How We Vote for PACS

PACSman: I voted today – we have early voting here in Florida, home of the dangling chad – and from what I can tell the candidate I voted for President – “None of the Above” – is well in the lead…

In the past week or so I have also been inundated with e-mails, mailers, radio and TV ads, and the like about the candidates. Almost all are highly critical of the candidates they are running against. No one seems to extol their own qualifications or virtues any more. It’s easier to cut the lil’guy down than stand up for what you believe in…although W.C Fields was probably right when he said “A man’s got to believe in something. I believe I’ll have another drink…”

I look at the way people vote and the way people buy PACS and the similarities are downright scary….Vendors don’t promote their own virtues but instead cut down the competition. Heck, I can’t even go to church without having the Christian Coalition of Florida (CCF) putting out their “Voter Guide Project” to help me make one of the most important decisions I’ll make in the next four years. You might say “Well what’s wrong with a lil help?,” but misguided help is worse than no help at all. Unfortunately, that is what most of these guides are – a misguided attempt at “helping.” The Christian Coalition tries to determine a candidate’s suitability based on a few very narrow stances like abortion, school vouchers, human cloning, adding sexual orientation to the definition of hate crimes and do you want English as the official language of the U.S. Government, and other areas of a similar ilk. I mean, let's get real – English as the official language of the U.S.? Come on people!!! That said, let’s see them hold the vote on sexual orientation during Disney’s unofficially sponsored Gay Days – where Mickey will gladly take your money, but never officially acknowledge you – or what the vote is on English as the official language is in North Cuba, I mean Mijammie, and any of the other cities in the state where the Hispanic population exceeds 30% of the total population. No hablo Spanglish – sorry. We have candidates running down here who, if we are to believe even 10% of what is said about them, shouldn’t even be running, yet they got the CCF stamp of approval! Heck one candidate even had two affairs that he admitted to (and God knows how many others he didn’t) and STILL got their stamp of approval – just because he supported their platform!! Not a single word about fiscal responsibility, their background and suitability to run the city, county, state or country, their moral character and other silly little details like that. I hear that high pitched woman’s voice in the late 60’s Sly and the Family Stone’s hit “Dance to the Music” – “Vote for me and I’ll set you free!!” My God - I’m hearing voices now…

It occurred to me as I filled in my little black boxes that not only is this how we choose our leaders, this is also how we choose our PACS – on a few very narrow platforms that we are aware of. And those we aren’t aware of we just fill in a box and hope for the best.
Do we ask hard hitting questions? No way, no how? Contract negotiations? We’ll accept whatever we are given…Penalties? Just trust me….It’s no wonder why more than half of all second generation PACS selections are made with different vendors – because we filled in the lil’ black boxes without knowing what we were voting for and it came back and bit us in the backside time and again. Just ask anyone who is looking at a $250K+ data migration bill they didn’t expect when the vendor said they archived their data in a DICOM file format when they bought the system years ago. Technically we did support DICOM, however…The devil is all in the details….

Bill Clinton at least had the audacity to dance when he needed to about Monica Lewinsky as reported in the Starr report. “It depends on what the meaning of the word 'is' is. If the – if he – if 'is' means is and never has been, that is not – that is one thing. If it means there is none, that was a completely true statement....Now, if someone had asked me on that day, are you having any kind of sexual relations with Ms. Lewinsky, that is, asked me a question in the present tense, I would have said no. And it would have been completely true.” So he was innocent – technically. And so are vendors who don’t tell you everything you need to know before you make a buying decision. You never asked so…It’s the same Clintonesque logic. Besides, when you think about it, it wasn’t Bill’s fault. Monica was simply too cheap to get her dress dry-cleaned, saving it instead as some sick form of souvenir. Either that or her girlfriend’s never taught her properly how to finish what she started. Either way, Bill was innocent…

Remember that when you vote next Tuesday – and you do need to vote – that it’s all a matter of what you ask for and what your perspective is…Then carry it through when you buy your next PACS.


Ms. PACS: PACSman, you have never been characterized before as “opinionated,” have you? Wow. Well, you should have been on one of the campaign platforms because you sure do want to tell the people what you think. Do you think that is the reason people run for president – because they want to stand from the highest podium to tell the masses what they think and actually get an audience to pay attention? Your next gig, PACSman, is definitely in radio – talking about PACS, of course.

I do agree with some of your comments - at least the overall message - reminding folks to be discerning when listening to a PACS vendor and use their critical thinking skills – like when they vote.

You are also right about how narrow minded people are when they vote. The sad thing is that most people vote less based on logically drawn conclusions and more based on their emotions – fear being the number one critical factor. Let's vote against what we don’t want, as opposed to voting for what we want.

Many buyers rely on similar criteria when buying a PACS – the IT guy/gal thinks, “I don’t want this system to break down and for all of the radiologists to blame me and to ultimately lose my job. So, even if this PACS falls short of providing any additional useful features, such as: presenting information in a user-friendly manner or indicating if there was a prior or if it has an embedded solution for critical results or whether the hanging protocols can actually be set up in day-to-day practice. They won’t know what they’re missing and I would rather stick with the status quo than to take any risks and actually improve the radiologist’s workflow.” Sound familiar?

The irony is that the last time the “majority” of Americans voted based on fear they ended up in a long drawn out war. Don’t do the same with your PACS - it will cost you dearly. Do your due diligence, don’t base the final decision on price alone (penny wise, pound foolish) because PACS is not a commodity, despite what some claim, and some systems do work better than others - it's your job to find which ones work better for you. So take a chance and actually raise the bar on your radiology department’s efficiency and workflow. In PACS, as in life, if we strive to be better, we might just get there some day.