Picture archiving and communication system (PACS) technology offers health care providers the potential for long-term
cost savings in radiology services by eliminating the expense of film processing and storage, among other things. In the short term, however, it should be noted that a PACS installation generally requires considerable up-front capital.
Administration of PACS technology requires daily data management, monitoring, backup and troubleshooting, and PACS administrators often work closely with supervisors of imaging machines, such as CT scanners and magnetic resonance imagers, as well as others on the radiology team to make sure data is accurate. Moreover, the technology requires ongoing network management and personnel training, giving PACS administrators multifaceted responsibilities.
- What is a PACS?
- What are the main components of a PACS?
- How does image data get shared in a PACS?
- Can PACS technology run over the Web?
- How are PACS technologies administered?
PACS technology uses networked hardware and software to store, retrieve, present and distribute digital diagnostic images, such as ultrasound or magnetic resonance images. The technology, which saw initial deployment in the United States in the early 1990s, reduces the costs of maintaining images on film, gives medical personnel faster access to images and related data and offers the possibility of improved efficiency and productivity. PACS technology also allows medical practices to save on film storage space, film processing equipment, supplies and personnel.
Typical PACS features include the following:
- Devices (known in the medical industry as modalities) for taking pictures, such as a magnetic resonance imager or a CT scanner;
- Servers for storing a large volume of image data and related information;
- A secure network, and
- Workstations, generally client computers, with high-resolution monitors for displaying the images.
It has been noted that a PACS installation is likely to be one of the largest purchases a radiology department can make, in addition to being one of the most complex installations for vendors to take on. PACS offerings often include functionality for managing workflow, creating and distributing reports and integrating the digital image technology with other information systems in the organization.
Picture-taking medical devices, such as CT scanners and ultrasound machines, deliver images to PACS servers, which store them and distribute them to workstations where they can be viewed. The Digital Imaging and Communications in Medicine (DICOM) standard, developed by the National Electrical Manufacturers Association, establishes a network communications protocol and a definition for file format. It allows PACS users to integrate hardware, such as servers, scanners, printers and workstations, from different providers.
The DICOM standard enables interoperability, which is considered important to reducing the cost of health care. It allows health care providers to offer radiology services in multiple sites, enabling the equipment in different sites to communicate and speeding the potential for diagnoses and treatment decisions. In addition, PACS integration makes it considerably easier to bring images from multiple PACS technologies together in a single user interface.
Increasingly, PACS technology is Web-based, allowing users to distribute images and corresponding data via the Internet. For security, the architecture of a Web-based PACS typically utilizes a virtual private network or Secure Sockets Layer.
Vendors such as GE Healthcare tout several advantages of Web-based PACS, including ease of use, the relative cost and maintenance savings over systems that require proprietary networks and other corporate infrastructure.
PACS administration is widely seen as a multifaceted task because the systems require daily monitoring to ensure the integrity of the data, the hardware has to be checked, the database has to be backed up and the archive and distribution processes must be reviewed. PACS administrators have to work closely with supervisors of modalities and with others on the radiology team to make sure data is accurate.
The role of the PACS administrator involves a variety of tasks, including the following:
- Managing both the operations and the network that connects the modalities, servers and workstations;
- Monitoring the system for quality and performance;
- Monitoring the software, the hardware and the event logs;
- Training and managing technologists and other users in what is widely seen as an ongoing task -- configuring workstations;
- Managing backup tapes, and
- Developing and maintaining security policies and procedures..
Finally, PACS administrators are involved in addressing database errors and often work closely with the technology vendors to solve problems. Problems can be addressed remotely if the PACS technology includes remote management functions.
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