Organizational techniques that enable small departments to function efficiently often fail as departments become larger. With the recent growth in imaging technology, the capacity of film-based systems to meet the increasing needs of radiology departments has decreased. Electronic picture anchiving and communication systems (PACS) have been developed in an attempt to provide economical storage, rapid retrieval of images, access to images acquired with multiple modalities, and simultaneous access at multi

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Despite the much-discussed advantages of the all-digital radiology department, the speed of electronic display continues to be a major obstacle to its acceptance; physicians generally agree that sophisticated workstation functionality cannot compensate for an interpretation environment that delays diagnosis.Two design schemes have been devised and discussed at length at the Bowman Gray School of Medicine (BGSM) that will improve the efficiency of image transmission significantly. The first of these is image routing and pre-loading. The central archive can use information associated with each exam and a set of rules to predict which workstations will be used to read the exam. The images can thus be sent automatically before the physician arrives at the workstation to interpret a series of exams. The second scheme, which is intimately associated with the first, allows a workstation to manage its own local disk to remove copies of exams so that new ones may be pre-loaded. This disk management algorithm assigns priorities to the exams based on their status in the acquisition/interpretation cycle and performs automatic deletion as the workstation's disk reaches its capacity. The effect is a virtually limitless disk that eliminates the time-consuming task of manual deletion and retrieval of images.

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