Picture archiving and communication systems.

Picture archiving and communication systems (PACS) are extremely versatile systems that facilitate the transfer of digital images and patient data throughout a healthcare enterprise. PACS are most commonly used in radiology departments to process images from diagnostic imaging modalities, such as digital radiography devices and magnetic resonance imaging (MRI) systems. In this article, we evaluate three such systems from three of the largest PACS suppliers--the Agfa IMPAX, GE PathSpeed, and Siemens Sienet. The ultimate goal of any PACS is to improve workflow within the enterprise. Our testing focused on whether, and to what degree, the systems could meet this goal. We found that all three PACS are fairly complete and able to support image distribution and improve workflow compared with film-based processes. However, we did identify significant differences--along with some noteworthy limitations--with respect to system design and operation, external integration capabilities, and supplier support and professional services. We have ranked the systems for each of these factors to help healthcare facilities identify the system that will best meet their needs. Also in this Evaluation, we present an overview of the technology, a Glossary of PACS terminology (see page 400), selection guidance, and discussions of PACS-related topics, including data compression options, the role of the DICOM standard, and concerns about data security in many of today's systems.