Imaging Update

In 2009, Newsletter, Volume 1 Issue 1 by Addison Clark

New Picture Archive Communication System Bridges Distance

Radiologic Associates of Fredericksburg (RAF) is launching a new Picture Archive Communication System (PACS) this fall. It will enable radiologists and clinicians to view complex medical images and reports from any location with internet connections.

“This new system helps radiologists diagnose patients more effectively and provides instant access of medical images and results to our referring physicians. It gives radiologists a new tool to provide our imaging expertise to any medical office with standard internet access,” said Neil Green, MD, RAF radiologist and physician director of Nuclear Medicine and PET imaging for Medical Imaging of Fredericksburg (MIF).

The new system is RAF’s latest involvement with PACS technology. PACS debuted locally in 2001 when MIF introduced a first-generation system to improve turnaround and storage of medical images. In 2003, Mary Washington Hospital joined in on the use of this technology. That system was replaced with a next- generation PACS in 2005 and has been enhanced significantly. It runs on MediCorp’s high-speed network.

The PACS used by the hospital and its partner medical imaging facilities does a “wonderful job handling images within the enterprise,” Dr. Green said, but there are limitations to its reach. “It is difficult for radiologists to move through images quickly when working remotely, without a high-speed connection.

If a facility outside the enterprise wants to share an image with us at the hospital and MIF facilities, they have to still send us CDs or hard copy films,” noted Dr. Green.

RAF’s new PACS will augment the system used within the hospital and partner medical imaging facilities. The RAF PACS system, developed by RamSoft, Inc., will enable radiologists and clinicians to send, receive, view, and store medical images with relative ease from virtually any internet connection, regardless of its speed, Dr. Green said. With the proper software, medical images can be viewed via a secure internet web site in a physician’s own office or off site location.

PACS Impact Felt Locally

Dr. Green has been involved with PACS technology since its introduction locally. He said PACS, combined with technologies such as voice-to-text recognition software, has enabled RAF to achieve paperless exams and worklists, which have resulted in a number of benefits. The technology:

  • Removes barriers that prevent sharing images with other clinicians.
  • Allows radiology subspecialists to interpret images from miles away.
  • Speeds turnaround of reports from hours to minutes for critical cases.
  • Enables instant comparison of prior exams.
  • Eliminates the physical storage concerns associated with housing “hard” copies, like X-ray film.
  • Improves clinical imaging capabilities. Exams with a large amount of images such as PET-CT scans or Cardiac CT scans, for example, aggregate tremendous amounts of data that would be impossible to support using films alone, Dr. Green explained.

Local System a Vendor Show Site

The next-generation PACS used by the hospital and its partner medical imaging facilities has been enhanced significantly in recent years.

The system incorporates add-on software that allows radiologists to obtain 3-D images of patients so surgeons and referring physicians can more readily envision their patients’ conditions. For example, 3-D images from CT scans of the heart can sometimes eliminate the need to schedule an invasive procedure such as catherization, Dr. Green said. It also enables radiologists to perform “virtual colonoscopies” using images that provide a visual fly-through of the colon.

The local PACS team also worked with a vendor to create its own communications program addressing radiology workflows and operations.

“Our PACS and add-on software provide a comprehensive workflow beginning from the time the patient is imaged, and diagnosed by the radiologist, to the point critical communications are made with the referring physician, and results are sent to his or her office. We have been recognized for our workflow efficiency by Philips Medical and have been visited by representatives of hospitals and outpatient centers across the country who wish to develop similar, efficient facility processes,” Dr. Green said.

Additionally, the system has been enhanced with add-on worklist sorting software developed by Primordial. This software flags high-priority cases. High-priority images are read first. Then, the system alerts clerical staff to fax high-priority reports quickly to referring physicians or get them on the phone for a direct consultation, Dr. Green said.


For more information, contact Neil Green, MD at or call (540) 361-1000 and leave a message.


Pictured above is VIVA’s Dr. Gleason views images using PACS.