The AMNCH in Tallaght has benefited from the relocation of the three original hospitals - the Adelaide, Meath and National Children's hospitals - to a greenfield site in 1998 and has been the first hospital in Ireland to introduce much of the new technology over the past decade.

Although it isn't yet using a full EPR system, it will do so eventually. It currently uses a paperless digital imaging system, and is gradually converting each department from the old methods.

The first move in setting up a digital network in a hospital is installing a Pacs (picture archiving and communication system) for the x-ray department. Due to the high storage needs of radiography, it has been one of the leading fields in pushing for the digital changeover, and it is often one of the first departments a critically ill patient is brought to.

"The x-ray department will drive what happens in a lot of the other departments," says Tom Reynolds, Siemens' full-time medical solutions representative at the AMNCH.

"For that reason the Pacs is the most important piece of equipment being installed and usually a new hospital will choose one supplier for the Pacs and then stay with them.

"The radiologists use Sun workstations with very high-spec monitors to examine the x-rays or CT scans, and they can also be brought up at PCs throughout the hospital, for example in A&E or the operating theatre, so you never need to print out the images." Integrated with the Pacs is a Mammomat Novation DR, for breast scans, the first in the country.

The hospital uses Sirona for its dental imaging services, including an OPG (orthopantomogram) scanner, which shows all of a patient's teeth on one film, and an intraoral, for looking at individual teeth.

Next month, the hospital will continue the conversion process when Siemens installs a full-field digital screening room for fluoroscopies.

This will allow 'live' x-ray images, where the x-rays pass through the body and hit a flourescent plate and are then transmitted to a television screen. This enables doctors to examine bloodflow or bone structure more easily than with a static image.