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PACS (picture archiving and communication system) is a healthcare technology for the short- and long-
A PACS allows a healthcare organization (such as a hospital) to capture, store, view and share all types of
images internally and externally. When deploying a PACS, the organization needs to consider the
environment in which it will be used (inpatient, ambulatory, emergency, specialties) and the other electronic
The universal format for PACS image storage and transfer is DICOM (Digital Imaging and
Communications in Medicine). Non-image data, such as scanned documents, may be incorporated using
consumer industry standard formats like PDF (Portable Document Format), once encapsulated in DICOM.
A PACS consists of four major components: The imaging modalities such as X-ray plain film
(PF), computed tomography (CT) and magnetic resonance imaging (MRI), a secured network for the
transmission of patient information, workstations for interpreting and reviewing images, and archives for
the storage and retrieval of images and reports. Combined with available and emerging web technology,
PACS has the ability to deliver timely and efficient access to images, interpretations, and related data.
PACS breaks down the physical and time barriers associated with traditional film-based image retrieval,
Hard copy replacement: PACS replaces hard-copy based means of managing medical images, such as film
archives. With the decreasing price of digital storage, PACSs provide a growing cost and space advantage
over film archives in addition to the instant access to prior images at the same institution. Digital copies are
referred to as Soft-copy.
Remote access: It expands on the possibilities of conventional systems by providing capabilities of off-site
viewing and reporting (distance education, telediagnosis). It enables practitioners in different physical
Electronic image integration platform: PACS provides the electronic platform for radiology images
interfacing with other medical automation systems such as Hospital Information System (HIS), Electronic
Medical Record (EMR), Practice Management Software, and Radiology Information System (RIS).
Radiology Workflow Management: PACS is used by radiology personnel to manage the workflow of patient
exams.
PACS is offered by virtually all the major medical imaging equipment manufacturers, medical IT companies
and many independent software companies. Basic PACS software can be found free on the Internet.
Typically a PACS consists of a multitude of devices. The first step in typical PACS systems is the modality.
Modalities are typically computed tomography (CT), ultrasound, nuclear medicine, positron emission tomography
(PET), and magnetic resonance imaging (MRI). Depending on the facility's workflow most modalities send to a
quality assurance (QA) workstation or sometimes called a PACS gateway. The QA workstation is a checkpoint to
make sure patient demographics are correct as well as other important attributes of a study. If the study information
is correct the images are passed to the archive for storage. The central storage device (archive) stores images and
in some cases reports, measurements and other information that resides with the images. The next step in the PACS
workflow is the reading workstations. The reading workstation is where the radiologist reviews the patient's study
and formulates their diagnosis. Normally tied to the reading workstation is a reporting package that assists the
radiologist with dictating the final report. Reporting software is optional and there are various ways in which
doctors prefer to dictate their report. Ancillary to the workflow mentioned, there is normally CD/DVD authoring
software used to burn patient studies for distribution to patients or referring physicians. The diagram above shows
a typical workflow in most imaging centers and hospitals. Note that this section does not cover integration to a
Radiology Information System, Hospital Information System and other such front-end system that relates to the
PACS workflow.
Hospital Information Systems (HIS), Radiology Information Systems (RIS) and EMR/EHR solutions provide
Without DICOM MWL, modalities must take patient healthcare information (PHI) and manually enter the
PHI into the modality, introducing human error and increasing unnecessary manual labor.
DCMSYS Enerprise MWL automates the transfer of information from any HIS/RIS/EMR to unlimited
modalities and also aggregates obsolete, non-scalable MWLs across the enterprise, turning any exam-
Features
Automatically transfers patient identifiers, created by the existing information systems to your network as
DICOM worklists
TLS encryption for remote location MWL support. Does not require a VPN
Incoming and Outgoing Modality worklist DICOM tag modification ability (optional)
Returns study statuses (converted from DICOM to HL7) to information systems and enables patient identifier in
Includes a powerful Web-based administration and remote technical support built-in functionality
PACS-Server with 35 Terabyte RAID Archive and high speed fiber optic switch
Modality worklist (MWL) is one of DICOM's workflow services that really make a difference. It's the
difference between grocery store workflow with notes on little pieces of paper and a true modern
accountable workflow.
Cerner ProVision
Fujifilm Synapse
GE Healthcare
Medicor Imaging
Novarad NovaPACS
OnePacs
OsiriX
RamSoft
Sectra
Agfa HealthCare
Carestream Health
RADinfo Systems