Update on digital image management and PACS

Abstract

Information technology is becoming a vital component of all health care enterprises, from managed care services to large hospital networks, that provides the basis of electronic patient records and hospital-wide information. The rationale behind such systems is deceptively simple: physicians want to sit down at a single workstation and call up all information, both clinical data and medical images, concerning a given patient. Picture archiving and communication systems (PACS) are responsible for solving the problem of acquiring, transmitting, and displaying radiologic images. The major benefit of PACS resides in its ability to communicate images and reports to referring physicians in a timely and reliable fashion. With the changes in economics and the shift toward managed and capitated care, the teleradiology component of PACS is rapidly gaining momentum. In allowing remote coverage of multiple sites by the same radiologists and remote consultations and expert opinion, teleradiology is in many instances the only option to maintain economically viable radiologic settings. The technical evolution toward more integrated systems and the shift toward Web-based technology is rapidly merging the two concepts of PACS and teleradiology in global image management and communication systems.

Performance of Web-based image distribution: server-oriented measurements

“…The test software developed for the present investigation bypasses those restrictions and allowed high numbers of measurements and repetitions with multiple concurrent clients and a high degree of synchronicity. To put our results in perspective, we assumed a reasonable waiting time for the display of images to be under 5 s, as has been reported in previous publications [3,5,17].…”

“…The importance of Web-based systems as a tool to provide hospital-wide distribution of radiological images [1,2,3] has increased over the past decade. Previous studies have examined the requirements of the personal computer (PC) client configuration, in order to identify combinations offering a suitable time-to-display (TTD) at a reasonable cost [4,5,6].…”

Performance of Web-based image distribution: client-oriented measurements

“…Moving towards an almost filmless hospital and an improved clinical work flow can only be achieved when this issue is solved [2,3]. Furthermore, recent studies have indicated that it could lead to considerable cost savings outside the Radiology Department [3]. Despite these facts, hospitalwide image distribution is still a challenge especially for larger hospitals.…”

Upload capacity and time-to-display of an image Web system during simultaneous up- and download processes

“…Together with the increasing importance of hospital-wide image distribution as a prerequisite to achieve cost-savings and campus-wide process optimizations in picture archiving and communications systems (PACS) projects [1,2,3,4], there is an increasing demand for proper data on the performance and configuration of Web-based image distribution systems. A sufficient amount of information exists for the client performance and requirements [5,6,7], but the available material on the important server component is dedicated to the download properties [8].…”