Essential PACS System for Radiology Guide

November 17, 2021

Featured image for what is pacs in healthcare blog post

In the face of the increasing trend towards digitization and digital services such as telehealth, healthcare organizations are actively looking for ways to efficiently manage administrative workflows and effectively process the growing volume of digital files and the ensuing data analytics.

Custom-designed software systems like the PACS system or Radiology Information System (RIS) that offer streamlined, secure file archiving and communications are proving to be a gamechanger for various sectors within the healthcare industry, particularly within diagnostic medical imaging. PACS Software has become a vital tool for radiologists to display, capture, store and share medical images in the fastest and most reliable way.

To provide a comprehensive overview, we’ll look at (Jump to the section by clicking the link):

Beginner to PACSExpert to PACS
Definition of PACSHow RIS PACS systems operate together
Image Types PACS handlesBenefits of RIS PACS integration
Major components of a PACSQuestions to ask yourself before purchasing a new system
How a PACS works?Cloud PACS vs On-premises PACS
Who uses PACSOpen Source system vs Commercial
Main uses for PACSWhat is an ideal solution for mid-sized imaging facilities
Benefits of PACSChoosing a new System for your hospital


Before moving to the details, you can watch the video below to understand the basics of these systems.


What is a PACS system?

Picture Archiving and Communication System (PACS) is a medical imaging technology that provides storage and access to digital images acquired by imaging modalities. It transmits digital images and reports electronically, which eliminates the need to manually file, retrieve, and transport film jackets. PACS is used in healthcare organizations such as hospitals, imaging centers, and radiology departments.

Little is known about the history of PACS in the medical milieu and the history of Radiology. Though generally considered to have been first developed in 1979, early adoption of the system did not see effective communication or file sharing between parties, due to insufficient capabilities in archiving and displaying images between different vendor devices. It wasn’t until the mid-1980s – thanks to imminent government oversight ­– the process to develop a medical imaging storing and transmission standard was undertaken by the American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA). This collaborative effort finally culminated in the 1993 development of what is now known as the DICOM (Digital Imaging and Communications in Medicine) standard.


Image types PACS handles

It has become a versatile tool in managing various medical image types generated from multiple imaging instruments including:

  • Ultrasound (US)
  • Magnetic resonance (MR)
  • Nuclear Medicine imaging
  • Positron emission tomography (PET)
  • Computed tomography (CT)
  • Endoscopy (ES)
  • Mammograms (MG)
  • Digital radiography (DR)
  • Phosphor plate radiography


The four basic components of a PACS

It is composed of four major elements:

  • Image acquisition devices (imaging modalities) – E.g., magnetic resonance imaging, computed tomography, PET, X-ray angiography, echocardiography, etc. These devices and acquisition gateway computers facilitate the digitization of images involving acquisition, conversion to PACS standard format (DICOM), and image data preprocessing (i.e., resizing, background removal, orientation calibration).
  • Communication networks – These networks enable a smooth transmission of medical data between all the components within the PACS environment, other external applications, and play a key role in transmitting data to remote locations.
  • PACS archive and server – Any patient information and imaging files are archived within the main working center of the system, the PACS server. Data storage and archiving is managed via the server’s two main components: archive system and storage media (database). Furthermore, Vendor Neutral Archive (VNA) consolidates, standardizes, and archives PACS images and data into a central, interoperable, highly accessible digital storehouse. In this way, you can eliminate the siloed storage groups coming from different healthcare departments' PACS systems such as Radiology PACS.
  • Integrated display workstations (WS) – The display WS’s are key in enabling the clinical interpretation of the images generated via the multiple modalities. Using these WS’s, radiologists and clinicians can determine primary diagnosis, thus their alternate name, diagnostic WS’s. Basic image processing functions provided by the WS’s include access, manipulation, evaluation, and documentation.

pacs system for radiology


How PACS software works

Sequenced structures are important in ensuring the system operates at peak in accuracy and quality. This sequence consists of three main structures:

  • Main server –This server lies at the heart of the operation of the system in its entirety. It’s responsible for liaising with the database structure, RIS interfacing (RIS will be discussed in more detail later within this blog), DICOM imaging import and export gateway, web servers, and other related imaging distribution infrastructure.
  • Database –All information pertinent to the operation of a PACS system is stored here, including patient and study-related information (e.g., notes, reports, exams, etc.).
  • HL7 (Health Level 7) – The part of the server that receives all RIS-generated information and distributes it to picture archiving and communication system.


Responsible for the storage and compression of DICOM imaging files, the PACS Archive is another integral structure, which is divided into two subcategories. “Full fidelity” ensures the DICOM imaging is stored using a lower compression ratio without sacrificing quality. “Clinical” optimizes reporting by utilizing higher compression ratio to streamline file size towards minimizing server space.


Who uses PACS?

Though radiology has traditionally been the leading producer of x-ray images, PACS has been implemented in many other practices being cardiology, nuclear medicine imaging, pathology, dermatology, and oncology.


Main uses

The four main ways in which the radiology PACS system is used for:

  • Hard copy replacement – It is designed to be the digital replacement of traditional hard copy medical image management (i.e., film archives, etc.).
  • Remote accessTeleradiology PACS inherent architecture is tailored to enable off-site viewing and reporting capabilities beyond the scope of conventional systems (distance learning, telediagnosis) while facilitating teleradiology solutions in allowing simultaneous access to the same information by healthcare professionals located in various areas.
  • Electronic image integration platform – It serves as an electronic platform for radiology image interfacing between different medical automation systems including Electronic Medical Record (EMR), Radiology Information System (RIS), Hospital Information System (HIS), and Practice Management Software.
  • Radiology workflow management – It is used by radiology personnel for workflow management related to patient exams.


Key benefits of PACS Systems

The advantages of PACS are numerous and transformative, marking a significant shift in the way healthcare services are delivered. Let's explore the benefits for both healthcare providers and patients in more detail.

Benefits for organizations

From the healthcare provider perspective, the system offers benefits that help organizations achieve their business growth objectives as well as optimize their patient care models. Four key benefits include:

The software is user friendly and scalable. The technology behind the platform allows it to be customizable and easily integrated into any automated system, whether RIS, HIS, or EMR. PACS software can grow along with an organization, thanks to the digital platform’s inherent scalability.

Patient reports and images are easily accessible. With the help of PACS in radiology, studies can seamlessly be accessed from anywhere, at any time—even from mobile devices, which is ideal for physicians on-the-go. Information can also be shared electronically to other facilities, enabling remote diagnosis, consultations, and care.

Image viewing and analysis is enhanced. Using PACS for radiology, technicians can easily manipulate and get a better view of generated images in order to assist clinicians in more effectively determining a diagnosis.

Data management is improved and more efficient. Through duplicate reduction, data integrity is maintained, allowing for consistent data accuracy and quality. Physicians can easily access prior images to ascertain a patient’s chronological radiology history to perform in-depth study comparisons.


Benefits for patients

Leveraging the radiology PACS system to streamline healthcare workflows and optimize patient care delivery can translate into the following key benefits for patients:

Receiving diagnoses quicker. Exams and tests can be performed anywhere, and the images and reports can be shared electronically to clinician teams, thereby eliminating the time lag between examination and determination.

Get more comprehensive care. Using the chronologic data and high-quality images made available via the system, physicians get a full view of a patient’s medical history, resulting in a more accurate diagnosis and holistic delivery of care.

Easy access to medical information. Patients can easily access their medical images and reports enabling them to make informed decisions regarding the quality of their care and actively engage with their health team.

Save time with payment processing. RIS/PACS can provide more accurate billing information and facilitate streamline paperless payment submissions to payers, resulting in faster turnaround times and peace-of-mind for patients.


How PACS integrates with Radiology Information System (RIS)

Healthcare organizations looking to improve their productivity and maximize usage of their radiology resources will turn to a RIS PACS integration solution. Integrating these two solutions into one, you are basically getting the best of two worlds while optimizing service to physicians and patients. Where the software enables seamless, virtual real-time access to images and studies among radiology, other clinical departments and facilities, and remote teams, the imaging and workflow management information provided by a RIS can be amalgamated to create a more in-depth, extensive radiology report. Consequently, these reports contribute to an improved service experience for referring physicians and patients.


A male doctor is using RIS and PACS


Top benefits of RIS/PACS integration

Radiology PACS systems have revolutionized the way radiology practices operate. They are the backbone for any diagnostic center or practice because of how they store and manage diagnostic images.

Having an integrated RIS PACS software will help your hospital streamline your workflow by executing the most critical functions such as: billing, order entry, and patient tracking.

Some key benefits of integrated RIS PACS software are:

Successful Time Management
Time is money and identifying ways to make day-to-day operations run faster and smoother could increase your business’ ROI. Using a single database solution will save your staff time and money in the following ways:

  1. Training on an all-in-one solution: Using the same system to meet all your needs will save your organization the thousands of dollars it would take to train staff on multiple solutions that meet the same needs.
  2. Ease of Use: You can seamlessly enter data into this all-in-one platform, which increases consistency and reduces user errors.


Increases ROI
Not only will a single-database system allow your practice to run more smoothly, but it will also help your practice surpass your business targets in ways such as being:

  1. Cost-Effective: An integrated system costs much less than buying a separate RIS and PACS for healthcare management. You’ll see increased ROI within months of buying a cost-effective single database solution.

Secure, Streamlined Data Radiology departments and practices hold a tremendous amount of patient data as compared to other crucial sectors of healthcare. Keeping your data secure, clean, and streamlined is a critical driver for your practice. Here’s how:

  1. Decreased Risk of Downtime: Thanks to our guaranteed SLA from Microsoft Azure, we’re able to provide high availability with OmegaAI. That means you can count on us to be there when you need us.

A RIS/PACS integration is only one piece of the puzzle. Our latest launch, OmegaAI, is an Imaging EMR system that consolidates RIS/PACS, VNA, and other integrated imaging tools. 

In review

  • Radiology PACS system offers reliable access to patient reports and images with flexible storage options such as cloud or on-premises.
  • Radiology PACS systems provide scalability and seamless integration with other systems to ensure the best interoperability for workflow.
  • You can harness all the power of a PACS system and more with OmegaAI: the world’s first Imaging EMR. Learn more today.