Many healthcare providers are in the process of evaluating Picture Archiving and Communication Systems (PACS), often as part of a larger transition toward electronic medical records. The decision to purchase a PACS is an important one, not only because initial costs can be as much as several million dollars but also because once a PACS is installed it may be difficult to migrate to a newer system later. In this context it is important to recognize that there is still considerable confusion regarding exactly what is and what is not important in real-life clinical practice. This article discusses the perspective on the PACS market with a particular focus on the field of cardiovascular imaging, for which the authors have over 15 years of experience in research, clinical care, and commercial products.
Myth: PACS are Complicated and Therefore Expensive
In its most basic form a PACS receives image data in Digital Imaging and Communications in Medicine (DICOM) format, stores it on a hard disk, and allows remote systems to retrieve copies of the image data via standard DICOM query/retrieve commands. The computing hardware needed to communicate over a network and provide sufficient storage for a yearÔÇÖs worth of images can be purchased off-the-shelf for less than US$50,000, and open-source software can be used free of charge for DICOM communication.
Myth: You Need Workstations for Your PACS
Many vendors strongly emphasize the importance of PACS workstations. A typical PACS workstation is specifically designed not only to communicate with the PACS via DICOM transfers but also to provide analysis functions such as distance/volume measurements, and post-processing functions such as volume rendering and maximum intensity projection (MIP). There is little doubt that these features are needed but it is unclear who needs them and for what purpose.