When are a company’s proprietary systems a bad thing? When it impedes you from doing what you want with your data. No, I am not talking about movies/music and DRM, although many parallels could be drawn in that direction. I am talking about modalities and other supporting systems that lock features and data away from the institutions that own them. There have been more than a couple of situations where I have been unable to get at settings, or more importantly, patient information, because an vender such as Kodak has decided to keep it’s systems locked up.

I only name Kodak to illustrate my point. Kodak supplies our film print servers. Like most things PACS related, these are nothing more than normal PCs running some special software/hardware. That means it should be really simple for me to, say, allow a new workstation to print. If only such was the case. No, Kodak locks these print servers down, requiring a costly service visit to do the most mundane of tasks. Luckily, being kind and courteous to your local service tech has rewards, and, for the moment, I have a means into the print server to make these fundamental and basic changes.

There may be many reasons a company like Kodak chooses to take such limiting actions. If you asked them, I am sure their first response would be that it protects us from ourselves, and ensures a stable system. And this argument has much merit. For the most part, computers are pretty stable devices. If you do one or two functions on them, and never deviate, there is no reason the computer will suddenly give you grief. My experience has been that computer problems stem either from user error, or a complex environment. And by locking their product down, Kodak prevents both of these complications, helping to ensure it’s product works as advertised.

I, however, do not think the true reasons are so noble. It is my belief that the main reason behind such actions is to generate revenue. Each time we need to modify our environment, to move equipment, we need to call out the service reps. And most of the time, all these reps do is punch in their secret passwords, and then type in the information I provide them. Imagine if Microsoft operated this way? Better yet, getting with the times, imagine if Google did? Sure, Google allows you to search for free. But what if they charged you each time you made a typo and had to re-compose your search query? Would this ever fly? No, suddenly the entire Internet would flock to Yahoo or some other site. Sadly, in the fledgling world of PACS, there just is not much recourse.

Would I be taking the time to write this, if the only impact on me and my organization was money? Perhaps. Luckily, there is another driving factor that bothers me much more. Not too long ago, I had a situation arise where an ultrasound technologist entered a PHN for the patient, but managed to put a space as the first character. Ultrasound tech’s are great people, who do a wonderful job for our company and for our patients. I can no more fault them for such a typo then I can fault myself for accidentally unplugging a live network wire that disrupted someone’s work! (hey, we all have our bad days!!) After all, that is one of the reasons I am around, to take care of situations like that. Well, in this case, the modality allowed the exam to continue, but it did not send to PACS. Upon closer inspection by myself, it seemed like a “bug” in the underlining database was preventing the system from accessing this PHN and the associated images. After a few minutes examining the problem, I surmised that there was little I could do. I could see that the study was approximately the correct size of MB’s, so I felt that the images were stored successfully. It was simply the software not letting me at the images that was the problem. And since this system was locked down so only the acquiring software was accessible to the user, I had no choice but the call vender support.

I posted the other day about my feelings on the quality of support techs, so I will avoid repeating myself. Suffice it to say, the tech was unable to get any further then I could, and simply told me the images were lost. No, I do not think so. I told the tech to get me into the operating system, and I would remedy the problem. With much resistance, he unlocked the system, and in a few short minutes, I found the raw images, copied them to CD, and imported them into PACS. But why did I have to waste hours of my day? If the vender would give us the access we need when we purchase the equipment, these, and other, frustrations would go away. Perhaps this is a lesson learned to be more specific and demanding in future contract negotiations.

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