The Dawn of PACS 3.0: The Evolution from Image Access to Workflow Intelligence

Picture Archiving and Communication Systems (PACS) have evolved over decades in response to changes in imaging technology, network and data storage infrastructure, and the scale of clinical practice. Early PACS emphasized digitization and local image management, while later generations focused on enterprise distribution and broad geographic access. Radiology is now entering a new phase of PACS evolution, referred to as PACS 3.0. In contrast to prior phases centered on image storage and delivery, PACS 3.0 will be defined by the integration of workflow-centered intelligence into the clinical environment. In this next phase, artificial intelligence will be incorporated to support routine clinical work performed by radiologists and technologists. This manuscript proposes and defines PACS 3.0 as an evolution of PACS that could allow its users to work efficiently while maintaining the high quality of care delivery.