A PACS (picture archiving and communication system) is a digital system that replaces conventional radiology film. It allows images to be acquired, stored, transmitted, and displayed digitally. Key benefits include images always being available anywhere, simultaneous viewing by multiple users, and organized storage and retrieval of patient images. While expensive to implement, a PACS improves efficiency and can pay for itself within 5 years through cost savings.
A picture archiving and communication system (PACS) is a medical imaging technology which provides economical storage and convenient access to images from multiple modalities.
In this presentation we are going to talk about:-
1-What is PACS?
2-History of PACS
3-Before and after PACS
4-PACS architecture
5-PACS integration with RIS
6-PACS and DICOM
7-Advantages and disadvantages
Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format.
DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple manufacturers into a picture archiving and communication system (PACS). The different devices come with DICOM conformance statements which clearly state the DICOM classes they support. DICOM has been widely adopted by hospitals and is making inroads in smaller applications like dentists' and doctors' offices.
A picture archiving and communication system (PACS) is a medical imaging technology which provides economical storage and convenient access to images from multiple modalities.
In this presentation we are going to talk about:-
1-What is PACS?
2-History of PACS
3-Before and after PACS
4-PACS architecture
5-PACS integration with RIS
6-PACS and DICOM
7-Advantages and disadvantages
Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format.
DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple manufacturers into a picture archiving and communication system (PACS). The different devices come with DICOM conformance statements which clearly state the DICOM classes they support. DICOM has been widely adopted by hospitals and is making inroads in smaller applications like dentists' and doctors' offices.
this slide sharer contents are basic principle of CT fluoroscopy , software and hardware parts of equipment and image aqua cation and radiation dose comparison and videos related to equipment .
This slide best explains the introduction of CT, basis and types of CT image reconstructions with detailed explanation about Interpolation, convolution, Fourier slice theorem, Fourier transformation and brief explanation about the image domain i.e digital image processing.
Brief definition of Multi-modality Diagnostic facility, Teleradiology, PACS, RIS, Quality Assurance Programme
Explanation of the Quality assurance Committee
Introduction to Chest X-ray technology and CR cassette
Quality Control Tests for Chest x-ray Technology
Introduction to Fluoroscopy Technology
Quality Control test for Fluoroscopy
Quality Assurance Program Review Test
Quality Assurance Drawback
HospitalSoftwareShop PACS | A Powerful, Web-based, Cost-Effective PACShospitalsoftwareshop
HospitalSoftwareShop PACS is a fully web-based image management solution, vital to the improvement and cost effectiveness of Radiology workflow. HSS PACS is integrated with RIS. Contact us for a demo.
Picture Archiving and Communication Systems (PACS) – A New Paradigm in Health...Apollo Hospitals
Digitization and transfer of images in Radiodiagnosis and Imaging dates back to to early 70s with the advent of Computerized Tomography Scanning, and, subsequently sending these images to cameras and printers hooked on to the machines through a local “network”. Rapid advancements in Information Technology (IT) as well as in the imaging technology have facilitated the healthcare organizations across the world to manage patient's images, records and other data more efficiently. Today, capturing images, archiving and retrieval have already reached great heights, and, further refinements are in progress. The infrastructural requirements for such a venture have to be very finely and judiciously planned well in advance with a view to go filmless as the ultimate objective. Involvement of all concerned and connected agencies is a must e.g. IT, Radiologists, Clinicians and the Vendors.
this slide sharer contents are basic principle of CT fluoroscopy , software and hardware parts of equipment and image aqua cation and radiation dose comparison and videos related to equipment .
This slide best explains the introduction of CT, basis and types of CT image reconstructions with detailed explanation about Interpolation, convolution, Fourier slice theorem, Fourier transformation and brief explanation about the image domain i.e digital image processing.
Brief definition of Multi-modality Diagnostic facility, Teleradiology, PACS, RIS, Quality Assurance Programme
Explanation of the Quality assurance Committee
Introduction to Chest X-ray technology and CR cassette
Quality Control Tests for Chest x-ray Technology
Introduction to Fluoroscopy Technology
Quality Control test for Fluoroscopy
Quality Assurance Program Review Test
Quality Assurance Drawback
HospitalSoftwareShop PACS | A Powerful, Web-based, Cost-Effective PACShospitalsoftwareshop
HospitalSoftwareShop PACS is a fully web-based image management solution, vital to the improvement and cost effectiveness of Radiology workflow. HSS PACS is integrated with RIS. Contact us for a demo.
Picture Archiving and Communication Systems (PACS) – A New Paradigm in Health...Apollo Hospitals
Digitization and transfer of images in Radiodiagnosis and Imaging dates back to to early 70s with the advent of Computerized Tomography Scanning, and, subsequently sending these images to cameras and printers hooked on to the machines through a local “network”. Rapid advancements in Information Technology (IT) as well as in the imaging technology have facilitated the healthcare organizations across the world to manage patient's images, records and other data more efficiently. Today, capturing images, archiving and retrieval have already reached great heights, and, further refinements are in progress. The infrastructural requirements for such a venture have to be very finely and judiciously planned well in advance with a view to go filmless as the ultimate objective. Involvement of all concerned and connected agencies is a must e.g. IT, Radiologists, Clinicians and the Vendors.
The Game-Changing Technology Everything You Need to Know about PACS.pdfPostDICOM
In the ever-evolving world of medical imaging, Picture Archiving and Communication Systems (PACS) have become an integral part of healthcare facilities. This technology revolutionizes the way medical images are stored, accessed, and shared, providing numerous benefits to both healthcare providers and patients. In this post, we will delve into what is PACS, how it works, and its importance in modern healthcare.
Telepatholgy is the practice of pathology at a distance . there are three types: static image based, dynamic/ real time/dynamic robotic, and virtual or whole slide imaging. uses of telepathology, advantages and problems.
HospitalSoftwareShop PACS | A Powerful, Web-based, Cost-Effective PACS</ti...hospitalsoftwareshop
HospitalSoftwareShop PACS is a fully web-based image management solution, vital to the improvement and cost effectiveness of Radiology workflow. HSS PACS is integrated with RIS. Contact us for a demo."/>
A Comprehensive Overview of Picture Archiving and Communication Systems (PACS...postdicomseo
Picture archiving and communication systems (PACS) are essential medical imaging technology that optimizes workflows and provides secure storage and access to images like X-rays, CT scans, MRIs, and more.
This comprehensive guide covers PACS capabilities, components, benefits, top vendors, implementation considerations, and the future landscape.
A Comprehensive Overview of Picture Archiving and Communication Systems (PACS...postdicomseo
Picture archiving and communication systems (PACS) are essential medical imaging technology that optimizes workflows and provides secure storage and access to images like X-rays, CT scans, MRIs, and more.
This comprehensive guide covers PACS capabilities, components, benefits, top vendors, implementation considerations, and the future landscape.
Unlocking Efficiency How PACS in Radiology Are Saving Time and Improving Pati...PostDICOM
In the field of radiology, Picture Archiving and Communication Systems (PACS) have revolutionized the way medical images are stored, accessed, and shared. This advanced technology has greatly improved efficiency and accuracy in radiology departments around the world. In this blog post, we will delve into the world of PACS in radiology and explore its various aspects, including its benefits, components, and implementation process. So, let's get started!
Cracking the Code How Radiology PACS is Streamlining Medical Imaging!.pdfPostDICOM
Radiology PACS (Picture Archiving and Communication System) is a crucial technology in modern medical imaging. It allows for the efficient storage, retrieval, and sharing of radiological images and reports. In this blog post, we will explore the different aspects of radiology PACS, including its benefits, components, and implementation process. We will also discuss the importance of PACS in enhancing patient care and improving healthcare workflows.
NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad, Mandi Bah...Amil Baba Dawood bangali
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Latino Buying Power - May 2024 Presentation for Latino CaucusDanay Escanaverino
Unlock the potential of Latino Buying Power with this in-depth SlideShare presentation. Explore how the Latino consumer market is transforming the American economy, driven by their significant buying power, entrepreneurial contributions, and growing influence across various sectors.
**Key Sections Covered:**
1. **Economic Impact:** Understand the profound economic impact of Latino consumers on the U.S. economy. Discover how their increasing purchasing power is fueling growth in key industries and contributing to national economic prosperity.
2. **Buying Power:** Dive into detailed analyses of Latino buying power, including its growth trends, key drivers, and projections for the future. Learn how this influential group’s spending habits are shaping market dynamics and creating opportunities for businesses.
3. **Entrepreneurial Contributions:** Explore the entrepreneurial spirit within the Latino community. Examine how Latino-owned businesses are thriving and contributing to job creation, innovation, and economic diversification.
4. **Workforce Statistics:** Gain insights into the role of Latino workers in the American labor market. Review statistics on employment rates, occupational distribution, and the economic contributions of Latino professionals across various industries.
5. **Media Consumption:** Understand the media consumption habits of Latino audiences. Discover their preferences for digital platforms, television, radio, and social media. Learn how these consumption patterns are influencing advertising strategies and media content.
6. **Education:** Examine the educational achievements and challenges within the Latino community. Review statistics on enrollment, graduation rates, and fields of study. Understand the implications of education on economic mobility and workforce readiness.
7. **Home Ownership:** Explore trends in Latino home ownership. Understand the factors driving home buying decisions, the challenges faced by Latino homeowners, and the impact of home ownership on community stability and economic growth.
This SlideShare provides valuable insights for marketers, business owners, policymakers, and anyone interested in the economic influence of the Latino community. By understanding the various facets of Latino buying power, you can effectively engage with this dynamic and growing market segment.
Equip yourself with the knowledge to leverage Latino buying power, tap into their entrepreneurial spirit, and connect with their unique cultural and consumer preferences. Drive your business success by embracing the economic potential of Latino consumers.
**Keywords:** Latino buying power, economic impact, entrepreneurial contributions, workforce statistics, media consumption, education, home ownership, Latino market, Hispanic buying power, Latino purchasing power.
how can I sell my pi coins for cash in a pi APPDOT TECH
You can't sell your pi coins in the pi network app. because it is not listed yet on any exchange.
The only way you can sell is by trading your pi coins with an investor (a person looking forward to hold massive amounts of pi coins before mainnet launch) .
You don't need to meet the investor directly all the trades are done with a pi vendor/merchant (a person that buys the pi coins from miners and resell it to investors)
I Will leave The telegram contact of my personal pi vendor, if you are finding a legitimate one.
@Pi_vendor_247
#pi network
#pi coins
#money
what is the best method to sell pi coins in 2024DOT TECH
The best way to sell your pi coins safely is trading with an exchange..but since pi is not launched in any exchange, and second option is through a VERIFIED pi merchant.
Who is a pi merchant?
A pi merchant is someone who buys pi coins from miners and pioneers and resell them to Investors looking forward to hold massive amounts before mainnet launch in 2026.
I will leave the telegram contact of my personal pi merchant to trade pi coins with.
@Pi_vendor_247
If you are looking for a pi coin investor. Then look no further because I have the right one he is a pi vendor (he buy and resell to whales in China). I met him on a crypto conference and ever since I and my friends have sold more than 10k pi coins to him And he bought all and still want more. I will drop his telegram handle below just send him a message.
@Pi_vendor_247
What price will pi network be listed on exchangesDOT TECH
The rate at which pi will be listed is practically unknown. But due to speculations surrounding it the predicted rate is tends to be from 30$ — 50$.
So if you are interested in selling your pi network coins at a high rate tho. Or you can't wait till the mainnet launch in 2026. You can easily trade your pi coins with a merchant.
A merchant is someone who buys pi coins from miners and resell them to Investors looking forward to hold massive quantities till mainnet launch.
I will leave the telegram contact of my personal pi vendor to trade with.
@Pi_vendor_247
Empowering the Unbanked: The Vital Role of NBFCs in Promoting Financial Inclu...Vighnesh Shashtri
In India, financial inclusion remains a critical challenge, with a significant portion of the population still unbanked. Non-Banking Financial Companies (NBFCs) have emerged as key players in bridging this gap by providing financial services to those often overlooked by traditional banking institutions. This article delves into how NBFCs are fostering financial inclusion and empowering the unbanked.
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Contact with Dawood Bhai Just call on +92322-6382012 and we'll help you. We'll solve all your problems within 12 to 24 hours and with 101% guarantee and with astrology systematic. If you want to take any personal or professional advice then also you can call us on +92322-6382012 , ONLINE LOVE PROBLEM & Other all types of Daily Life Problem's.Then CALL or WHATSAPP us on +92322-6382012 and Get all these problems solutions here by Amil Baba DAWOOD BANGALI
#vashikaranspecialist #astrologer #palmistry #amliyaat #taweez #manpasandshadi #horoscope #spiritual #lovelife #lovespell #marriagespell#aamilbabainpakistan #amilbabainkarachi #powerfullblackmagicspell #kalajadumantarspecialist #realamilbaba #AmilbabainPakistan #astrologerincanada #astrologerindubai #lovespellsmaster #kalajaduspecialist #lovespellsthatwork #aamilbabainlahore#blackmagicformarriage #aamilbaba #kalajadu #kalailam #taweez #wazifaexpert #jadumantar #vashikaranspecialist #astrologer #palmistry #amliyaat #taweez #manpasandshadi #horoscope #spiritual #lovelife #lovespell #marriagespell#aamilbabainpakistan #amilbabainkarachi #powerfullblackmagicspell #kalajadumantarspecialist #realamilbaba #AmilbabainPakistan #astrologerincanada #astrologerindubai #lovespellsmaster #kalajaduspecialist #lovespellsthatwork #aamilbabainlahore #blackmagicforlove #blackmagicformarriage #aamilbaba #kalajadu #kalailam #taweez #wazifaexpert #jadumantar #vashikaranspecialist #astrologer #palmistry #amliyaat #taweez #manpasandshadi #horoscope #spiritual #lovelife #lovespell #marriagespell#aamilbabainpakistan #amilbabainkarachi #powerfullblackmagicspell #kalajadumantarspecialist #realamilbaba #AmilbabainPakistan #astrologerincanada #astrologerindubai #lovespellsmaster #kalajaduspecialist #lovespellsthatwork #aamilbabainlahore #Amilbabainuk #amilbabainspain #amilbabaindubai #Amilbabainnorway #amilbabainkrachi #amilbabainlahore #amilbabaingujranwalan #amilbabainislamabad
Falcon stands out as a top-tier P2P Invoice Discounting platform in India, bridging esteemed blue-chip companies and eager investors. Our goal is to transform the investment landscape in India by establishing a comprehensive destination for borrowers and investors with diverse profiles and needs, all while minimizing risk. What sets Falcon apart is the elimination of intermediaries such as commercial banks and depository institutions, allowing investors to enjoy higher yields.
how to sell pi coins on Bitmart crypto exchangeDOT TECH
Yes. Pi network coins can be exchanged but not on bitmart exchange. Because pi network is still in the enclosed mainnet. The only way pioneers are able to trade pi coins is by reselling the pi coins to pi verified merchants.
A verified merchant is someone who buys pi network coins and resell it to exchanges looking forward to hold till mainnet launch.
I will leave the telegram contact of my personal pi merchant to trade with.
@Pi_vendor_247
when will pi network coin be available on crypto exchange.DOT TECH
There is no set date for when Pi coins will enter the market.
However, the developers are working hard to get them released as soon as possible.
Once they are available, users will be able to exchange other cryptocurrencies for Pi coins on designated exchanges.
But for now the only way to sell your pi coins is through verified pi vendor.
Here is the telegram contact of my personal pi vendor
@Pi_vendor_247
how to sell pi coins effectively (from 50 - 100k pi)DOT TECH
Anywhere in the world, including Africa, America, and Europe, you can sell Pi Network Coins online and receive cash through online payment options.
Pi has not yet been launched on any exchange because we are currently using the confined Mainnet. The planned launch date for Pi is June 28, 2026.
Reselling to investors who want to hold until the mainnet launch in 2026 is currently the sole way to sell.
Consequently, right now. All you need to do is select the right pi network provider.
Who is a pi merchant?
An individual who buys coins from miners on the pi network and resells them to investors hoping to hang onto them until the mainnet is launched is known as a pi merchant.
debuts.
I'll provide you the Telegram username
@Pi_vendor_247
how to sell pi coins in South Korea profitably.DOT TECH
Yes. You can sell your pi network coins in South Korea or any other country, by finding a verified pi merchant
What is a verified pi merchant?
Since pi network is not launched yet on any exchange, the only way you can sell pi coins is by selling to a verified pi merchant, and this is because pi network is not launched yet on any exchange and no pre-sale or ico offerings Is done on pi.
Since there is no pre-sale, the only way exchanges can get pi is by buying from miners. So a pi merchant facilitates these transactions by acting as a bridge for both transactions.
How can i find a pi vendor/merchant?
Well for those who haven't traded with a pi merchant or who don't already have one. I will leave the telegram id of my personal pi merchant who i trade pi with.
Tele gram: @Pi_vendor_247
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The European Unemployment Puzzle: implications from population agingGRAPE
We study the link between the evolving age structure of the working population and unemployment. We build a large new Keynesian OLG model with a realistic age structure, labor market frictions, sticky prices, and aggregate shocks. Once calibrated to the European economy, we quantify the extent to which demographic changes over the last three decades have contributed to the decline of the unemployment rate. Our findings yield important implications for the future evolution of unemployment given the anticipated further aging of the working population in Europe. We also quantify the implications for optimal monetary policy: lowering inflation volatility becomes less costly in terms of GDP and unemployment volatility, which hints that optimal monetary policy may be more hawkish in an aging society. Finally, our results also propose a partial reversal of the European-US unemployment puzzle due to the fact that the share of young workers is expected to remain robust in the US.
how to sell pi coins at high rate quickly.DOT TECH
Where can I sell my pi coins at a high rate.
Pi is not launched yet on any exchange. But one can easily sell his or her pi coins to investors who want to hold pi till mainnet launch.
This means crypto whales want to hold pi. And you can get a good rate for selling pi to them. I will leave the telegram contact of my personal pi vendor below.
A vendor is someone who buys from a miner and resell it to a holder or crypto whale.
Here is the telegram contact of my vendor:
@Pi_vendor_247
2. • Picture archiving and communication system (PACS) is a
modality of imaging technology that helps in image
transmission from the image acquisition site to multiple
physically-disparate locations.
• Economical (film-less department),
• convenient to access multiple modalities (radiography, CT,
MR, ultrasound etc.) simultaneously at multiple locations
within hospitals or across the globe.
3. A picture archiving and communication system (PACS) is a
computerised means of replacing the roles of conventional
radiological film:
• images are acquired,
• stored,
• transmitted,
• and displayed digitally.
When such a system is installed throughout the hospital, a
filmless clinical environment results.
4. Basic structure
• PACS is usually an integration of:
1. input from digital or digitized analog devices, which may be
any radiological modality e.g. x-ray, CT, MRI or ultrasound
2. image acquisition device
3. image storage device/server for short or long term storage of
data
4. transmission network: local or web-based
5. display stations: imaging workstation and user interface
6. camera: to convert into hard-copy images on need basis
7. integration with radiology information system (RIS)
8. INFORMATION NEVER LOST
• The main advantage a PACS is the improvement in efficiency
resulting from electronic data handling:
• Once an image has been acquired onto PACS it cannot be lost,
stolen, or misfiled.
• Thus, images are always available after a PACS has been installed, so no patient
appointment is cancelled, no clinical decision deferred, no images are repeated
because they are missing, and no time is wasted by doctors or other healthcare
workers looking for missing films. All images are available day and night for
viewing anywhere in the hospital (and outside the hospital if there is a
teleradiology facility).
9. MULTILOCATION VIEWING
• Simultaneous multilocation viewing of the same ,whereas
conventional film can only physically exist in one place at any
one time.
• This means, for example, that a doctor in the emergency department can discuss a
patient’s images with the radiologist, with both clinicians viewing the images yet
neither having left their department. Similarly, by the time a patient has returned
to the outpatient department after being sent for an urgent radiological
examination, the images will be available on PACS for viewing by the referring
doctor.
10. ORGANISED DATA
• The PACS database ensures that all images are automatically
grouped into the correct examination & are chronologically
ordered, correctly orientated and labelled, and can be easily
retrieved using a variety of criteria (for example, name,
hospital number, date, referring clinician, etc).
• All imaging studies of a patient are immediately available on the PACS which
encourages review of examinations with preceding studies and intramodality
comparisons.
11. • Working with soft copy images on monitors allows the full
gamut of computer tools to be used to manipulate and post-
process the images.
• Alteration of the contrast width and level allows soft tissue
and bony structures to be well seen on a single exposure.
• This is also partly the result of the photostimulable phosphor
plate acquisition , which have a greater dynamic range than
the conventional screen-film combination which leads to
improved simultaneous visualisation of structures of widely
differing radiodensity, and also permits a lower exposure
dose to be used in many cases.
12. • Graph showing the sigmoid relation between optical density and
radiation exposure for conventional film–screen radiography, compared
with the linear response seen with photostimulable phosphor plate
computed radiography. The phosphor plate has a much greater dynamic
range (latitude) falling within diagnostic levels of optical density, and so
can show a larger number of tissue structures well at any given
exposure, and responds better than film at lower doses.
13. Example of PACS computer tool: linear measurement of
cardiothoracic ratio drawn onto soft copy chest image.
14. • PACS does allow some direct economic savings from the lack
of expenditure on film, film packets, film processing
chemicals, and the redeployment of space previously used for
film storage.
• Cost savings are, however, not as great as predicted.
• The aim when introducing a PACS is to be at least cost neutral
with respect to conventional radiology.
15. The Hammersmith Hospital PACS
• The Hammersmith Hospital in West London has been
operating as a totally filmless hospital since March 1996.
• Films are printed only for use at outside institutions.
• There is a centralised storage system with a long term archive
of 2 terabytes on optical disks and a short term storage
system of approximately 10 days worth of imaging
examinations on a 256-gigabyte random array of inexpensive
disks (RAID)
16.
17. • A RAID is a multitude of hard drives (or disks) where the
information is written to all the disks so that it is distributed
over the entire RAID.
• This means that if any of the disks were to fail, only a small
proportion of the data would be lost. In addition, the RAID
management software has an error-correcting algorithm that
is able to rewrite any lost data with a high degree of accuracy,
so that data loss is very unlikely.
• The network architecture of the PACS is centralised, with the
archives at the hub and the 168 workstations and 23 imaging
modalities on spokes, each connected to the hub by a
dedicated point to point high capacity optical fibre using a fast
protocol, as rapid transmission is crucial for moving around
the vast amount of data contained in radiological images..
18. • Images are retrieved in two seconds from short term storage
and in approximately two minutes from long term storage.
The vast majority of images viewed in the hospital are already
on the short term server as they have been prefetched
overnight prior to being needed the following day.
• Integration of the PACS with the hospital and radiological
information systems (HIS and RIS) triggers the appropriate
prefetches as these latter systems know which patients will be
in- or outpatients the following day, and which have been
booked to undergo imaging procedures
19. PREFETCHING
• Prefetching is the process whereby previous images on a
patient are automatically retrieved from the long term archive
onto the short term server, prior to the acquisition and
viewing of the current imaging examination on that patient.
• This software feature is commonly sufficiently sophisticated to
take the form of an “intelligent prefetch”. This means that
only a configurable number of examinations from the same
modality and of the same body part as that currently being
imaged are prefetched from the long term archive.
• Because it is unnecessary to overload PACS network and short
term server with data irrelevant to the current clinical
problem.
20. • Intelligent prefetch software is an advantage of PACS for both
paediatric and adult populations.
• For instance a patient with an old tibial fracture came for
follow up; Intelligent prefetch can be set up to recall only the
previous tibial images to the short term storage when the
patient attends for a follow up tibial radiograph.
21. DEFAULT DISPLAY PROTOCOLS
• This software feature automatically arranges and displays the
current image, with relevant past images on the PACS
monitor(s) in the correct chronological order, in a manner
which allows immediate comparative viewing without the
need for time consuming dragging of images into a preferred
configuration.
• Modern PACS generally allow numerous such DDPs to be
personally set up by individual users to cater for individual
viewing preferences and for different image types.
22. • Many of the soft copy post-processing tools available on any
PACS workstation (review or diagnostic) are particularly
relevant to viewing image.
• Magnification and zoom/ pan tools are useful for enlarging
and examining in detail the small images of neonates or
focusing on a particular area.
• The “invert greyscale” facility, whereby images may be
viewed as black structures on a white background (rather
than the conventional white on black presentation) is
considered by many to be helpful in precisely identifying the
tips of thin lines, such as arterial and venous umbilical
catheters.
23.
24. The disadvantages of PACS
• The installation of a hospital wide PACS is expensive.
• But a reasonable conclusion is that PACS will pay for itself in
about five years after installation from direct and estimated
indirect cost savings.
• There is no question that PACS greatly improves the efficiency
of healthcare, although again this is difficult to quantify.
25. • When PACS has been installed it is vital to guard against a
total system failure as a hospital cannot function without an
imaging service.
• As much less as is economically possible needs to be built into
the PACS architecture.
• Daily data backups must occur automatically.
• Part of the PACS maintenance contract should involve the
presence of an information technology engineer on-site to
deal immediately with day to day problems such as the
malfunction of a workstation.
26. • Although many PACS vendors are increasingly relying on
remote access modems for maintenance, this is not generally
sufficient.
• A contingency/ backup plan should be drawn up in advance to
be put into operation should a total system failure occur, so
that the hospital is able to maintain a minimal imaging service
or emergency work.
27. • Another potential problem of a PACS is the fear that medical
staff will not have sufficient computer literacy to be able to
use the new technology.
• This is not an issue for the majority of the current generation
of junior doctors.
• It is important that the graphic user interface of the PACS
workstations is as user friendly and intuitive as possible.
• An increasing number of PACS vendors have realised the
benefit of working with clinicians in the design of PACS
software to render it clinically relevant and simple to use.
28. THE FUTURE
• One of the most significant developments in PACS over the
past couple of years has been the exploitation of conventional
web browser technology to access images and display them
on ordinary desktop personal computers.
• This has provided a cheap and easy means of reviewing
images without the need for expensive specialised PACS
review workstations. It has also facilitated the development of
teleradiology whereby doctors can review emergency images
from their homes at night.
• This would be expected to be a beneficial development if it
means that there will be greater recourse to senior medical
opinion for difficult emergency cases.
29. • Desktop PCs have single colour (relatively low luminance)
monitors; there are some areas in the hospital where higher
quality two screen diagnostic workstations may still be
necessary. These should be located in the radiology
department.
30. • Now that filmless radiology has been achieved in a number of
hospitals worldwide, the next step must be to achieve
completely paperless radiology as a step on the way to
realising a complete electronic patient record.
• Paperless radiology requires that there be remote order entry
(ROE)/order communications, so that any imaging procedure
will be ordered electronically by the requesting physician or
general practitioner, directly from the ward, outpatient clinic,
or general practice.
• Generally such electronic requests will be entered onto the
hospital information system (HIS), which should be
bidirectionally linked to both the radiology information system
(RIS) and the PACS.
31. • Thus the requesting doctor will have access to the
appointments schedule at the time of booking and the
clinical details he/she enters will ultimately be transmitted to
the PACS to be read in conjunction with the images once
these are acquired.
• It is important that a unique identification number is
generated for each imaging examination, and this number
must be known to all computer systems (the RIS, the HIS, and
the PACS).
32. ROE-Remote Order Entry
• ROE means that the patient no longer has to go to (or contact)
the Imaging Department to arrange an appointment and
receive a letter containing preprocedural instructions because
everything can be instructed by a clinician at the time of
booking.
• Such an integrated system is much more efficient and avoids
human errors and communication problems between patient
and radiologist as well as between radiologist and clinician.
33. EPR –Electronic Patient Record
• The EPR would incorporate PACS and ROE, and would contain
other clinical data in digital format (histopathology, clinical
photographs, electrocardiograms, etc), as well as an electronic
version of the patient notes.
• Some would argue that the EPR should be recorded on a
microchip of which a copy is entrusted to the patient.
• While such a concept may still seem somewhat fanciful, there
is no doubt that filmless radiology has already been
successfully achieved and that PACS has now proved itself in
clinical practice.
A radiology information system is a system that radiologists use for recording patient radiology histories as well as for scheduling appointments.
HIS – Hospital information system
RIS – radiology information systems
There is a centralised storage system with a long term archive of 2 terabytes on optical disks (with plain radiographic images lossily compressed after reporting at 10:1), and a short term storage system of approximately 10 days worth of imaging examinations on a 256 gigabyte random array of inexpensive disks (RAID) (fig 4).
(A RAID is a multitude of hard drives (or disks) where the information is written to all the disks so that it is distributed over the entire RAID. This means that if any of the disks were to fail, only a small proportion of the data would be lost. In addition, the RAID management software has an error-correcting algorithm which is able to rewrite any lost data with a high degree of accuracy, so that data loss is very unlikely.) The network architecture of the PACS is centralised, with the archives at the hub and the 168 workstations and 23 imaging modalities on spokes, each connected to the hub by a dedicated point to point high capacity optical fibre using a fast protocol, as rapid transmission is crucial for moving around the vast amount of data contained in radiological images. (There are approximately 10 megabytes of data in one chest radiograph.) Textual demographic data are carried by slower ethernet protocol.