Costs and Benefits of Picture Archiving and Communication Systems

TLDR

PACS is an electronic, filmless system for acquiring, storing, and displaying medical images that has rapidly expanded in hospitals, yet its cost‑effectiveness must be proven before widespread adoption. The article introduces the basic components of a PACS and investigates explanations for differing cost‑effectiveness findings. The authors review existing PACS cost‑analysis literature, covering both direct and indirect costs. Authors find conflicting cost‑effectiveness results, note that most studies focus only on direct costs, and call for uniform criteria to calculate PACS costs and savings.

Abstract

A picture archiving and communication system (PACS) is an electronic and ideally filmless information system for acquiring, sorting, transporting, storing, and electronically displaying medical images. PACS have developed rapidly and are in operation in a number of hospitals. Before widespread adoption of PACSs can occur, however, their cost-effectiveness must be proven. This article introduces the basic components of a PACS. The current PACS cost-analysis literature is reviewed. Some authors conclude that the PACS would pay for itself, while others find the PACS much more expensive. Explanations for these differences are explored. Almost all of these studies focus on direct costs and ignore indirect costs and benefits. The literature characterizing the indirect costs of PACS is reviewed. The authors conclude that there is a need for uniform, well-defined criteria for the calculation of the costs and savings of PACSs.