Preparing a business justification for going electronic.

Exponential advances in the technology sector and computer industry have benefited the science and practice of radiology. Modalities such as digital radiography, computed radiography, computed tomography, magnetic resonance imaging, ultrasound, digital angiography, and gamma cameras are all capable of producing DICOM compliant images. Text can likewise be acquired using voice recognition technology (VRT) and efficiently rendered into a digital format. All of these digital data sets can subsequently be transferred over a network between machines for display and further manipulation on workstations. Large capacity archiving units are required to store these voluminous data sets. The enterprise components of radiology departments and imaging centers--radiology information systems (RIS) and picture archiving and communications systems (PACS)--have thus undergone a transition from hardcopy to softcopy. When preparing to make transition to a digital environment, the first step is introspective. A detailed SWOT (strengths, weaknesses, opportunities and threats) analysis, with a focus on the status of "electronic preparedness," ensues. The next step in the strategic planning process is to formulate responses to the following questions: Will this technology acquisition provide sufficient value to my organization to justify the expense? Is there a true need for the new technology? What issues or problems does this technology address? What customer needs will this technology satisfy today and tomorrow? How will the organization's shareholders benefit from this technology? The answers to these questions and the questions that they in turn generate will stimulate the strategic planning process to define demands, investigate technology and investment options, identify resources and set goals. The mission of your radiology center will determine what you will demand from the electronic environment. All radiology practices must address the demand of clinical service. Additional demands based on your mission may include education and research. The investigation of options is probably the most time consuming portion of the analysis. It is in this stage where the system architecture is drafted. Important contributions must be solicited from your information technology division, radiologists and other physicians, hospital administration and any other service where the use of imaging technology information is required and beneficial. Vendors and consultants can be extremely valuable in generating workflow diagrams, which include imaging acquisition components and imaging display components. A request for proposal (RFP) may facilitate this step. A detailed inventory of imaging equipment, imaging equipment locations and use, imaging equipment DICOM compatibility, imaging equipment upgrade requirements, reading locations and user locations must be obtained and confirmed. It is a good idea to take a careful inventory of your resources during the process of investigating system architecture and financial options. An often-ignored issue is the human resource allocation that is required to implement, maintain and upgrade the system. These costs must be estimated and included in the financial analysis. Further, to predict the finances of your operation in the future, a solid understanding of your center's historical financial data is required. This will enable you to make legitimate and reasonable financial calculations using incremental volumes. The radiology center must formulate and articulate discrete clinical and business goals for the transition to a digital environment that are consistent with the institutional or enterprise mission. Once goals are set, it is possible to generate a strategic plan. It is necessary to establish individual accountability for all aspects of the planning and implementation process. A realistic timetable should be implemented. Keep in mind that this is a dynamic process; technology is rapidly changing, as are clinical service demands and regulatory initiatives. It is therefore prudent to monitor the process, make appropriate revisions when necessary and address contingencies as they arise.