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The Johns Hopkins Health System and Implementation of the Picture Archiving and
Communication System

STRENGTHS WEAKNESSES
1) Long-running, formidable reputation 1) Comparatively mediocre in Oncology,
for clinical expertise Cardiology & Heart Surgery, Diabetes
2) Especially prominent in Ear, Nose & Endocrinology, Nephrology,
and Throat, Geriatrics, Neurology Gynecology, Orthopedics and
and Neurosurgery, Rheumatology, Pulmonology
Urology, and Rehabilitation 2) Relatively poor coverage of
medicine disadvantaged patients.
3) Referral and epidemiological center
for Baltimore/Washington
metropolitan area
4) Well-entrenched government
contractor for overseas social
marketing and epidemiological
campaigns
5) Very strong as a teaching and
research-oriented hospital
OPPORTUNITIES THREATS
1) PACS still relatively scarce but would 1) Federal regulations of 2011 and 2012
advance ideal of completely filmless put caps and non-usage penalties on
data acquisition, sorting, transport, Medicare and Medicaid payments
storage, retrieval and display. 2) Cost-benefit ratio of PACS remains
2) Paves the way for more widespread questionable.
use of tablet PCs and wireless
terminals
3) Optimal compliance with regulatory and
insurer EHR requirements

Johns Hopkins enjoys tremendous prestige, having been ranked first for 21 years

running in the Best Hospitals rankings published by U.S. News & World Report. The

aforementioned expertise in Ear, Nose and Throat, Geriatrics, etc. and in general

medical research (see “Strengths” above) may not be critical in terms of general

healthcare but the tertiary institution definitely attracts a continuous stream of local and

foreign patients (Johns Hopkins Health System, 2013), as do other leading US

hospitals. On the other hand, Johns Hopkins does not rank among the best when it

comes to the dread diseases that are endemic to North America and Europe:
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hypertension, cardiovascular disease, various cancers and diabetes. Houston’s

University of Texas MD Anderson Cancer Center, New York’s Memorial Sloan-Kettering

Cancer Center, the Mayo Clinic, Cleveland Clinic, and New York-Presbyterian

University Hospital of Columbia and Cornell are more formidable in these respects (U.S.

News and World Report, 2013).

PACS has long promised to advance the state of electronic health records, itself

a long-running initiative of regulators and health insurers. Though the costs of putting

enough bandwidth in place and acquiring the software itself are substantial, costs have

declined sharply since the early and mid-1990s. Hence, one may reasonably expect

that benefit-cost ratios have improved. Diagnostician radiologists and clinicians can

count on more rapid access to current and historical patient records, faster throughput,

sharper diagnoses, reduced length of stay, and lower risks of malpractice costs. In turn,

Johns Hopkins itself can do a better job of assembling radiology teaching materials,

attain optimal communication with physicians, and look forward to better staff retention

owing to improved morale and professional satisfaction (Becker & Arenson, 1994).
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References
Becker, S. H. & Arenson, R.L. (1994). Costs and benefits of picture archiving systems.
Journal of the American Medical Informatics Association, 1 (5) 361-71.
Johns Hopkins Health System (2013). Awards and recognition: The Johns Hopkins
Hospital ranked #1 in the nation in 2013. Retrieved from
http://www.hopkinsmedicine.org/usnews/.
U.S. News and World Report (2013). U.S. News best hospitals 2013-14. Retrieved from
http://health.usnews.com/best-hospitals/rankings.