Top-down design of a picture archiving and communications system (PACS) by means of simulation.

The development of picture archiving and communications systems (PACS) for medical applications can be regarded as a challenging field in medical informatics. Since 1982, several projects have been started into this direction worldwide. The Dutch IMAGIS (Image Information System) project, started in 1984, is one of them. Within this project, a top-down design strategy is chosen, with the following first steps: (1) A thorough information analysis for a Radiology Department, in which both qualitative and quantitative aspects are included. Such an analysis can be used to estimate the workload on a future PACS system. (2) The construction of a flexible performance prediction tool, based on discrete even simulation. Such a tool can be used to predict the performance of a certain computer system configuration under a certain workload. Based on the information analysis, and using the performance prediction tool, a PACS system is drafted for the thorax section of the Diagnostic Radiology Department of the Leiden University Hospital. In this first design attempt, the assumption was made that current working procedures concerning images will be maintained as much as possible.