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Picture Archiving Communication System (PACS) is a loose term to describe a set of systems that facilitate the archiving, processing and viewing of digital radiological images and their related information.

The images are acquired, archived and retrieved over a network for diagnosis and review by physicians. These images can be interpreted and viewed at workstations, which can also double as archive stations for image storage.


The introduction of client/server computing, improved digital imaging and computer network technologies, along with the advancement of the DICOM and HL7 standards have put PACS along side radiology information systems (RIS) as an ideal solution for managing radiological images. Some of these images include:

  • X-ray photos

  • Cycloplegia Retinoscopy

  • Computed Tomography

  • Magnetic Resonance Imaging

  • Radio Isotope

  • Ultrasound

PACS first emerged in the 1980s, although initially trumpeted as a solution to lost films, healthcare organisations, especially the larger ones, have found that digital images can easily be lost as well.

One of the main benefits that PACS provides is the ability to provide a timely delivered and efficient access to images, interpretations and related data throughout the organisation. This helps to ease consultations between physicians who can now simultaneously access the same images over networks, leading to a better diagnosis process.

It is also beneficial to physicians in emergency situations, as they need not wait for long periods in order to view a patient’s radiological images as these are instantly available on the network when ready.

Another feature of PACS is the ability to digitally enhance the images, providing more detailed and sharper images. This improves diagnostic capabilities at radiological examinations.

Since the 1990s, organisations have taken the steps to fully integrate PACS with RIS, when the basic features and adapt needed to mange the acquisition, processing and storage of images, becomes the responsibility of the PACS.

The high costs of PACS has led to vendors offering mini-PACS, which is a cheap alternative for organisations that cannot afford the cost of a full PACS system or those seeking to implement seeing to implement some form of a digital image management system but would rather start off with something small.

While PACS are considered to be at a minimum hospital wide, mini-PACS usually tend to be departmental-based (radiology, emergency room, or orthopedics). Mini-PACS are easy to maintain and cheap to repair, and they can gradually be upgraded to a fully functioning hospital wide PACS.

Advantages of PACS

  • Rapid access to critical information to decrease exam-to-diagnosis time. This is especially useful in emergency and operating rooms.

  • Elimination of film, handling and storage costs

  • Images can be easily shared between reading radiologists, other physicians and medical records.

  • Images can be archived at secure locations using database servers manages the transfer, retrieval and storage of images and relevant information; the archive provides permanent image storage.

  • Radiologists can access soft-copy images instantly after acquisition to expedite diagnosis and reporting at the almost any available workstation.

  • Web servers can be used to most cost-effectively share images with other departments, even referring physicians across town. They can access the images using the Internet or the local intranet.

Hardcopy films or paper printouts can be made when needed for traditional archiving or the provision of images to other departments.



International Medical Informatics Association
American Medical Informatics Association
UK Health Informatics Society
Healthcare Information and Management Systems Society

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Last Updated: 10 August 2006.

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