Picture Archiving and Communication Systems (PACS) are the backbone of modern medical imaging departments. They store, retrieve, and distribute X-rays, MRIs, CT scans, and other medical images across and between healthcare networks.
Healthcare facilities can choose between two primary deployment models for PACS software. Traditional PACS systems operate on local servers within the facility’s infrastructure and are managed by in-house IT teams. Cloud-based PACS solutions run on remote servers accessed through the internet and are managed by third-party providers.
Each model presents advantages and challenges that impact workflow, accessibility, cost structure, and maintenance requirements. In this article, we’ll explore both options to help healthcare decision-makers select the most appropriate PACS solution for their facility.
What is Traditional PACS Software?
Traditional PACS software runs on dedicated servers housed within a healthcare facility’s premises or on collocated servers in a data center. The PACS software manages the flow of medical images from acquisition to storage to viewing. It includes components for processing and archiving images, as well as viewing applications and interfaces that connect to imaging devices and other hospital systems, including electronic medical records software.
The traditional PACS model requires substantial infrastructure investment. Healthcare facilities must purchase and maintain physical servers, storage hardware, and networking equipment. They also cooling, power, and physical security measures. IT staff are responsible for managing data backups, system updates, hardware replacements, and information security and compliance.
What is Cloud-Based PACS Software?
Cloud-based PACS software provides medical imaging management through software running on remote servers accessed via the Internet. Cloud PACS evolved from traditional PACS as healthcare organizations sought more flexible, scalable solutions without significant hardware investment.
The core architecture of cloud PACS includes secure data centers that host software applications and image storage. Healthcare facilities connect to these systems through lightweight on-site gateway devices or direct internet connections.
When a radiographer or imaging professional performs an exam, images are uploaded to centralized cloud storage and are accessible to authorized users regardless of location. Radiologists view and report on studies from anywhere with internet access. The cloud model allows for unified worklists that distribute studies efficiently across radiology teams.
Integration with other healthcare systems is supported through industry-standard protocols. Cloud PACS solutions typically support HL7 interfaces to communicate with EMR and RIS systems, DICOM connectivity for imaging devices, and secure API connections for additional applications.
Advantages of Traditional PACS
Traditional PACS systems offer several operational benefits that appeal to healthcare organizations, primarily related to data control, independence, and predictability.
- Data control and ownership: Organizations maintain possession of all patient imaging data within their infrastructure. Consequently, they are solely responsible for security, privacy, and compliance management.
- One-time capital expenditure model: The hardware costs represent a single upfront investment rather than recurring expenses, although licensing and support costs may be ongoing.
- Network independence: These systems continue functioning during internet outages since they operate on local networks.
Disadvantages of Traditional PACS
Traditional PACS systems present several challenges that can impact long-term operational efficiency and flexibility.
- High upfront costs: Organizations must invest in servers, storage, software licenses, and infrastructure.
- IT staffing requirements: Maintaining traditional PACS requires dedicated IT specialists with knowledge of healthcare imaging systems.
- Maintenance responsibilities: Healthcare organizations assume full responsibility for system backups, security, hardware replacements, and disaster recovery.
- Limited accessibility for remote users: Accessing studies outside the facility typically requires VPN connections or other complex remote access solutions.
- Upgrade complexity and costs: System updates often involve significant downtime, additional hardware purchases, and complex data migrations.
Advantages of Cloud-Based PACS
Cloud-based PACS solutions offer significant benefits that align with modern healthcare delivery models and IT management preferences.
- Lower initial investment: Implementation requires minimal hardware purchases, dramatically reducing upfront costs compared to traditional systems.
- Operational expenditure model: Subscription-based pricing converts major capital expenses into predictable monthly operational costs that scale with usage.
- Anywhere, anytime access: Authorized users access images and reports from any location with internet connectivity, supporting teleradiology and remote work.
- Automatic updates and maintenance: Vendors handle software updates, security patches, and system maintenance without disrupting clinical operations.
- Built-in disaster recovery: Cloud providers maintain redundant data centers and automated backup systems, protecting against data loss without additional investment.
- Easier multi-site collaboration: Centralized image storage and unified worklists enable seamless collaboration between radiologists and facilities across different locations.
Disadvantages of Cloud-Based PACS
While cloud-based PACS offers many advantages, healthcare organizations should consider these potential limitations:
- Ongoing subscription costs: Monthly or annual fees continue throughout the system’s lifecycle.
- Internet dependency: System availability relies on internet connectivity, creating potential vulnerability during network outages.
Key Decision Factors for Healthcare Providers
When considering whether to choose a cloud or traditional PACS solution, healthcare organizations should evaluate the operational and clinical factors that impact their medical imaging workflows.
Operational Requirements
- Facility size and study volume: Large and growing facilities benefit from cloud solutions that scale automatically. Small facilities with predictable volumes might find a traditional on-prem solution sufficient.
- Multi-site vs. single location: Organizations with multiple locations gain significant workflow advantages from cloud-based systems that centralize image management across all sites.
- IT resources and expertise: Facilities with limited budgets for IT staff benefit from cloud solutions that reduce on-site management requirements and technical complexity.
- Disaster recovery needs: Cloud-based systems typically offer superior disaster recovery capabilities through geographically dispersed data centers and automated backup systems.
Clinical Workflows
- Remote reading requirements: Practices that rely on teleradiology or need radiologists to read studies from home or multiple locations benefit from cloud solutions’ inherent remote accessibility.
- Collaboration needs: Organizations requiring frequent consultation between specialists in different locations gain efficiency from cloud systems that facilitate image sharing and communication.
Where Cloud PACS Excels
Cloud-based PACS solutions are the preferred choice of healthcare organizations that prioritize efficient patient care, flexibility, accessibility, and reduced IT burden.
- Multi-location healthcare networks: The best cloud PACS software creates unified worklists across all network locations, enabling centralized management, balanced workloads, and consistent reporting standards regardless of where images originate.
- Teleradiology practices: Remote reading workflows are straightforward with cloud solutions that provide immediate access to studies from referring facilities without complex VPN setups or image transfers.
- Resource-limited facilities: Organizations with constrained IT budgets or limited technical staff benefit from reduced infrastructure requirements and vendor-managed maintenance.
- Organizations seeking scalability: Cloud systems accommodate growth without additional hardware investments, allowing practices to add locations, radiologists, or study volume without system overhauls.
OnePACS: The Superior Cloud PACS Solution
OnePACS delivers a comprehensive cloud-based PACS platform developed by radiologists for radiologists. The system prioritizes clinical workflow efficiency and seamless multi-site operation with 99.9% uptime reliability.
OnePACS features include:
- OneWorklist®: Streamlines workflows by integrating image transmission, viewing, reporting, and distribution through a single unified interface with one login and one comprehensive view of all practice activity.
- Report Generator System: The structured reporting system automatically formats complete reports based on the radiologist’s dictated findings. Study types are automatically detected, and critical elements are automatically populated.
- Multiple FDA-cleared viewers: OnePACS supports numerous diagnostic viewing preferences with options for Windows, macOS, Linux, and zero-footprint HTML5 viewing on mobile devices.
- Advanced AI capabilities: The AI-powered Impression Generator feature accelerates reporting and generates impressions in the radiologist’s preferred style.
- Comprehensive integration services: Offers industry-standard HL7 integration options, including unidirectional and bi-directional interfaces, automatic study confirmation, and DICOM Modality Worklist.
- Robust collaboration tools: Enables instant messaging, study notes, and CaseLink® features for sharing cases with patients, colleagues, and healthcare providers.
OnePACS is the best PACS system for healthcare organizations that want faster, more efficient radiology workflows with a reduced IT burden.