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How will the future of picture archiving and communication systems (PACS) look, and how
will this future affect the practice of radiology? We are currently experiencing
disruptive innovations that will force an architectural redesign, making the majority of
today’s commercial PACS obsolete as the field matures and expands to include
imaging throughout the medical enterprise. The common architecture used for
PACS cannot handle the massive amounts of data being generated by even current versions of
tomography and magnetic resonance scanners. If a PACS cannot handle
today’s technology, what will happen as the field expands to encompass
pathology imaging, cone-beam reconstruction, and multispectral imaging? The
ability of these new technologies to enhance research and clinical care will be impaired if
PACS architectures are not prepared to support them. In attempting a structured approach
to predictions about the future of PACS, we offer projections about the technologies underlying PACS as
well as the evolution of standards development and the changing needs of a broad range of
Simplified models of the history of the PACS industry are mined for the assumptions they
provide about future innovations and trends. The physicist frequently
participates in or directs technical assessments for medical equipment, and
have extended these activities to include imaging informatics. It is hoped that by
applying these speculative but experienced-based predictions, the interested
medicalphysicist will be
better able to take the lead in setting information technology strategies that will
help facilities not only prepare for the future but continue to enjoy the benefits of
innovations without disruptive, expensive, and unexpected changes in architecture. A good
PACS strategy can help accelerate the time required for innovations to go from the drawing
board to clinical implementation.
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