Filmless digital radiology--feasibility and 20 month experience in clinical routine.

We present the clinical experiences of PACS based on 20 months routine operation of the first filmless radiology department worldwide. PACS planning and implementation strategies for potential vendors are discussed. The actual implementation status of this major teaching hospital with currently 560 acute-care beds comprises three computed radiography systems, five digital fluoroscopic units, eight ultrasound machines, five mobile units, three angio suites and two CT's interconnected with a PACS, a RIS, which is coupled with three voice-recognition systems for report generation during nights, and a HIS. Primary diagnosis is performed on 16 workstations with two to six high-resolution, high-contrast monitors. Twenty-six peripheral viewing stations provide image display on the wards and in outpatient clinics. During the first 20 months 586.047 images have been acquired, resulting in 1.3 Tbyte of data stored on optical disks. Currently the daily data production is 5-6 Gbyte, the network traffic 15-18 Gbyte. Benefits of PACS primarily are reliable access to image information, speeding up report cycle time, which contributes to the reduction of the average patient length of stay (LOS). The LOS in our hospital is the shortest (6.4 days) of all Austrian hospitals. So it may be stated that PACS improves the quality of health care.