Since 1994, Presgar Companies has grown to become one of the largest privately-owned medical imaging service companies in the U.S., with 40 imaging centers staffed by more than 75 radiologists and 700 employees. Combined, those centers complete an estimated 325,000 exams per year using all modalities, including CT, MRI, ultrasound and x-ray.

With numbers like those, efficiency is paramount. In fact, the quest for heightened efficiency and improved economy led the Tampa, FL-based company straight to Toronto, Ontario, Canada-based RamSoft, which is installing PACS systems at most of Presgar’s imaging centers. Thus far, RamSoft PowerServer PACS have been installed at 23 imaging centers and the RamSoft Gateway Router at another three; 12 more installations are planned.

“Our main interest was achieving the efficiencies and cost savings that we knew these PACS systems would provide,” said David Kost, PACS administrator for Presgar, adding that various PACS configurations existed at 25% of Presgar’s imaging centers. However, there was little integration, no continuity, and systems were used largely to enable teleradiology in emergency situations rather than to facilitate day-to-day reading.

As the company looked for a better solution, Presgar’s chief operating officer conveyed positive reports about the RamSoft PACS and recommended the company evaluate it. The system was initially installed at the Pittsburgh imaging center where Kost was IT manager, and beta testing began.

Kost had previously used PACS developed by other vendors, so he had a reference point. From the get-go the RamSoft system astonished both him and his radiologists.

“Our radiologists were much happier with the RamSoft PACS—they felt it was more intuitive and easier to use than any of the systems they had used previously,” Kost said. “I converted our center to PACS and away from film pretty quickly, so we decided to go with RamSoft across our system.”

Offered in various configurations, RamSoft’s PowerServer provides a reliable, fault-tolerant, web-based approach to PACS, accommodating unlimited users and workstations. Key features include:

 • Study tracking from start to finish.
 • Flexible viewing protocols, allowing image display according to users’ preferred layout
 • Unmatched real-time worklist flexibility.
 • Prefetching of current and prior studies to each site or workstation.
 • A full suite of clinical tools for optimal image manipulation.
 • A digital dictation module that allows physicians to dictate reports.
 • Automatic configuration of workstation client PCs, which are updated by the server.

“It’s not efficient for techs to stand by a processor, wait for the films to come out, then sort and put them in jackets,” Kost said. “It’s also not efficient for radiologists to then pull the films out of their jackets and hang them in the order they want. That’s very time consuming.”

Additionally, not all facilities have resident radiologists. Those that do not were having to wait for a radiologist to come on site to have their films read.

With RamSoft PACS, those shortcomings are eliminated. Radiologists read using soft copy and can connect remotely to read off site; remote consults also are enabled. A dictation interface with the RamSoft PACS allows reports to be uploaded as soon as they are typed and transcribed, with reports automatically attached to the proper exam.

The return on investment also has been impressive. The RamSoft PACS has minimized the use of film and processing, saving the company more than $1 million annually. The system has allowed Presgar to reduce staffing, including the number of radiologic technologists at some sites, through attrition—saving considerable additional money. And, courier costs also have been eliminated.

“What sold us on the system was that it had more key features than most of our radiologists actually need—at a competitive price,” Kost said. “And, RamSoft has been incredibly responsive. If we express a desire for a particular capability, they’ll quickly develop an upgrade.”

Today, in clinics where the RamSoft PACS has been implemented, techs and radiologists are more productive. Images can be manipulated for optimal reading. Film comparisons are always at a physician’s desktop. Administrators such as Kost can do more administrative and less support work. And, film filing has been greatly reduced. Everyone is more productive.

In fact, at centers that use RamSoft PACS, physicians are able to read films up to 33% more quickly. Radiologists have increased the number of films they read in a given period by up to 50%. And, patient wait times to receive films have been slashed by 90% or more. Indeed, Presgar is looking forward to a productive year, with several more centers going online with RamSoft PACS.

“The RamSoft PACS has been huge, and the benefits will increase as we get all of our centers on line,” Kost said. “Everyone is more efficient, we’re saving considerable money, and things are running more smoothly than ever before. The RamSoft PACS has really made a difference.”