to service it may be a sign that the company is too big or unfocused and not getting good feedback from customers. If the only way to get a response from your vendor is by calling a senior executive, it may be time to move on.
4. No commitment to the IHE roadmap:
IHE builds upon HL7, DICOM and other standards to help make them plug-and-play. If your sales representative looks confused when you ask for IHE requirements and asks you to spell it out for him/ her, be very afraid. By now everyone in the industry should have heard of IHE and a sales rep that has never heard of it might be working for a vendor that is not very interested in best practices for integration. A commitment to participation in the IHE connectathon and a mention of IHE on the vendor's website or mission statement can indicate a strong belief in the benefits of standards and interoperability. Be concerned if your vendor bases its business model off of nickel-and-diming you with proprietary integration.
3. Poor system reliability or performance:
If you click on a patient image, go to lunch and return to find your image still hasn't loaded, it's time to look at another vendor. If your system is moving slowly now, imagine what will happen when you add that new 64-channel CT scanner. Your vendor should keep you in the slipstream of technology by introducing products with high fault tolerance and limited points of failure.
2. You are buying PACS hardware on eBay:
If your reel-to-reel tape drive just broke and you are buying spare parts on eBay, it may be time to look for another vendor or upgrade your PACS. Although older UNIX equipment has historically had great reliability, don't be lulled into a false sense of security. Failure rates increase with equipment age and repairing your older systems becomes more costly over time. You should not be forced to buy 'new' computer equipment from your PACS vendor that is no longer available in the general market.
1. Poor understanding of your needs:
If your request for new features causes your sales rep to slide a quote across the table, it may be time to re-think things. It's important that vendors understand that your system should be able to grow and change based upon your changing needs. New functions five years ago should become core functions today. Whether your hospital purchases a new 64-channel CT scanner or adds a new imaging center, its nice to know that your vendor has a flexible cost and technology model in place to make things work.
July 25, 2024 
