Traditional PAC systems are radiology systems that capture, archive and deliver image and associated textual data upon demand. PACS has revolutionized the field of radiology with soft copy reading becoming the established standard for all examinations containing very large image data sets. The core of such traditional systems is a server array that supplies the main radiology department. Due to the cost of these legacy type workstations and the complexity of allowing distributed or remote access to users with such systems, many vendors and implementing facilities use a second web-based image distribution product to get the required data to users outside of the main radiology department. The functionality of web-based products can match or even exceed the capabilities and end user tools that are available using a web-based solution. When a browser-based approach is used, many of the restrictions that limited legacy type PAC systems access to areas outside of radiology vanish. Cardiology clinical, multimedia data can be distributed including ECG, cardiac catheterization, echocardiography, electrophysiologic studies using DICOM structured reporting to match the cardiac cycle information between all the different examination types. Similar examples can be given from endoscopy, ophthalmology, dermatology, ENT and every other medical specialty and arena that involves multimedia type data. In a web-based environment, coping with the data display and manipulation requirements becomes a matter of identifying the proper viewer for the task. There is no requirement that the same viewer software is used for all applications or even that the same viewer is used for any extended period of time. The database and archive features become commodities based upon established standards and organizational rules. The viewer software is, therefore, relegated the role of simple commodity that may be replaced as soon as something better or cheaper arrives and implementation and training is budgeted and allocated. In this model, there is no restriction against using multiple different viewers in a parallel manner. Security too is handled in a manner that can follow the rigid financial industry and e-commerce standards. Is PACS really already a dead concept?
1. Understand the implications of the disposable viewer concept. 2. Understand the product cycle time of a web-based versus legacy PACS approach 3. Understand the concept of PACS functions as simple commodities