The Danube Hospital digital radiology as a prerequisite for a health care network

Abstract

The history of “PACS” is closely related to the Danube Hospital. The Opening of the worlds first entirely large-scale filmless radiology department in 1992 was a milestone in the early stages of digital radiology. At that point, PACS had just taken the step from being an idea to becoming an adventure, undertaken by a few pioneers worldwide. At the beginning, mere feasibility was the head-topic. Security and reliability became the other important factors to be worked on in a trial-phase before the first patients were admitted into the newly built hospital. Soon after, it was perfectly clear that there is more to digital radiology than just handling images: the whole system had to work together as one functional unit in order to be beneficial for the staff and contribute to speeding up the workflow. The first step from “PACS” to an integrative “digital radiology” system was taken. Ever since computer technology has improved rapidly. Simultaneously new and improved imaging modalities provide greater numbers of images that consist of larger matrix sizes. This development, the expanding of the hospital, integration in a wide area health care and other factors determined the need for upgrading and updating of the system in various steps. Maintenance support and stand by duty are still a necessity. Today digital radiology serves as a central platform for image distribution. The radiological image date of about 40 GB/day are accessible for authorized health care personnel and can be taken over by a great number of specific computer applications such as neurosurgical or radiotherapeutical planning devices with a wide range of resulting synergy effects. Regarding the economic side, we are well beyond the break-even point. In the beginning only medium- to large-scale applications had a chance of being economically successful. Today there is almost no lower or upper limit in this respect. Changing of doctor's needs, development of new imaging modalities and progress in computer technology are expected to continue in the same pace as experienced during the last decade. Therefore the attitude has changed and the philosophy has shifted from “possession” to “utilization” of this meanwhile well-established technology in the sense of a pay-per-performance contract.