Not long now until the PACS Sig Group meeting when hopefully many of the issues in the current thread will become clear (er). I suspect that the silence around the LSPs in relation to PACS is because of the negotiations that are taking place through them to bring the price of a typical PACS offering down by a significant amount. We should know the outcome of these discussions before or at the SIG meeting. Failure to agree pricing at this stage may well result in more significant delays in procurement and implementation depending on RGs approach.
The thinking around the PACS product or solution is that as the majority of the Hardware required for PACS can be sourced out with the pacs supplier then more realistic prices can be sort and be made more transparent to the purchaser, which is not unreasonable is it! My expectations from the Vendor is to provide the PACS application and know-how to deliver the functionality and clinical utility that we the clinicians demand as has been pointed out in the above thread re the OBS.
The OBS that was constructed for the purpose of the national programme was but a list of specifications (some were debatable) to which the vendors had to meet in order to be included as an approved vendor. This was not a true OBS in the sense that as part of a business case a list of requirements of functionality would be made to which the vendor could or could not provide a solution irrespective of the specification needed to deliver the functionality. As such the National OBS has stretched the limits of several PACS Vendors although they do come above the line. In terms of the local needs for PACS Functionality the Range of Vendors that are above the line in terms of the National OBS should be able to deliver through the support of the LSP the functionality that you require locally.
Hence at the end of the day we should have access through the LSPS to several PACS Vendors where pricing is realistic, Fair to all, (win-win as they say) transparent and of a level of functionality that meets all our needs now and in the future.
Although PACS and RIS (? should we wish to make them separate entities for the purposes of discussion) are not CORE, i.e. a pricing has not been agreed in contractual terms, and are currently not high priority for the contractual obligations of the LSPs: It is still the overall plan to have the vast majority of acute trusts with full PACS by the end of 2006, and as such the LSPs will have an additional remit as it were to facilitate this on top of their current core requirements. Agreed pricing is essential to kick start this process!
Will there be some funding to kick start this process? Perhaps, need to wait and see. Success on the pricing may mean that through our local business cases (concentrating on the Management Case and the Financial Case) that the cash releasing savings over the life of the PACS service may well provide for a revenue neutral position which in addition may improve with larger community cases, although I think it is likely that the cases will commence with trust based solutions. (Data, Image storage solutions will need to be integrated in a phased manner and will involve the LSPs and the National Service Providers).
In term of realizing the Funding requirements, Affordability Gaps and Implementation processes it is essential that clear processes are established locally to establish the local case and that the links and relationships between the key players at the local level, SHA level, Cluster Level (Regional Implementation Director) and LSP are understood.
I understand that all cases will be channelled through the SHA (CIO) and then onto the RID. ANY Decisions as to funding (if any) and timing will rest with the RID who then will ‘ instruct’ the LSP. It is my hope that once the LSP has got the go ahead that there will be set up a joint implementation project board involving the trust, the pacs vendor and the LSP. We all know that a successful PACS Implementation takes considerable time and involvement of lots of people. A PACS solution cannot be imposed.
Keith has already said the advice I would like to give. Each SHA community of trusts should set up a PACS group including a key figure from the SHA and crack on now developing the scope of PACS functionality required. This will inform the SHA on the state of readiness of the trusts and enable them, to find (have in mind!) any capital to enable schemes to get going.
Support from the NHS IA in the form of business case templates and tool kit should be forthcoming soon but this may (should) come under the scrutiny of the NCAB PACS Subgroup and the PACS SIG First. Further help from the National PACS Board in terms of support for implementation is envisaged. Hopefully this will be elaborated upon at the next PACS Group Meeting SO BE THERE! Laurence.
Oh, It is also my understanding that if a given solution is better provided by a vendor associated with a different Lsp then there will be NO major barrier to using them. Just need to provide reasonable justification
posted on Thursday, March 18, 2004 - 09:18 am
What about a solution not associated with any LSP if it would pass a VFM test or is the cosy coterie of LSPs and PACS vendors afraid of some competition?
Thanks Laurence. In our case the LSP and SHA projects are at an early stage of evolution, and are not yet joined up. The PACS Group meeting next Thursday will hopefully shed some more light on the national vision of how this should work in practice, although the devil is always in the detail. I am looking forward to hearing how other projects are progressing, and sharing our own experience.
We envisage the local SHA project collecting the information to develop the local investment case and local OBS, building on the national OBS with the more detailed local requirements. The national PACS programme has developed a local OBS template in draft form that we will be using to collect the information. As we will be effectively trialling this process, the national programme have offered to run a local seminar to go through the templates and provide a telephone help line. This approach looks promising. Our CIO is writing to Chief execs in each trust asking them to form local steering groups/project teams to collate and validate the data, at a minimum comprising a lead clinician, a representatives from IT and a representative from finance. The optimal size of the group will become clearer although, clearly, all clinical groups will need to be consulted. Those trusts that have already undertaken a formal project will be able to compile the information more easily.
It is hoped the local cases will then dovetail in with the LSP/cluster project, although this is where a lot of the uncertainty still exists. I will be looking for clarification on this at the meeting. We need a clearer vision of how local projects, no matter what the size, are to link together to allow seamless transfer of imaging and reports around the country. I think it is vital that we have a national solution for this, ideally through the national data spine, and it would make sense for this development to run in parallel with the local and LSP/cluster wide projects.
P.S. I am aware that some members are unable to attend next week’s meeting because of other commitments. If you have any particular points you would like clarification on then please post them up here or email me directly and I will try to feedback any answers after the meeting.
RG is reported to be saying that he has got PACS down to 50% of original prices. Well founded rumour says that we can expect to hear something by the end of the week, probably through e-health insider! Rumours are starting that, provided the price is down, the DoH may finance PACS at least for first year. Hopefully not too long to wait now.
See the latest e health insider. There may be more deliberations at the procurement level or there will be a massive drive for implementation when perhaps many organizations are not prepared for it.The implementation process, the how, is to be revealed soon I hope by Kate Prangley and her team. We need to understand how organizations develop their business cases alongside the LSPs. More over how do the potential clinical users develop lines of communication within the processes; a subject raises at the last PACS SIG Meeting.