Critical Components Associated with Hospital-wide Filmless PACS Operation and Digital Image Management

Author: Wei-Chih C. Chang

Primary Advisor:

Committee Members:

Masters thesis, The University of Texas School of Health Information Sciences at Houston.

Introduction:
 
Information technology is becoming a vital component of all health care enterprises, ranging from managed care services to large, comprehensive hospital networks. Its utility lies in the ability to provide the basis for electronic patient records and hospital-wide information. A Picture Archiving and Communication System (PACS) is a computerized means of replacing the role of conventional radiological film; in essence, images are acquired, stored, transmitted, and then displayed digitally. The setup can be as simple as a film digitizer connected to a display workstation with a small image database, or as complex as a complete hospital image management system. First developed in the late 1980’s, PACS at the time was designed primarily on an ad hoc basis, serving small subsets of the total operations of many radiology departments [1]. When such a system is installed throughout the hospital, a filmless clinical environment results.
 
Although there are many hundreds of PACS installations operating throughout the world today, many are rarely small.  For example, they often link the intensive care unit with the radiology department, or networking several workstations together [2]. It should be pointed out that at the present time, however, there are still relatively few (less than 20) truly filmless hospitals in existence [3]. Although the technologic concepts of PACS and its potential benefits can be readily perceived, it has not always been easy to implement reliable and fully functional systems. Moving images in the range of 40 millibytes per procedure at millisecond speed, integrating nonstandard information systems, and replacing films with digital workstations on a cost-effective basis have been formidable obstacles to widespread implementations of PACS.