The PACS system has at the base the modalities, which are the imaging equipment. A Radiologic Information System manages the data and processes requests for information, billing, and scheduling of appointments. High-resolution monitors are located at workstations to view the images, or the data is transmitted to mobile devices over wireless transmission.
PACS has many advantages over the traditional method of film reproduction, viewing, and storage. Digital archiving takes far less physical space and can be located offsite. The digital images can be transmitted to any area with the restrictions of geography and time. In addition, PACS allows multiple specialists to consult on a problem or offer a second opinion. The specialists can be available around the clock at any remote location. The cost savings can be significant. Staff can be restructured to reduce redundant tasks and capital equipment can be more fully utilized.
While PACS has considerable advantages over the traditional film storage, it is also prone to problems. There can be hidden costs in the conversion of existing data. Infrastructure, such as transmission lines, needs to be upgraded to handle the increased data flow. The move towards an enterprise PACS solution can be daunting when making compromises of standardization against the best available technology on a departmental basis. In addition, staff will need to be retrained and skills upgraded to work in the PACS computerized environment.
The concerns of data storage are considerable. As more examinations are performed and more departments begin to utilize PACS, the capabilities of the hospital or medical center may be overwhelmed. Outside application service providers will need to be hired to manage the storage, retrieval, and transmission of the data. In implementing PACS, it becomes necessary to make the data available to many individuals that may or may not require it. HIPAA has mandated requirements for the storage and transmission of this data. In addition, personal privacy of medical records has become ever more important. Security will be one of the paramount issues concerning the implementation of PACS.
PACS is here to stay and will continue to grow and evolve. Hospital and PACS administrators will need to be multi-skilled to manage the flowering new opportunities. PACS has the opportunity to be a cost effective enhancement to patient care, but runs the risk of being a high-cost failure if implemented incorrectly or without prudent planning.
Daniel Federman, the Associate Dean of Harvard Medical School, once commented that, "We in medicine love progress...but we don't like change" (qtd. in Sandow and Hogben 59). Federman's comment illustrates the love-hate relationship that medicine has with the