The following themes and questions should be reviewed when considering a PACS migration:
Merger of two or more archives
There are business and technical drivers behind merging an archive. A hospital could have acquired a clinic. A migration often follows as part of an effort to reduce overall costs and standardizing on one PACS vendor. Also, information systems and clinical workflow considerations can drive an archive merger. For example, it may be that Mammography and Cardiology studies need to be consolidated with studies from other sources.
XDS-I to enable referencing foreign studies and documents as an alternative to migration
XDS-I is gaining acceptance as a technique to enable a PACS to make its studies available to another XDS-I enabled PACS. This may be an alternative to a complete PACS Migration – often there is a need to share studies and build a common repository.
Mismatched patient/study information
It is possible to clean up mismatched data and it is possible to automate most of the clean up, for example, make modifications to study identification in the DICOM header and maintain the original identifiers.
Value from studies that do not pass RIS verifications tests
It is often a good idea to consider an unverified store that can be queried by external applications. There are sometime minor issues that make a study unverifiable, for example, date of birth or family name errors that are input at the modality. The study can still make a considerable difference to a radiologist seeking prior studies from a variety of sources.
Archive vendor proprietary issues
It is not unusual for vendors to charge handsomely for a study list and an estimated volume of studies in the current PACS. Migrating just a few studies with a variety of dates, study-types and media sources provides indications of the migration effort.
It is also not unusual for a PACS vendor to underestimate the migration effort. This can create a difficult scenario to carry out the migration when the migration effort is tied to acquisition of a new PACS, because it may not meet committed time frames.
Vendor proprietary tags & annotations
It is often a surprise that many annotations and tags used on studies are not DICOM compliant. It is difficult to retain the tags and annotations in a migration because the migration uses DICOM standards to move the studies. Setting expectations in this regard is key to addressing this issue.