REQUEST FOR INFORMATIONDartmouth Hitchcock Medical Center

This RFI was used at Dartmouth-Hitchcock Medical Center to obtain information from different PACS vendors. You are free to use any portion of this RFI to develop your own RFI.

The purpose of an RFI is to give the vendor as much information about your operation, your expectations and limitations as you can - this will enable the vendors to tailor the information to your facility or withdraw from consideration if they cannot meet your stated needs. Request for Information for a Picture Archive and Communications System (PACS) for the Department of Radiology at Dartmouth Hitchcock Medical Center (DHMC) and the Dartmouth Hitchcock Alliance. The Dartmouth Hitchcock Alliance is a group ten of affiliated hospitals - it works like a GPO.

Background

DHMC is a 400-bed teaching hospital with the following imaging equipment modalities:

Current number of imaging rooms updated as of 1/2004 shown in red.

2 1.5T GE MR units 3 plus 1 mobile2 GE CT units 33 GE Interventional/Angiography units5 Mammography units Plus 1 digital mammo11 Radiographic and R/Fluoroscopy suites 6 DR rad, 3 fluoro3 Nuclear Medicine imaging suites4 Ultrasound imaging suites1 CT/PET mobile

An expansion of the department scheduled to open in mid-2004 will add 3 DR, 2 CR, 1 CT/Angio, 2 ultrasound, 2 digital mammography, 1 PET/CT, 1 CT

The Radiology Department at DHMC does approximately 155,000 studies each year using the above imaging modalities. 2004 project 220,000 exams

Currently the only section of the department that has converted to "filmless" imaging is the Ultrasound Department. Ultrasound uses the Kodak InSite system, which is being phased out by Kodak at the end of 2001.

As part of its preparation for PACS, the Radiology Department is planning to start the installation of a Computed Radiography system in its plain film section (DX). A CR vendor has not been selected yet. We expect this installation to be complete by October 2001. We determined that DR was better for us. In 2003, DHMC purchased six DR rooms and 4 CR units. Another 3 DR and 2 CR units on order for expansion.

The DHMC Radiology Department has an IDXrad radiology information system operating at the 9.7 version. It is anticipated that this system will be upgraded to the IDXrad 10 version in 2002. The upgrade of the RIS was postponed to 1/2004 to avoid doing too many changes at the same time. It is expected that any PACS equipment vendor will integrate seamlessly into either IDXrad V9 or V10.

The following issues were critical to DHMC being able to install a PACS. Some vendors could only work with a 100BastT network throughout the facility. To rewire the hospital would have cost additional millions - one estimate was $6,000,000. Several vendors withdrew from consideration.

The DHMC main campus was designed in the late 1980s and opened in 1991. The data network design reflected the best standards of the period for the cabling plant that would be required for ongoing computerization of the medical center. It was modern for the time, consisting principally of Category 3-compliant copper cabling to the desktop. This limits transmission speeds to 10 megabits-per-second. Data network equipment provides switched 10BaseT services. Ten wiring closets of the 81 in the complex have been upgraded to Category 5-compliant cabling to all stations (Only one of these ten closets is in the Radiology area, and it will be abandoned as part of the major construction/renovation project). In these ten closets data network equipment provides switched 10/100BaseT services. In most closets, further cabling upgrades are impossible without physical expansion. For this reason any PACS proposal that requires 100 megabit-per-second or greater transmission speeds will require substantial

investments in network infrastructure and will probably have physical space and construction impact as well. This will be taken into account in evaluating the RFI and RFP responses. The DHMC Radiology Department will expand as part of an institutional expansion project scheduled to be completed in 2004. These new sections, the Diagnostic and Treatment Building and the Ambulatory Care Center will include the following additional equipment:

Diagnostic and Treatment Building (D&T)

2 CT units 2 MR units 1 Positron Emission Tomography (PET) units

Ambulatory Care Center (ACC)

2 Mammography units3 Ultrasound units 2 Diagnostic Radiology (plain film) units

The Goal

The DHMC Department of Radiology goal is to develop a phased approach to convert from film-based imaging to digital imaging for all modalities except mammography by 2004. The PACS will be seamlessly integrated into the IDXrad RIS. Images will be available for interpretation within Radiology and viewing from the personal computers (PC) of the clinicians at the DHMC campus and clinicians located away from the DHMC campus via the Internet.

Phases for PACS Integration

Phase 1 - The introduction of computed radiography (CR) in portions of the DX and ED sections will be completed in FY2001. Image recording will continue to be film-based until the full PACS is deployed. DHMC went with DR for primary radiographic equipment with CR for portables and special cross-table work.

Phase 2 - The replacement of the Kodak InSite Ultrasound digital recording system. This must be done by January 2002. This could be an independent system, which will later be integrated into the PACS network, or it could become part of the initial PACS network.

Phase 3 - CT, MR and CVIR (Interventional Radiology) to provide both softcopy interpretation, digital archive and the ability to export images from Radiology to the PCs of referring clinicians both on the DHMC campus and those located in other communities.

Phase 4 - Nuclear Medicine and Diagnostic Radiology migration into the PACS network in FY2003.

Phase 5 - Installation of the PACS into the D & T and ACC buildings by their scheduled opening in 2004.

As part of our PACS planning process, we are requesting information from your company in order to determine whether your company will be invited to respond to our request for proposal (RFP), which will be issued in mid-2001.

Require the vendors to respond in the exact way you have outlined the questions. This will make it easier to compare vendors.

Please respond to the following broad information categories:

1. PACS product name2. Years your company has had a PACS product3. Years your current product line has been offered4. Total number of PACS installations in 2000 (US only)5. Total number of PACS installations in 2000 (Worldwide)

Product Offered - Please provide detailed information on the following:

6. Servers7. Archives8. Web server9. RIS interface with IDXrad10. Entry level teleradiology11. Computed radiography

12. Digital radiography13. Digital mammography14. Off-site storage15. CD-ROM - DVD burner

Hardware and Software - Please provide detailed information on the following:

16. Software platformFile serverWeb serverArchive

17. Workstations18. Preferred Archive

MediumCapacity per disk/tapeMaximum capacity (TB)

19. Digital scannerType

20. LAN network supported21. LAN network recommended22. WAN network supported23. WAN network recommended24. Is third party software used?

If so, whose?In what applications?

25. DICOM interface manufacturer used26. HL-7 interface engine manufacturer used27. HIS vendors implemented a working interface to28. RIS vendors implemented a working interface to

OEM Partners - Please provide detailed information on the following:

29. Hardware30. Archive31. Web browser32. Computed radiography33. Digital radiography

Service - Please provide detailed information on the following:

34. Size of your PACS field serviceLocation

35. Service response time guarantee36. Up-time guarantee37. What differentiates your PACS from others?

Information from the RFI will be used to structure the RFP. For example: In the service section above - the RFI asks what their service response time and up-time is -- when you write the RFP you will require a specific service response time and up-time. It makes not sense to require a 1 hour service response time of none of the vendors are able to do better then 4 hours - perhaps because you are in a rural area as DHMC is.