Prior to the implementation of the digital systems in radiology practices, studies have indicated that physicians spent an average of one to three hours ‘searching’ for hard-copy films during the day . Shown below is a flow-diagram illustrating a typical hospital workflow for reviewing radiology images (adapted from ) in the pre-digital (or pre-PACS) era as opposed to reviewing images on a digital system (namely, PACS). This illustration helps one truly appreciate the inefficiencies of a pre-digital radiology practice, specifically in terms of time spent developing, retrieving and interpreting radiology images. Digital data storage and retrieval eliminates several steps in an otherwise convoluted print pipeline, paving the way for real-time reporting, on-the-fly quantitative analyses and minimal paper-pushing. The digital age and its manifestation in radiology practice has helped lower costs of radiology practices the world over, while increasing efficiency and quality of reporting.
The RIS is a computer system designed to support operational and business workflows within a radiology department. It is a repository of patient data and report which is often populated into the electronic patient record. However, an RIS by itself is debilitated in the capability to store and access the radiology images themselves! This is the role that PACS fills in; while the RIS manages patient data and department scheduling task, PACS specifically focuses on images. PACS is in principle a three-component assembly integrated together by digital networks which is constituted of an image data acquisition gateway (i.e. connections to the imaging systems themselves!), a server with substantial data-archival facilities, and of-course several display workstations for retrieving, reviewing and reporting on the acquired and stored images. An RIS integrated with a PACS makes patient data and image access lightning-fast for busy physicians whom shouldn’t be spending inordinate amounts of time on data or image access.
While an RIS integrated with a PACS, like any digital system, could certainly fall prey to the known risks for technological disaster such as unforeseen power-failure or data-corruptions in storage media, their advantages greatly outweigh such low-likelihood adverse events. In any event, modern PACS are equipped with the ability to recover from such disasters through programs that regulate routine data-backups and disaster recovery, reasserting the fact that digital data storage and retrieval is quite a reliable system. Further, digital image storage through direct connectivity with source imaging acquisition systems (eg: X-Ray, MRI, CT etc.) drastically diminishes the chance that images are “lost in transit”, presenting another major advantage over print-based radiology.
To conclude, RIS and PACS – the cornerstones of today’s digital radiology era – have together made a tremendous impact on the overall sustainability and quality-of-care offered by modern radiology practices. PACS-empowered digital radiology practices have great potential to further augment quality of care through integration with quantitative image post-processing software packages, therefore making them an infinitely extendable platform technology equipped to catapult your radiology practice into the future of quantitative imaging based healthcare.
 Srinivasan, M. (2012). Saving time, improving satisfaction: the impact of a digital radiology system on physician workflow and system efficiency. Digital _Medicine, 1(1).