By John Brosky, AuntMinnieEurope.com contributing writer

October 21, 2011 -- Click here for the French translation of this article.

PARIS - France is abandoning a top-down strategy for building PACS networks, giving way to what healthcare bosses hope will be the robust emergence of successful regional programs.

The French Health Ministry is likely to announce on Sunday at the annual congress of the French Radiology Society (SFR), les Journées Françaises de Radiologie (JFR), the names of the four regions that will share 2.4 million euros ($3.3 million U.S.) to advance the acquisition of PACS. Laurent Tréluyer, who led the ministry's work group developing the France Sans Film initiative, announced on Friday at the first day of the JFR congress that he also has shifted to a regional role.

In early October, Tréluyer said he took up the post of director of strategy for the newly created health authority for the Île-de-France region surrounding Paris, where he will be directly involved with a flagship program built on a cloud-computing approach to image archiving. France also designated PACS as one of five priority areas to share 400 million euros in the new funding scheme, called the Digital Hospital, that takes over from the Hospital 2012 funding authorizations that are now expiring.

The renewed push for PACS in France is driven by the recognition that the country has underinvested in radiology equipment for many years.

At the JFR, Tréluyer presented an April 2011 report from the European Commission's Directorate for Information Society and Media showing that France is among the lowest ranked countries for PACS usage among the 27 EU member nations, just below Cyprus. "At least we can say we are ahead of Greece," Tréluyer added, "though only slightly ahead."

PACS Usage in the European Union
PACS Usage in the European Union
France holds one of the lowest PACS utilization rates among all EU member states at 25%. The low deployment of PACS is especially significant among the large industrialized countries of Western Europe. Responses from a survey of 906 chief information officers in the EU for the "eHealth Benchmarking III" report, published 13 April, 2011, by the Information Society and Media Directorate-General of the European Commission. All charts courtesy of Laurent Tréluyer, director of strategy for the Agence Régionale de Santé, Île-de-France.

The health ministry is employing a creative approach to help the four regions with funding for their respective PACS programs. This is the first time France has dipped into the Program of Support for Expensive Innovative Technologies (Programme de Soutien aux Techniques Innovantes Coûteuses, PSTIC) for an outright technology acquisition, Tréluyer noted. PSTIC is typically used to back advanced clinical studies requiring high-end instrumentation.

The funds will help the four to-be-named regions assess their current equipment, identify needs, and send requests for proposals. Funds are expected to see each regional program through the selection process and deployment.

The ministry will track the progress and selected solutions of these four benchmark regions to determine how national funding can further help other regions.

As many as five regions have already established PACS networks that are mature enough that "they did not even bother to apply for the PSTIC funding," Tréluyer said.

In January, Tréluyer acknowledged the national effort to connect PACS archiving with a cloud-based architecture was struggling, admitting that "each region is working on some kind of imaging project."

PACS Connectivity in the European Union
PACS Connectivity in the European Union

Continental France has 22 regions, with a further four regional authorities in the overseas territories administered as French departments. The shift by the health ministry to decentralize PACS development is consistent with the recent roll out of the 26 Regional Health Agencies (Agences Régionales de Santé) created by the healthcare reform act passed last year.

The transition to regional authorities has only set France further back in capital outlays for equipment. In 2011, ministry funding earmarked for radiology equipment was frozen while the regional authorities were put in place.

"I am a bit more optimistic for 2012," said SFR General Secretary Dr. Jean-Pierre Pruvo, who said the society has been working with regional committees combining radiologists and clinicians to build support for the purchase of much-needed scanners.

Vendors participating in the JFR technical exhibition said they are looking forward to better days. "This past year has been the worst on record for our company for bookings," said one executive charged with sales for France.


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