Consolidated Imaging: Implementing a Regional Health Information Exchange System for Radiology in Southern Maine

The traditional, film-based radiology system presents serious limitations for patient care. These include forcing clinicians to make decisions based on information that is often less than optimal and making transfers of films and prior studies to other facilities more complicated than they need to be. Picture Archiving and Communication Systems (PACS) address these issues by allowing for acquisition, storage, display, and communication (e.g., transportation) of images in a digital format. Although PACS has been shown to improve patient care, many rural health care organizations have found obtaining these systems cost-prohibitive. The Consolidating Imaging Initiative (CI-PACS) in Maine provides an alternative way to offer this technology to rural hospitals. Through CI-PACS, a tertiary care hospital and its health care system have implemented a shared, standards-based, interoperable PACS in two rural hospitals (one belonging to the larger health system and one not). In this article, we discuss how the regional system works, and how it will be sustained. We also highlight the unique challenges associated with implementing a regional system.