Impact of filmless radiology on the Baltimore VA Medical Center

The new Baltimore VA Medical Center opened in January 1993 as a pilot site for digital medical imaging. The Medical Center, which is physically connected to the University of Maryland Hospital, has a bed capacity of about 280 and performs approximately 52,000 radiology and nuclear medicine examinations per year. One of the major advantages of opening a new Medical Center designed for digital imaging was the ability to ensure that the appropriate infrastructure was present within the hospital to facilitate digital imaging. Within the imaging department (radiology and nuclear medicine) in addition to the plans for the Picture Archiving and Communications System (PACS), equipment was purchased specifically to facilitate digital imaging. The radiology/nuclear medicine/cardiology PACS is utilized for 100 % of the imaging studies at the Baltimore VAMC including conventional radiography (computed radiography), ultrasound, CT, MRI, fluoroscopy, nuclear medicine, and the cardiac catheterization lab. Mammograms are obtained conventionally with film and then transferred into the PACS using a film digitizer. The practical experience and data collection at the Baltimore VA Medical Center have demonstrated that the large scale PACS and virtually filmless operation have been very successful. Further studies of the economic, quality of care, and patient outcomes impact of PACS the medical center are ongoing.