PACS integration with an electronic health record means the imaging system and the patient record exchange information automatically instead of relying on someone to re-type it. In veterinary practice the record usually lives in the practice management system (PMS), so the integration that matters most is between the PACS and the PMS: the patient booked in one appears on the modality in the other, and the images and the radiology report come back to the record without a manual step. Done well, it removes the most common source of mismatched studies and lost charges in a busy clinic. Done badly, or not at all, every imaging case carries a small tax of re-entry, searching and reconciliation that adds up across a year.
Key facts
- In veterinary practice the "EHR" is usually the practice management system. PACS integration is therefore mostly PACS to PMS, with the same goals as human-medicine PACS to EHR work: one patient identity, one place to find the images and the report.
- The DICOM standard already contains the mechanism for the first half of the loop. The Modality Worklist (MWL) service lets the imaging device pull scheduled patients and their demographics from the scheduling system, so the study is created with the right identifiers before the first exposure.
- The second half of the loop, images and reports returning to the record, is where systems differ most. It ranges from a link in the record that opens the study in the viewer, to the signed report and key images being written back automatically.
- Keystone Omni integrates with practice management systems and teleradiology services so that exams can be ordered with billing captured up front, patient information populates at the imaging device, and completed consult reports update the patient record automatically.
- Integration depends on data quality. A 2018 survey of 488 veterinary referral studies found only 5.1% fully carried the recommended veterinary identification tags, which is why DICOM conformance is worth checking before assuming any integration will match patients reliably.
What does PACS to PMS integration actually do?
Four things, and it is worth naming them separately because vendors use the word "integration" for any one of them.
Scheduling flows into imaging. When a patient is booked for radiographs, CT or ultrasound in the PMS, the request reaches the modality worklist. The technician selects the patient on the device rather than typing name, species, breed, sex and date of birth into a console. That single step removes the most common cause of studies filed under the wrong patient, which is a typing error at the modality.
Images attach to the record. Once acquired, the study is linked to the patient in the PMS. Depending on the system this is a link that opens the study in the PACS viewer from inside the record, or the images themselves being available in the record. Either way, the clinician looking at the chart does not open a second application and search for the patient again.
Reports come back. If the study is sent for interpretation, whether to an in-house radiologist or a teleradiology service, the signed report returns to the patient record. With Keystone Omni the request itself is submitted from inside the PACS with no separate DICOM send, the record updates when the report is completed, and the practice receives an email notification at the same time.
Billing is captured once. Ordering the exam creates the charge. Nothing waits for someone to remember that a radiograph was taken. Keystone Omni captures billing for radiology work up front, at the point the exam is ordered, which is the single change practices most often point to when they describe the integration paying for itself.
Where does the time actually go without it?
Not in any one dramatic failure. It goes in small repeated actions.
A patient is entered twice, once at reception and once at the modality, and the two entries disagree by a middle initial or a transposed date. A radiograph is taken, the case moves on, and the charge is added a week later during a reconciliation, or not at all. A referring veterinarian phones to ask whether the report is back, and someone opens the PACS to check because the record does not say. A locum cannot find last year's thoracic study because it was filed under a previous owner's name.
Each of these costs a minute or two. A practice imaging fifteen patients a day accumulates hours of it in a month, and the cost is paid in attention by the people least able to spare it.
How is the integration built?
Two standards do most of the work.
DICOM handles the imaging side: the Modality Worklist that delivers scheduled patients to the device, the storage of the study in the archive, and the identifiers that tie a study to a patient. Any modern modality supports it, though how completely each vendor populates the identification tags varies more than most practices expect.
HL7 is the messaging standard most practice management and hospital systems use to exchange orders, results and demographics. A PACS that speaks HL7 can receive an order from the PMS and return a result message when the report is signed. Some veterinary practice management systems expose this directly; others expose their own interface, and the PACS vendor builds to it.
The practical consequence is that "does it integrate with our PMS" has a specific answer for each system. Keystone Omni's integrations page lists the practice management and teleradiology partners it connects to today, with a page per partner describing what the connection covers. Current practice management partners include Shepherd, Covetrus Ascend, DaySmart Vet, NaVetor, VisionVPM, OpenVPMS, VetlinkPRO, Instinct, PetBooqz and Tracks Software, and teleradiology partners include IDEXX VetMedStat, Vets Choice Radiology and eImaging. If yours is not on the list, that is the first question to ask rather than the last.
What about cloud imaging platforms?
The same loop applies, and cloud architecture changes where the pieces sit rather than what they do. NewLumen, Asteris's cloud-native platform, receives studies by DICOM from the modalities or through an edge node on the practice network, and delivers signed reports back to the referring practice by email, as a PDF, and by automated delivery for connected practice management systems. For teleradiology groups it also tracks billing codes across every connected clinic and exports them as CSV, which is the same "capture it once" principle applied to the reading side of the business.
What should you check before connecting?
- Which of the four functions the integration covers. Worklist only? Images linked? Reports written back? Charges created? Ask for each by name.
- Whether your modalities populate DICOM identification tags consistently. Open a few recent studies and compare the patient and study fields to the PMS record. Integration can only match what the modality writes.
- What happens to a study acquired without a worklist entry. Emergency cases are imaged before they are booked. The integration should let you reconcile that study to the right patient afterwards, not strand it.
- Who owns the interface. A connection maintained by the PACS vendor and the PMS vendor together survives upgrades. One built by a third party on a version that no longer exists does not.
- How the referring practice sees the result. If you read for outside clinics, the report has to reach their record, not only yours. Keystone Community and NewLumen both address this, in different ways.
Frequently asked questions
Is PACS integration with an EHR the same as PACS integration with a PMS?
In veterinary practice, effectively yes. The patient record lives in the practice management system, so the integration connects the PACS to the PMS. The goals are the same as in human medicine: one patient identity, and images and reports available from the record.
Does Keystone Omni integrate with Shepherd?
Yes. Shepherd is one of Keystone Omni's practice management partners. The Shepherd integration page describes the connection: patients scheduled in Shepherd reach the modality worklist, and images and reports attach back to the patient record.
Does integration require replacing our practice management system?
No. The question is whether your PACS has a connection to your existing PMS. Keystone Omni lists its practice management partners on the integrations page, each with a page describing the connection. If your system is not listed, ask; the answer depends on the interface your PMS exposes.
Will integration fix patient records that were entered inconsistently in the past?
No. Integration prevents new mismatches by removing re-entry. Existing duplicates and misfiled studies still need a one-time clean-up, which is worth doing before go-live so the matching rules start from consistent data.
How does billing capture work with an integrated PACS?
Ordering the exam creates the charge in the practice management system at the same time it creates the worklist entry. The radiograph cannot be taken without a charge existing, so nothing depends on someone remembering later.
Do cloud PACS platforms integrate with practice management systems?
The same principles apply. NewLumen delivers signed reports to connected practice management systems automatically and tracks billing codes across connected clinics; the specific systems supported are confirmed for each practice during evaluation.
See how it works with your systems
Tell us which practice management system and modalities you run and we will show the integration on your own workflow rather than a demonstration set. Contact the team or browse the integration partners Keystone Omni connects to today.