A major task in preparing for PACS replacement is engineering the appropriate size of the new system – how much storage, both cache and long term, how big a database, how much network I/O bandwidth, how many CPUs to support the load, etc. The goal is a system design that will be responsive to the user demands, as well as cost-effective for the organization.

An ordinary PACS replacement planning approach looks at the current organizational requirements – number and types of modalities, number of studies per day and per year, study size, number of workstations needed for the staff, desired response time. This planning can result in a system “right-sized” for the organization at the lowest cost.

However, a better planning approach looks beyond the current requirements to take into account the future – the emerging needs for radiology in the next decades, such as evolution to higher resolution imaging and larger study sizes, new 3D and 4D modalities, requirements for new AI-enabled diagnostics and imaging-guided therapies, and potential organizational growth, both organic and through consolidation with other practices. System capacity designed with this kind of foresight is often called “future-proofed.”

But even foresight is deficient without hindsight. A PACS replacement needs to accommodate the years or decades of historical studies from the prior system, a trove of valuable data. Therefore, a superior PACS planning approach looks beyond the current and future needs to requirements of the past – making the historical data of the organization available to support the current and future needs of the practice. Planning for the past means providing sufficient capacity and bandwidth in the new PACS to import the volume of historical studies in a reasonable time frame. Many institutions have 10-20 times the current yearly volume of studies in their archive. Simply moving that data into the new PACS within, let’s say, a year, would easily overwhelm a “right-sized” or even a “future-proofed” system.

So in designing your new replacement PACS, use the superior approach, and plan for the past! Ensure that the system has the capacity to bring your valuable historical data into the new operational environment in a timely manner. Of course, Laitek has the tools and experience to make that transfer efficient, and actually improve the data quality in the process. We can help – give us a call.

Author Harry Solomon is an interoperability consultant for Laitek Inc., and past Co-Chair of the DICOM Standards Committee. He has been involved in the development of DICOM since 1993, and has taught graduate courses in healthcare interoperability and standards at Northwestern University and at Oregon Health & Science University. Contact him at hsolomon@laitek.com or harry.solomon@ieee.org.