Picture archiving and communication system (PACS) is a medical imaging technology. Medical facilities and other healthcare establishments implement a PACS medical imaging system in the work of the radiology department to facilitate image storage and retrieval. 

Earlier, without PACS being part of the radiology department workflow, radiologists and other specialists could work with medical images strictly on their workstations. That included physical inconvenience as well: healthcare providers had to go to the radiology department to look at patients’ examination results because they were stored locally, and a patient needed to carry a hard copy with them each time they visit a doctor. 

With medical imaging software development, there can be several access points (computers) throughout the clinic that are connected to a single server where all data is stored. In this article, we’ll explore what PACS consists of and how to integrate it with other medical imaging technologies.

What Is PACS and How Does It Work?

To communicate and manage medical imaging information and related data, it’s worth talking about DICOM. DICOM stands for digital imaging and communications in medicine and refers to:

  1. a format of medical images;
  2. a protocol used by medical imaging devices communicates with the application server whenever an image needs to be transmitted.

PACS isn’t just a system for collecting medical images and providing constant access to them. Let’s consider all the components of the PACS solution in action:

  • Medical imaging hardware or modalities refer to medical equipment that supports the DICOM standard. Examples of such equipment are scanners for X-rays, computer tomography (CT), computer radiography (CR), magnetic resonance imaging (MRI), ultrasound (US), ophthalmic tomography (OPT), and others. 
  • PACS server is the place where DICOM documents are stored. The server retrieves,  backs up, and archives files for long-term storage. 
  • Workstations are devices that load, read, and process medical images. They are linked to a PACS server to help radiologists retrieve, view, and interpret medical images.
  • DICOM viewer. With the help of it, medical specialists can display and scrutinize images. Such viewers can come with PACS or you can choose from the list of independent DICOM viewer vendors. 
PACS architecture

However, the most value from PACS you can get after setting up a connection with other systems that are available in a clinic. For example, a lot of hospitals use EHR (electronic health record), EMR (electronic medical record), or HIS (hospital information system). Big hospitals also provide the radiology department with RIS (radiology information system). Such a decision helps them efficiently work with patients and manage workflows inside the clinic. Systems like these provide archiving for patient data, serve as an appointment scheduling solution and are helpful for other types of work. 

How PACS Integrates with EHR, EMR, RIS

In a nutshell, EHR is an electronic version of all patients’ medical records, both clinical data, and details about a patient’s care. 

An EMR only contains the medical and treatment history of the patients.

RIS is a system for managing the work of radiology departments. Its core functions include patient scheduling, resource management, examination performance tracking, reporting, and more.

To make the PACS solution more effective and handful you can configure data exchange between PACS and the systems mentioned above. 

Choosing a PACS integration solution, you can go for a direct integration through the software’s application programming interfaces (APIs). With the help of them, developers can establish a connection between several systems through requests. Each request contains an appeal for information or specific action that should be completed. For example, to include a person to a list of whatever.    

There is also an easier way – you can develop an interface that will interconnect all systems. 

By integrating all systems, you will enable your medical practitioners to:

  • have constant access to medical images 
  • display and view medical images in a standardized format (PNG, IMG, or SVG) right from their working computers, helping them avoid the necessity to use local PACS server

As an extra feature, you can also consider automating the process of enrolling a patient in an examination session right from the EHR/EMR/HIS system. This will reduce the amount of human work and accelerate the completion of regular tasks.

What Drawbacks Are There and How to Overcome Them?

One of the drawbacks of working with PACS is actually its archive. Choosing a specific PACS provider you automatically sign up to its configurations for medical image storage. The specifics is that you won’t be able to access medical images from another PACS software in case you would like to change the provider. 

You will have to store images from scratch or copy them to local archives inside your clinic or choose an additional measure of storing images so that you can work with them even with a new vendor. 

That’s what vendor-neutral archives (VNAs) exist for. A VNA is an independent software a clinic will have to implement and install. Via VNAs clinics can avoid using archives from the PACS vendor and store medical images directly in the VNA. Choosing them will provide the clinic with a chance of changing a PACS software vendor in the future. This can be local archives or cloud ones, such as AWS, Google, or Microsoft Azure.

Wrapping up

With PACS, radiologists can work with medical images in a more swift and effective manner.  

PACS has a developed infrastructure that consists of hardware, a PACS server, workstations, and a DICOM viewer. At the same time, to make the most of the PACS functionality within a medical organization, PACS needs to be integrated with other electronic systems. Integration can be set through an API or via an interface that will interconnect all systems. The latter needs to be developed from scratch. 

The main bottleneck of using a PACS is image archiving. VNAs can help overcome this challenge to ensure continuous access to medical images.