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PACS and Imaging Informatics: Basic Principles and Applications, Second Edition by H. K. Huang, D.Sc., FRCR, FAIMBE

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CHAPTER 19

PACS Clinical Experience, Pitfalls, and Bottlenecks

This chapter’s presentation of clinical experience and lessons learned is excerpted from the last edition of this book and based on the clinical experiences of two medical centers: the Baltimore VA Medical Center and the St. John’s Healthcare Center in Santa Monica, California. The Baltimore VA case is a study of a successful filmless PACS operation. The St. John’s Health Center case is a study of two PACS operation issues and solutions that resulted in an upgrade of the archive server and off-site backup archive. We predicted in our 2004 edition that many existing and future PAC systems would face similar issues; we provide two new case studies at UCLA and at the University of Southern California, that substantiate our prediction.The remaining topics in this chapter explore PACS pitfalls, PACS bottlenecks, and pitfalls in DICOM conformance. Figure 19.1 (excerpted from Fig. 1.3) shows how this chapter corresponds to other chapters of Part III.

19.1 CLINICAL EXPERIENCE AT THE BALTIMORE VA MEDICAL CENTER

This section is based on a retrospective of the filmless radiology department at the Baltimore VA Medical Center by Drs. Eliot Siegel and Bruce Reiner that appeared in Computerized Medical Imaging and Graphics (Siegel and Reiner, 2003).

The Baltimore VA Medical Center (VAMC) started its PACS implementation in the late 1980s and early 1990s. The VAMC purchased a PACS in late 1991 for approximately $7.8 million, which ...

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