Although Picture Archiving and Communication Systems (PACS) are being pushed increasingly away in favor of enterprise imaging systems and other data management systems, they are also evolving in their own right. This shift in how clinicians interact with patient records and medical images will result in ongoing pressures on the PACS market and ultimately mark the end of one PACS era, and the start of another.

Our current generation PACS (or PACS 2.0), evolved from what was originally a now seemingly antique workflow of digitizing film images for storage and sharing purposes, PACS 1.0. PACS 2.0, which many agree is very quickly on its way out, faces its own challenges and ongoing pressures from current health care trends.

Firstly, the shift away from a fee-for-service health care model highlights the need for radiology to display value by its ability to manage imaging, rather than simply offering readings. This means that the new generation of PACS systems needs to offer tangible advancements in the value proposition (aka meaningful use) in order to qualify for reimbursement.

Additionally, as a result of increasing hospital consolidation and Electronic Medical Record (EMR) adoption across facilities, enterprise imaging has become the key focus, reducing the onus on stand-alone PACS systems. We are therefore very quickly on our way to PACS 3.0, which is characterized by interoperability with existing facility systems, and a Vendor Neutral Archive (VNA) which can support a variety of specialties, rather than a model of a specific radiology PACS with the support of third-party applications. Another key feature of the latest PACS is its compatibility with cloud-based storage. Medical images could make up around 30% of all storage globally, so facilities recognize the administrative and cost benefits of storing images on the cloud, where storage scalability is a feasible and relatively low-cost option. As Mike Gray and Donald Dennison agree, change is definitely occurring.

From a competitive standpoint, it will be interesting to note how PACS vendors will adapt and respond to this change. With the advent of PACS 3.0, the ?best of breed? spotlight will return to the PACs arena?meaning that there?ll be an increasing focus on therapy area-specific tools and applications built in to the systems, rather than the standardized, ?one-size-fits-all? concept with extra add-ons we see with PACS 2.0. Vendors will be encouraged to differentiate themselves and promote their products for a specific imaging purpose again, which was actually also seen in the initial generation of PACS. Therefore, while there is a lot of change going on and a lot to look out for in the coming years, it seems that certain elements on the PACS pendulum that were there at the start, may in fact be swinging back once again.  

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