Picture archiving and communication system
Combined with available and emerging web technology, PACS has the ability to deliver timely and efficient access to images, interpretations, and related data.
PACS reduces the physical and time barriers associated with traditional film-based image retrieval, distribution, and display.
Clinical areas beyond radiology; cardiology, oncology, gastroenterology, and even the laboratory are creating medical images that can be incorporated into PACS.
A radiologist typically sees a viewing station, a technologist a QA workstation, while a PACS administrator might spend most of their time in the climate-controlled computer room.
Depending on the facility's workflow most modalities send to a quality assurance (QA) workstation or sometimes called a PACS gateway.
Without stepping outside the focus of the PACS architecture, WADO becomes the solution to cross platform capability and can increase the distribution of images and reports to referring physicians and patients.
A query (C-FIND) is performed as follows: Images (and other composite instances like Presentation States and Structured Reports) are then retrieved from a PACS server through either a C-MOVE or C-GET request, using the DICOM network protocol.
A C-GET, on the other hand, performs the C-STORE operations on the same connection as the request, and hence does not require that the "server" know the "client" TCP/IP address and port, and hence also works more easily through firewalls and with network address translation, environments in which the incoming TCP C-STORE connections required for C-MOVE may not get through.
It is important (and required in the United States by the Security Rule's Administrative Safeguards section of HIPAA) that facilities have a means of recovering images in the event of an error or disaster.
Ideally, copies of images should be maintained in several locations, including off-site to provide disaster recovery capabilities.
The use of storage systems, using modern data protection technologies has become increasingly common, particularly for larger organizations with greater capacity and performance requirements.
Whenever HIPAA protected data is moved, it should be encrypted, which includes sending via physical tape or replication technologies over WAN to a secondary location.
HIPAA HITECH mandates encryption of stored data in many instances or other security mechanisms to avoid penalties for failure to comply.
Due to the high volume of images that need to be archived many rad centers are migrating their systems to a Cloud-based PACS.
Historically, Ultrasound, Nuclear Medicine and Cardiology Cath Labs are often departments that adopt such an approach.
The rapid deployment of FFDM in the US following the DMIST study has led to the integration of Digital Mammography and PACS becoming more commonplace.
Diagnosis Report is created based on the images retrieved for presenting from PACS Server by physician/radiologist and then saved to RIS System.
These may offer a number of advanced features: The PACS installation process is complicated requiring time, resources, planning, and testing.
Acceptance testing of a new installation is a vital step to assure user compliance, functionality, and especially clinical safety.
[5] The acceptance test determines whether the PACS is ready for clinical use and marks the warranty timeline while serving as a payment milestone.
[6] Failures ranked from most-to-least common are: Workstation; HIS/RIS/ACS broker interfaces; RIS; Computer Monitors; Web-based image distribution system; Modality interfaces; Archive devices; Maintenance; Training; Network; DICOM; Teleradiology; Security; Film digitizer.
The Society for Imaging Informatics in Medicine (SIIM) is the worldwide professional and trade organization that provides an annual meeting and a peer-reviewed journal to promote research and education about PACS and related digital topics.
