April 22, 2016

Picture Archiving and Communication System (PACS)



What is PACS and How It Works
The “P” (Picture, the digital image) is used to “A” (Archiving, the soft/electronic storage of image) for “C” (Communication, the retrieval, sending & displaying of images) in the “S” (System, the dedicated computer network) is called PACS.

PACS is sophisticated array of hardware and software that not only generates archives for the storage of multi-modality images such as X-ray, Ultrasound, CT and MRI but it also displays and communicates images and patient information by integrating images with patient data base and facilitates laser printing of images through a complex network of computer.

The contemporary healthcare technology enables the clinicians to store, archive and display digital images to move from film-based archiving to digital acquisition and archiving (soft-copy storage), radically improving the workflow. The digital images are housed in PACS archives which work as “virtual film library”.

Current Standards, Cloud-Based PACS, RIS & VNA
The connection of various equipment types and modalities to a PACS is complex. Standards have been developed to ensure that all manufacturers and types of equipment are able to communicate and effectively transmit images and information. Current standards include DICOM (Digital Imaging Communications in Medicine) and HL7 (Health Care Level 7). Although standards may not always provide for an instantaneous functionality between devices, they do allow for resolution of connectivity problems.

A radiology PACS is frequently deployed alongside a radiology information system (RIS) that is used to schedule patient appointments and record a patient's radiology history, whereas PACS focuses more on image storage and retrieval.

A vendor neutral archive (VNA) can provide a single, consolidated archiving platform with which to host files from different PACS softwares. Larger healthcare systems with outdated or ineffective PACS software sometimes choose to implement an enterprise-wide VNA, rather than upgrading to a newer PACS.

Cloud-based PACS is a type of PACS architecture that stores and backs up a healthcare organization's medical imaging data in an offsite server, not within the organization's physical location. Users with permission to access medical images can do so at any time through the cloud PACS. Cloud PACS can also enable medical personnel to view medical imaging data from any of their approved devices.

Components of PACS
There are four major components of PACS structure that includes:
  • Imaging modalities such as X-ray, Ultrasound, CT and MRI
  • Secure online network for distribution and exchange of information
  • Stationery and mobile workstations to access storage area of patient records and images
  • A secure cloud or local server with capabilities of high definition of images and videos that could be accessed any time latter
The core elements in the system are ordinary hardware integrated with the advanced software and excellent bandwidth. All the equipment must be DICOM compliant, a protocol for handling, storing, printing, and transmitting information in medical imaging.

Advantages of PACS
  • Picture Archiving and Communication System (PACS) is a valuable tool for healthcare organizations, enabling physicians to quickly and easily share enterprise medical imaging reports electronically.
  • Even as they become a standard platform at most facilities, their usefulness is growing as options such as a vendor neutral archive and other options are available.
  • PACS facilitates quick and easy access to patient images and reports. With PACS, tests can be performed anywhere and results can be shared electronically with other remote facilities. It also allows staff to remotely view images, submit reports, archive images and transport them if necessary via portable media.
  • PACS’ digital images allow you to zoom in on images and manipulate them for better viewing and analysis. It can help reduce the number of duplicate images since previous results are available electronically, improving data management efficiency.
  • PACS allows physicians to acquire a chronological view of patients’ radiology histories, facilitating the comparison of a number of previous studies.
  • PACS has a number of add-ons available to make it even more user-friendly for staff and beneficial to patient care. Vendor Neutral Archives (VAN) allows you to better organize your stored imaging data, with a centralized, accessible system that’s agnostic to database, operating system, image generating device and infrastructure. Peer Review allows for a seamless, efficient review of radiology cases within a physician’s daily workflow.
Global PACS Market
According to GBI Research, the global PACS market was estimated at $2.9 billion and expected to grow at CAGR of 9% to surpass $5.3 billion by 2020 whereas Spearhead Acuity’s estimated market in 2014 was $4 billion with compound annual growth rate (CAGR) of 4% to reach $6.5 billion in 2019.

Global Industry Analysts, Inc. (GIA) however forecasts PACS market to reach at $7.1 billion by 2020, “driven by the acute need to effectively manage the growing volumes of imaging data and the ensuing emphasis on digitizing healthcare information”.

United States, Germany United Kingdom, France, Netherlands, Canada, Japan and Spain are the majority of the world’s developed economies where hospitals can afford to install PACS systems on a large scale. This can be interpreted into North America and Europe being the largest markets for Healthcare Information Technology (HIT) systems currently.

North America is the largest market for radiology PACS with a share of nearly 48% of the global market in 2014. The market is mainly driven by technological innovations, according to PRNewswire report.

“PACS is an innovative technology that has helped reduce the physical barriers associated with customary film-based image retrieval, distribution, and display. The system has widespread application in hospitals and clinics, as it eliminates the need of maintaining hard copies of images. It offers highly accurate and precise digital copies of medical images, which are efficiently managed in comparison to the traditional imaging systems. Cloud-based PACS solution is the latest market development that is expected to rise in the next 5 years,” according to MicroMarket Monitor.

Key Players
The major players in global PACS market are:
  • Agfa Healthcare (Impax Agility)
  • Brit Systems (Roentgen Files/Works)
  • Carestream Health (Vue PACS)
  • Cerner Corporation
  • DR Systems (Unity PACS)
  • FujiFilm (Synapse Radiology PACS)
  • GE Healthcare (Centricity PACS)
  • INFINITT Healthcare (Infinitt PACS)
  • Intelerad Medical Systems Inc.
  • Mckesson Corporation
  • Merge Healthcare (Merge PACS)
  • Mckesson Corporation
  • Philips Healthcare (IntelliSpace PACS)
  • Rogan-delft B.V.
  • Siemens Healthcare (Syngo PACS)
  • Sectra A.B. (Sectra PACS)