Digital optical recording (DOR) is a data-acquisition and storage technology important to the development of picture archiving and communication systems (PACS). DOR offers attractive advantages in high-density, low-cost archival storage of images and other information. At present, film is used as the storage medium for archiving images generated by both conventional equipment and digital technologies such as computed tomography, digital subtraction angiography, magnetic resonance imaging, and nuclear medicine. The basic methods of DOR data storage are discussed together with requirements essential for making DOR an acceptable alternative to film archiving. The impact of DOR technology on the operation of an imaging department is projected.

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Picture archiving and communication systems (PACS) are seen as an expensive application of computer technology in diagnostic medicine. They are, admittedly, an important expansion of medical informatics into the management of images, but the cost of such systems is not easily justified. Analysis of published data shows that high technology equipment has not significantly contributed to the alarming increase in health care cost in the United States. Furthermore, within the new reimbursement scheme for Medicare procedures radiology costs amount only to less than 5%. The paper gives an analysis of where high cost in PACS is concentrated and suggests ways of justifying the expense of a PAC system.

Downloaded From: http://proceedings.spiedigitallibrary.org/ on 06/23/2016 Terms of Use: http://spiedigitallibrary.org/ss/TermsOfUse.aspx Dr. Joe Darlak. Can I make a comment in view of your remarks. I think that we, working diagnostic radiologists, have been out in the field, we have seen the millions of standard X-ray units out there that create the film. I think that is where the problem is. I think that we should have a parallel effort, that we need some fast film scanning device to get it into a PAC system. I think that that is where the major emphasis should lie. I know its easy to go digital, but some of us don't have that 25% of our equipment or effort in digital radiography.Dr. Carol Newton. One more point?Bill Glenn. Well, one point, if you fail to take a step for medical communication of images and soak up some of what will become available in communications space on those satellites, then porno kings will get it from you and you won't have it in the future.Dr. Carol Newton. Just the issue of the question of sharing. It seems to me that you have probably got, with the security codes and special keys, as good a system as any for limiting the availability of these films to whomever you wish to have them. So, that is the last point the speaker from the floor brought up. I don't regard that as being too serious if its well done.Jef Kouwenberg. I think it may create a situation that (allows) management to make quality control checks. In our situation where medical records are stored, sometimes it appears that lab results are not correctly interpreted, that a wrong diagnosis is made. There are things that can be revealed when the information is made available. Then there will not be the issue of making a PACS with locks on that image information because there are people who are entitled to see that information and it is no longer information reserved strictly to the person who made that diagnosis. That is the problem I see.Bill Glenn. The gentleman in the blue suit.