Amicas vs. Fuji 1/05

Posted to AuntMinnie 1/05...

I now have Amicas LightBeam PACS at two of the hospitals I cover. The other, larger hospital is upgrading Agfa Impax 3.5 to 4.5. A large oncology clinic we staff uses GE Centricity 2.0. We looked extensively at several systems. I will spare everyone the gory details, and stick to the question at hand. Maybe someday I will team up with Mike Cannavo and write up the whole search saga. It might make a good mystery novel....
I am very pleased with Amicas, and I would buy it again in a minute. All the rest is commentary, as they say. My partners now pay them the highest complement: when referring to PACS in general, they usually say "Amicaspacs", all in one word. In brief, the AmicasRealTime Worklist is incredible, and that is what sold me on them at SCAR in Boston in 2003. You see what you need to see at a glance; you know what needs to be read, what has been read, and the status of various things right there in a clear, color-coded format. The list can be customized any way you want it, even to the point of having a different set of lists for each user. The viewer itself is very straightforward and intuitive. The few major tools you need about 90% of the time (scroll, window/level, pan, zoom) cycle by a quick right mouse click, and all other tools are either on the menu bar of available through a right-click-and-hold pop-up menu. There is an embedded subset of the Voxar 3D tools, and there can be integration with the full Voxar 3D program or alternatively with a TeraRecon server.
As near as I can tell, the guts of the system are similar to Fuji Synapse, using Windows Server, for better or worse. Both are completely web-based, i.e., each image has its own URL. Both deploy software over the internet/intranet/LAN, i.e., the "thin client" approach. One's opinion on an interface is just that, an opinion. Some like Fuji's client; I am among those who do not. They use a folder analogue instead of a worklist; that is OK as far as it goes, but every time I tried it, I ended up with folders all over my desktop. Probably just user error, and I have been flamed repeatedly for disliking their system. I have been told by a senior exec at Fuji (who since left and went to another similar company) that I was far from alone in my feelings about their interface. In our PACS search, we actually hit two Fuji demo sites, one in Austin, Texas, and one in Virginia. The Austin site has a spectacular communications network, set up mainly by the experts within that particular radiology group and Time Warner Cable, and NOT by Fuji, again as nearly as I could tell at the time. Studies were delivered fully within 3 seconds of the request. This came at a tremendous cost in communications; thousands of dollars per site per month. One thing becomes clear when you talk with Synapse users: They like the product, but they seem to have to do most of the maintenance on their own. A common theme is that Fuji has not yet mastered the sales or the service on an otherwise good product.
Amicas has not yet reached the level of perfection, either, lest I leave you with that impression. Our install has taken longer to come up to 110% functionality than I would have guessed. Some of this is due to the fact that we have only one PACS administrator for two good-sized hospitals, and his helpers from IT have a thousand other things to do at any one time. Still, I am overall satisfied with what we have to date.
Agfa is a whole 'nother story. I am willing to slog through Impax 4.5 in hopes of eventually having 6.0 installed sometime in late 2005. (I urged that hospital to put some onerous penalties in the contract should 6.0 not appear, but I don't know if they did so...)
Bottom line: Amicas is a good company with a good product. They do have a significant number of "real" PACS systems installed in large hospitals. I recommend them highly. For what that's worth, anyway....