[The filmless hospital: 3-year experience at the Hammersmith Hospital, London]

A hospital-wide PACS (Picture Archiving and Communication System) is a computerised electronic system which entirely replaces conventional x-ray film by acquiring, archiving, transmitting and displaying digital images on a network of workstations throughout the hospital. Such a system has been operating without film for 3 years now at Hammersmith Hospital, London. PACS has a number of advantages over conventional films. These include time savings, reliability of the system, space savings, economies in consumables and personnel, reduced patient irradiation, efficiency of data management, accessibility of images and teaching benefits. The disadvantages of PACS are: its cost, the need for specialised personnel for its installation and maintenance, training of users, the possibility of breakdown, and data security issues. PACS has altered the work patterns of all its users, including non-radiologist clinicians, radiologists and radiographers. PACS is a step on the way to achieving the future objectives of teleradiology and the complete electronic patient record.