PACS Systems: An Overview and How They Can Benefit You

Not too long ago, PACS, or Picture Archiving and Communication System, was available solely to large institutions. Cheaper storage costs and increased market competition however, have made PACS affordable for virtually any health care provider doing any kind medical imaging. This will provide information on what PACS is and what features are available, and how it can benefit you.

What is PACS? A Quick Overview

In its most basic form, PACS is a software and hardware system that facilitates the efficient storage and retrieval of medical images. For the purposes of this Buyer’s Guide we will assume that PACS is a server with substantial hard drive storage space and software to organize, receive and distribute medical images. Almost universally, PACS utilizes the DICOM format for storing and transferring images.

A basic PACS scenario involves four main components:

• PACS server
• At least one modality
• viewing workstation
• A network

This sample scenario begins with the acquisition of the medical images. These images are acquired at an imaging modality. CT, MRI, x-ray (CR or DR), ultrasound or PET are some of the most common modalities. When the images have been acquired they are sent in DICOM format from the modality to PACS over a secured network.

When PACS receives the images sent from the modality there are a number of things it can do. In this scenario, PACS will store the images and organize them for easy retrieval. Each DICOM image comes with embedded information about the image, the study and the patient so that images can be easily located later and aren’t accidently mixed up with unrelated images. Often PACS is used as a centralized repository for long-term storage of medical images and as a way to quickly access these images.

Accessing the images for viewing is the next step (viewing workstation). One method is to use query and retrieve to pull studies from PACS to a standalone piece of software installed on a viewing workstation PC. This software allows the user to enter search criteria such as patient name, patient ID or study date, then query PACS for results matching that criteria. The software will then allow the user to pull the desired studies from PACS to the workstation for viewing. An alternate method that is available for many web-based PACS is web viewing. In this scenario the user logs into and views directly from PACS over the web. This is increasingly popular and gives care providers a lot of flexibility regarding where and when they can view images. There is no inherent image quality difference between web viewing and a standalone piece of software.

The final component of this PACS scenario is a secured network. All of the images sent from the modality to PACS and shared with viewing workstations are using a network. As with any other aspect of health care, patient confidentiality is of paramount importance. The transmission of images over an open network such as the Internet needs to be encrypted. For example, an imaging center sending images from their PACS to a radiologist’s PACS in another city would require that the images be encrypted so that they can be sent securely. This isn’t as difficult as it may seem and there are a number of ways to achieve this.

Most providers have a local office network secure enough to facilitate the sending of images between modalities and PACS as long as they aren’t sent over the open Internet.

The example above outlines a very basic scenario. Each health care provider has very different needs and PACS manufacturers have taken these needs into account and have provided an incredibly wide array features.

Benefits

The benefits of purchasing PACS can be enormous. There are potentially dramatic improvements in report turnaround time and technologist efficiency as well as savings in office space, courier costs and much more. One of the immediate benefits of PACS is a greatly simplified organizational structure for medical images. PACS can allow users to find studies in seconds by a number of different search criteria such as patient ID, patient name, study date, referring physician, study description and more.

Individual patient studies are stored in one central location. This eliminates the problem of misplaced film jackets and optical media such as MODs, CDs and DVDs. The size of most PACS servers is incomparably smaller than the requirements for physically filing films. Digitally scanning older films can also free up valuable office space and make virtually any study easily available from PACS.

Any study on PACS can be quickly and easily sent to other DICOM destinations around the globe without the costs and delays caused by shipping and couriers. Web viewing can also improve efficiency by allowing authorized users to access images on demand, freeing up staff to focus on providing higher quality medical care.

Integration with EMR or RIS can also significantly improve productivity in some health provider organizations by enabling easy access to images from EMR or RIS. For other care providers adding a dictation, transcription or voice recognition component can allow for automated distribution of reports by fax or secure email as well as directly from a referring physician web portal.

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