As an example of cost-effective implementation of the Insight ™ system, consider a moderate-sized hospital with an installed PACS system that includes a number of diagnostic workstations within the radiology department. Based on the success of the PACS system, a number of clinical departments and users are requesting PACS workstations with the same capabilities as those used by radiologists. Five workstations are required in all, one for the trauma department, two for surgical wards (with dual monitors), one for the ICU, and one for home use by a radiologist that is frequently on-call on weekends. Figure 2 shows the desired configuration with five physical PACS diagnostic workstations.

Now consider the configuration shown in Figure 3 with the Insight ™ system providing distributed access to the data, PACS functions, and computational power of the central server machine.

Figure 2. Expansion of a PACS system with the addition of five diagnostic workstations.

Each of the five access stations is functionally a complete PACS diagnostic workstation, but physically each station is an inexpensive and light client or simple PC (which includes a screen type that reflects radiological need - size, resolution, brightness, etc).

The resulting cost of investing in each of these two configurations can roughly be calculated as follows. For the first configuration (Figure 2), hardware costs are simply five times the price of a diagnostic workstation (estimated at 43.960 USD per unit, excluding 6.280 USD for a typical high-quality screen). For the Insight ™ configuration, the cost is the same for the screens, but the client devices are 1.256 USD each, and the Insight ™ server 2 is approximately 31.400 USD. The total investment is thus 81.650 USD for the Insight ™ solution, versus 263.800 USD for the configuration consisting of dedicated workstations.

Figure 3. Expansion of a PACS system with the addition of an Insight ™ server and five thin-client devices that function as diagnostic workstations.

2 The Insight ™ server in this configuration consists of an IBM Intel-Linux PC Cluster with three nodes: an Application/Cache Node and two Render Nodes. Note that the given hardware setup can support up to ten additional workstations/users.

This investment analysis assumes that software license costs and system support costs are the same for both configurations. However, one area where the Insight ™ solution exhibits an additional advantage is regarding expansion of the system. If five more workstations/users need to be added, this is done by connecting five more thin-clients or PCs to the Insight ™ server (no additional Render Nodes are required). Thus, the total investment for ten PACS workstations becomes  537.893 USD for dedicated equipment versus  134.473 USD for the Insight ™ solution.

An Insight ™ system with five Render Nodes has been operating at Aalborg University Hospital in Denmark over the last year. According to Dr. Henrik Gregersen of the Radiology Department, and the project leader, “it has been extremely simple to meet the growing PACS needs of our radiologists and clinicians – anytime an additional diagnostic or clinical workstation is required, we simply re-use an existing PC or install a thin-client. The return-on-investment is extremely rapid for each new seat.”