Presented by Jef Williams

PACS to PACS Conversion

Critical Pre-Project Planning Questions that Must be Answered

Overview

Converting from one PACS to another will create greater challenges and potential disruption than going from film to filmless Below are a filmless. set of questions you need to have clear answers for in order to make the transition smooth and ensure the greatest outcome. These questions are based in 5 categories: System Selection Hardware & Architecture System Installation & Build Conversion & Migration Testing & Validation Go Live & Cutover

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System Selection

What is the impact of application feature changes on users? How will you manage application customization from legacy to new system? How will you transition worklist modifications from legacy to new system? How well do vendors collaborate with transition? What information in current system is proprietary to the vendor? What is the plan to ensure there is no gap in coverage between current vendor support and new vendor support? Who will manage troubleshooting between both systems during build testing build, testing, conversion, migration, and cutover? Have you conducted full system requirements including Technical, Functional and Clinical for new system based on lessons learned from legacy system (workflow, image distribution, archiving, integration, image export/import, remote reading, etc.)

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Hardware & Architecture

What is the existing storage architecture and what changes are required with new system? Are you pursuing vendor-neutral archive solution with transition? Have you performed gap analysis between existing and future vendor support including hardware, software, downtime, and support model? g , , , pp Is EHR and HIE included in future roadmap? Have you performed gap analysis for end user hardware/network requirements for new system? Do all hardware components of new system comply with existing infrastructure and IT policy? How will you design and manage High Availability? How will you manage network design during build, test and cutover?

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Hardware & Architecture (contd)

Do you have a well-documented and understood DR policy in place? What differences exist between legacy and future system databases including vendor and location within system? How are backups managed currently vs. future system? What SOA requirements currently exist or will exist in the future and what is your strategy? What is your virtualization strategy and how is it accounted for with future system?

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System Installation & Build

Has data center space been allocated for both systems running concurrently? Have you identified a build environment for all necessary systems? (HIS, RIS, EMR, Dictation, Legacy PACS) Are there IHE requirements that must be considered? What are they? Have you identified all uni/bi-directional interfaces to existing PACS? y g Have you identified all uni/bi-directional interfaces to future PACS in concurrency with legacy system during transition? How will you manage interface build to existing systems without affecting legacy live environment? Have you considered and budgeted for all interface costs to upstream/downstream systems? What changes will users experience with new system integration to 3rd party applications? How will you manage integration to 3rd party applications during build/testing phases?

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System Installation & Build (Contd)

Have you documented and accounted for all customized interfaces in current environment? Have you documented and accounted for all translation tables? Have you accounted for direct connect vs. HL7 interfaces? Are there custom scripts for specific values in current system that need to be y identified and managed going forward? Have you considered EHR or HIE in system build? Have you accounted for MPPS? What is your strategy for building dictionaries? Stay with existing structure or re-design for better efficiency? How will you manage legacy codes during conversion? How will you use the dictionaries to validate RIS/PACS consistency? Will you maximize this opportunity to standardize codes and descriptions? How will changes to codes/descriptions affect reading workflow?

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System Installation & Build (Contd)

Has EHR integration been planned to meet existing requirements? Future requirements? How will the application change effect how referring physicians provide care and efficiency measured? Will the new system provide the referring physicians a flexible full featured tool set consistent to what they use today?

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Conversion & Migration

Have you budgeted for all conversion/migration costs? How will data formats in legacy system be converted? How will you manage the dirty data in your existing system? How will you manage proprietary data (annotations, measurements) that cannot be converted? How will you manage broken studies? Have you identified the source of truth (RIS vs PACS)? What limitations exist in current system for outbound threads for conversion/migration? i / i ti ? Is there a targeted migration strategy possible with legacy/future systems? Have you determined the unique identifier for accuracy purposes? What Wh t compression is applied or di i i li d dissolved d i th migration? l d during the i ti ? Much storage has been allocated for the migration? Has additional Storage space been procured for migrated data until legacy space can be reclaimed?

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Testing & Validation

What is your testing and validation methodology? Who is responsible for testing and validation? Who will write your testing scripts? How will you validate the converted/migrated data? How will you manage data flow testing upstream/downstream including modalities?

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Go Live & Cutover

What is your cutover/Go Live strategy for dataflow? What is your cutover/Go Live strategy for modalities? What is your cutover/Go Live strategy for users? (Rads, Techs, Referring Physicians)? What is your internal training model? What will be the source of truth during cutover/Go Live? How will you manage the integration components to the third party applications during cutover/Go Live? Who ill Wh will manage application d l li ti deployment and cutover? t d t ? Can existing workstations accommodate concurrent applications during testing and cutover? How will the legacy system be retired and who will own the process?

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