Web and PACS: heralding the new age of imaging in the health care community


The progressive spread of Picture Archiving and Communication Systems (PACS) in medical imaging and the explosion of the World Wide Web constitute some of the major changes in our daily environment during the past decade. The basic idea that motivated the development of both the PACS and the Web is very similar to providing rapid access electronically to information “anywhere” “anytime” to “anyone” who needs it to make appropriate decisions and generate complementary information. The concept of the World Wide Web was born in 1980, when Tim Berners-Lee, while consulting for the CERN, the European Particle Physics Laboratory near Geneva at the Swiss–French border, wrote a notebook program Enquire-Within-Upon-Everything, which allowed links to be made between arbitrary nodes containing different types of documents and data [1]. Each node had a title, a type, and a list of bidirectional links. The concept of PACS was also formulated in the early 1980s. This word appeared at the First International Conference and Workshop held at Newport Beach, California, in 1982, under the leadership of André J. Duerinckx [2]. After almost two decades of research and pioneer work, often the source of frustration for its proponents and looked upon with skepticism in both the medical and radiologic communities, PACS, like its big brother the Web, has made its way into reality. Technical advances have resulted in ever-increasing computer power and network performance, whereas costs have continuously decreased. As a key issue, user-friendly software has been developed and is still rapidly improving, facilitating smooth communication between different imaging modalities and workstations, optimizing radiologic workflow, and enabling efficient distribution of radiologic information [3]. Several hospitals in the United States, Europe, and Japan have made the transition from a “film-based” to a “film-less” radiology department with PACS [3]. Recent surveys have shown that this transition to electronic management of medical images, which was often considered a costly migration, is becoming a top priority in the majority of medical institutions. Even more important for the future of PACS, as financial pressure and competition among health care providers increase, is that the majority of decision makers in health care, not only radiologists, are now convinced that a comprehensive electronic medical patient record with easy and instant access to all forms of patient information, including images, is unavoidable to improve productivity and quality in health care. Such a comprehensive patient record database, where PACS data are integrated with the radiology and hospital information systems (RIS and HIS, respectively) can potentially link several health care centers into a “virtual” radiology department, or even a “virtual” hospital. In this network of databases, Web technology is becoming the tool of choice for efficient database query and data retrieval [4]. It is now obvious that similarly to the WEB, which has a tremendous impact on our society through socioeconomic, philosophical, and ethical implications, PACS will radically change the way we practice our profession. With the implementation of PACS, be it performed in one step or gradually, reengineering of the entire radiology department becomes necessary. However, this transformation cannot be a top-down process; it must rely on a team of representatives from all the professions involved in the daily work of the radiology department. Ideally, this team should also include representatives from the other departments in the hospital, which are the major clients of the radiology department. Because images are part of the patient’s medical record, they must be available whenever and wherever they are needed. This instantaneous and ubiquitous availability of radiologic images throughout the hospital will force us, the radiologists, to change many of our convictions and habits. We will no longer be in a position to claim a copyright on the images we produce. In return, we will have access to the entire information contained in the Abdom Imaging 25:331–332 (2000) DOI: 10.1007/s002610000002 Abdominal Imaging

DOI: 10.1007/s002610000002


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@article{Terrier2000WebAP, title={Web and PACS: heralding the new age of imaging in the health care community}, author={F. Terrier}, journal={Abdominal Imaging}, year={2000}, volume={25}, pages={331-332} }