Design and implementation of a picture archiving and communication system: the second time

Area of Science:

• Medical Informatics
• Health IT Systems
• Radiology Informatics

Background:

• Two large-scale Picture Archiving and Communication Systems (PACS) were designed and implemented over a 10-year period.
• The first system was developed at UCLA (1983-1992), and the second has been evolving at UCSF since 1992.

Purpose of the Study:

• To describe the design and implementation experience of two large-scale PACS.
• To highlight the evolution of PACS design concepts over a decade, moving towards open, integrated systems.
• To compare the architectural differences and technological advancements between the UCLA and UCSF PACS.

Main Methods:

• Comparative analysis of two distinct PACS implementations.
• Focus on system reliability, data integrity, and 24-hour on-line service.
• Evaluation of technological choices in software, digital communication, and system interfaces.

Main Results:

• The UCSF PACS features a completely open architecture, unlike the earlier UCLA system.
• The UCSF system incorporates more advanced technologies and adheres to stable industry standards.
• Both systems prioritize reliability and data integrity, ensuring no image loss.

Conclusions:

• The trend in PACS design has shifted from closed architectures to open, hospital-integrated systems.
• An open architecture PACS, utilizing advanced technologies and standards, is crucial for future-proofing against technological obsolescence.
• The UCSF PACS design exemplifies a robust, adaptable, and reliable system for modern healthcare environments.