Shawn H Becker, Ronald L Arenson, MD.
Journal of the American Medical Informatics Association Vol 1 No. 5 1994; 1:361-371
The picture archiving and communication system (PACS) is an electronic and filmless information system for acquiring, sorting, transporting, storing, and electronically displaying medical images. The basic components of PACS involve image acquisitions, a data management subsystem, a display workstation and a network. The data management computer is the core of the PACS and is functionally equivalent to the administration office in a film-based system. The critical component of the PACS for a clinician is the display workstation.
Health care costs are forever increasing and for a hospital administration to purchase and install a PACS, the cost effectiveness should be proven. This paper reviewed sourced articles and found that some authors concluded that PACS is cost effective while others conclude it is an expensive project. Some authors take only direct costs into account ignoring the indirect benefits PACS has to offer. This paper outlined the need for a uniform and well defined criteria for the calculation of costs and benefits of a PACS. The benefits of the PACS were found to be:
1. Benefit to the diagnostician
- Improved access to current patient records
- Improved access to patient history records
- File integrity and speed of retrieval
- Better diagnosis
2. Benefits to the referring physician
- Better patient management/earlier intervention
- Better patient outcome
- Reduced length of stay
- Reduced legal costs due to maladministration claims based on loss of films and a lack of patient history.
3. Benefits to the patient
- Reduced radiation exposure from x-ray equipment
- Shorter examination times
- Reduced radiation exposure as a result of less need for retakes of images
- Reduced patient inconvenience in attending hospitals for examinations and re-examinations
- Reduced chance of adverse reaction to contrast agents
4. Benefits to the hospital
- Better communication with physicians
- Better hospital administration
- Better training of radiology and other students through access to on-line image files and to digital teaching files
- Greater staff retention due to improved morale
