Implementation of a Digital Imaging System to Support the Predoctoral Program at UTHSCSA

To share a perspective on the implementation of Digital Imaging System (PACS) to support a predoctoral dental educational program.
Digital radiography provides for significant improvements in storage, organization and utilization of images for patient care. With ability to deliver images as part of a computer-based patient record at the point of care, student and patient education can also be enhanced. The rapid adoption of digital radiography in private practice makes it imperative that dental graduates be prepared to utilize this technology. In an academia-industry collaborative effort, the Dental School has developed a DICOM-based, scaleable Picture Archive and Communications System (PACS) providing the functionality that was needed for an dental treatment and education system to support the large number of patients and providers (faculty, staff, and students), in a dental school environment. The PACS has been integrated with a computer-based dental record in the pre-doctoral clinics and includes: a client "Viewer" application installed on laptop computers for retrieval and display and a "Server" application for storage of all digital images acquired in the dental school. The system supports digital intra- and extra-oral radiography using CCD/CMPOS sensors and Photostimulabe Phosphor (PSP) technology. PSP imaging plates have been chosen as the school's primary replacement for conventional x-ray film for intra-oral radiography. Physical plant renovations were made to optimize PSP scanning and quality control procedures. Extra-oral imaging is provided by four direct digital pan/ceph x-ray machines. PACS training was integrated into initial clinical activities at the onset of the academic year. The PACS contains over 15,000 images with access by more than 400 users. Preliminary data indicates increased effectiveness of the use of images.  In the future, more long- term assessments will be made including satisfaction surveys of users, both internal and external. Current efforts include improving:  management of network security; performance of the integration to the CIS; control of the display environment (laptops); and management of updates to client and server OS and JAVA applications related to the impact on the CIS and PACS systems.
The UTHSCSA Dental School has successfully implemented and continues to enhance the use of a Digital Imaging System (PACS) for digital radiography in the Predoctoral Clinics.