We have encountered two challenges when using the PACS system. First, PACS users are limited to certain bandwidths and locations. Second, Web PACS machine replacement is too costly, management is difficult, and better image stability is needed. There are also speed variations for different users at different locations. For instance, radiologists use medical image workstations with direct access to the PACS information system and so have a greater speed for querying and file retrieval. Physicians, on the other hand, use web browsers with no direct access to the PACS information system, which leads to slower network speeds. Physicians also affect one another in overall network speed by processing queries and file retrievals via web browser. There are also insufficient network bandwidth concerns. These often arise when exchanging medical images with other hospitals or downloading large numbers of images. Since these large file volumes are transferred via WANs, insufficient network bandwidths limit upload and download speeds. And if the Web PACS breaks down, the hospital must ask professional engineers for replacements, and spend large amounts of money about a NT$ million or more per unit. This is not only troublesome for system managers, but also costly for the hospital. * †
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