The suspension of the Picture Archiving and Communication System (PACS) by its service provider has hampered all scan report reviewing, including CT and MRI, at Sri Lanka’s leading government hospitals. The PACS system, widely criticized as a white elephant, cost USD 31 million when purchased by a previous government, despite local doctors having developed and operated a similar system for just around Rs. 1 million.
The Malaysian company Redtone, which obtained the deal through an unsolicited proposal, recently suspended the service citing non-payment of dues by the government. As a result, doctors cannot access patient scan reports, severely hampering treatment procedures and diagnosis.
An accident for the Accident service
According to Mawbima Sunday newspaper, this suspension has critically affected the country’s premier accident care service – the Accident Unit of the National Hospital of Colombo. Additionally, two MRI machines at the Accident Service have been out of order for several days, causing a double blow to patient care, according to hospital sources.
“You know that medical tests are essential to determine the medical condition of patients who come to hospitals for treatment. Among these tests, radiological investigations such as X-rays, CT scans, EEGs, and MRIs are crucial. Each doctor recommends these tests according to the patient’s condition and needs,” a senior doctor explained.
He said while X-ray machines are common, CT and MRI machines are only available in major hospitals. Previously, test reports were printed on X-ray films, but due to high costs and the ease of digitization, reports are now sent to doctors in digital format via computer systems or CDs. This information is stored in the PACS database.
Creating chaos in patient management
However, due to the suspension of payments to the company, it has blocked access to the system, creating chaos in patient management. Hospitals no longer have films to print these reports, and in many cases, doctors take photos of scans on mobile phones and share them via WhatsApp for urgent treatment decisions.
More worryingly, the company is now refusing to release past patient data stored in the PACS system, effectively holding vital medical records hostage.
The story behind this situation is deeply concerning.
In 2015, the Ministry of Health realized the need for a PACS system. Five selected doctors were sent to the United States for a special residential advanced course and returned as PACS masters. Working since 2016, Sri Lankan medical teams developed an indigenous PACS system at a cost of less than Rs. 1 million. By 2019, this local system was successfully operational at the Maharagama Cancer Hospital, Jaffna Hospital, Kandy National Hospital, and Ragama Hospital.
However, in 2016, an unsolicited proposal for an ultra-expensive PACS system was submitted by the private sector, backed by a Deputy Director General of Health. Despite strong objections from the Ministry’s Technology Committee, which deemed it an unnecessary waste of public funds – especially as local doctors had already created a working system for Rs. 1 million – the project was pushed forward.
The cost of this foreign PACS system was Rs. 800 million, double the cost of massive national projects like the Victoria Dam at the time. Despite rejection by the Technology Committee and the then Director General of Health Services, a separate committee was appointed under pressure, bypassing standard evaluation.
A USD 31 million loan was arranged from a Scandinavian country
Due to a lack of local funds, a USD 31 million loan was arranged from a Scandinavian country. Implementation was delayed by the change in government in 2019, but the project was revived under the subsequent administration. Ultimately, Sri Lanka was burdened with a USD 31 million debt for a system inferior to what local doctors had already developed.
Today, this PACS system, run by a Malaysian and Chinese consortium, holds the scan data of patients from 18 government hospitals. Due to non-payment, the company has deactivated the system and is refusing to release historical patient data, effectively paralyzing the health system and placing patient care at risk.
“It is like holding the entire health system and patient records hostage,” a senior consultant said, adding that urgent government intervention is needed to protect patients, retrieve their data, and ensure medical services are not held ransom by a private vendor.
