Future Trends in Picture Archiving and communication System (PACS) Mona Alhajeri ,PhD1 and Malcolm Clarke Computer Science, Brunel University ,West London Abstract Methods and Materials This research investigates the opinions of radiologists regards requirements for improving current Picture Archiving and Communication System (PACS). Responses to a questionnaire were collected from 120 of the 200 radiologists in five governmental hospitals of Kuwait. The study the determines the importance of the solutions for future PACS from the radiologists point of view as: PACS must be integrated with other hospital information systems (100%); there must be multi hospital PACS access across different organizations (99%); web based PACS solutions (97%) and PACS applications in mobile phones (97%) are seen as an improved solution for future PACS. Whereas, the radiologists expressed strong concerns over the barriers for implementing web PACS solutions including: technical issues (91%); lack of training (85%); and cost (76%). This study was conducted in the five main governmental hospitals of Kuwait; Alsabah, Farwaniya, Mubarak Alkabeer, Jahra, and Alamiri. All 200 radiologists were to be approached and given an assisted questionnaire that was designed to elicit their opinion on the limitations, concerns and future direction of PACS. 120 of the radiologists were available to be given the questionnaire, and all agreed to participate. The data were inspected for quality, analyzed and presented in statistical form. % % Chart 1. Radiologists satisfaction with current PACS Chart 2. The level of agreement on the use of Web PACS and PACS in mobile phones as a solution to the limitations % % Chart 3. The opinion of radiologists on the future trends in PACS Chart 4. The factors that limit the functionality of PACS. Introduction Results Discussion Radiology departments have moved to a filmless or digital environment. The system replaces hard copy based film with a filmless environment and is called Picture Archiving and Communication System (PACS).[1] However, traditional PACS has limitations; second generation PACS must address these and provide solutions. The main limitation of current PACS has been identified as the lack of support for mobile and distributed access.[2,3] Moreover, access is restricted to a limited number of local workstations. The increasing expectation is to have ubiquitous access to medical images anywhere and at any time.[4,5] (figure 1) Frequently the PACS will act in isolation, with minimal integration with other hospital information systems (HIS).[6] Future implementations can include adapting the PACS user interface to an internet browser and to benefit from the use of rich internet application (RIA) web pages to improve presentation of medical images.[7] (Chart 1) around half of the radiologists were slightly satisfied with the current PACS (52%). While, 38% extremely satisfied, with only a small number dissatisfied (8% slightly dissatisfied, and 2% extremely dissatisfied) (Chart 2) determines the level of agreement on the use of Web PACS and PACS in mobile phones as a solution to the limitations. 64% of the radiologists strongly agree and 33% agree, whereas, only 3% disagree and none strongly disagree. There was equal agreement and disagreement on the issue of restricted access to the PACS in office only; with 50% who agree or strongly agree, and 50% who disagree or strongly disagree. (Chart 3) determines the opinion of radiologists on the future trends in PACS. The results show that most of the radiologists would welcome new techniques and approaches in the PACS industry for the best next generation PACS functionality. (Chart 4) determines the factors that limit the functionality of PACS. The greatest limitation is the lack of connection between hospitals; with 70% who agree or strongly agree and 30% disagree or strongly disagree. Search functionality was also considered a limitation by many; with 57% who agree or strongly agree and 43% disagree or strongly disagree. The study allows us to generalize the results to all PACS systems, not only PACS in Kuwait: the radiologists were asked about PACS systems in general and not only those used in Kuwait; and the data were collected from a number of hospitals with PACS from different vendors. Figure 1. Web PACS solutions Conclusions It is widely recognized that PACS has limitations. By interviewing the clinical PACS users (radiologists) to seek their opinion on next generation PACS, we have identified their perception of the importance of specific themes regarding functionality that might be added to PACS to provide better quality clinical practices. This research highlights the importance of having web based PACS and PACS in mobile phones as solutions for future PACS, but with concern expressed on some technical, practical, and financial issues. The findings of this research can be used as recommendations to vendors, and for medical institutes to consider in the implementation of PACS and training future radiologists. Contact References Mona Alhajeri Computer Science, Brunel University Email: mona.alhajeri@brunel.ac.uk Phone:+447586538946 L.Faggioni, “The future of PACS in healthcare enterprises”, European Journal of Radiology, vol. 78, pp.253-258, 2011. C. Rosset, Rosset, A. and Ratib, O., “General Consumer Communication Tools for Improved Image Management and Communication in Medicine”, Journal of Digital Imaging, vol. 18, no. 4, pp.270-279, 2005. P.Ross, and H.Pohjonen, “Images crossing borders: image and workflow sharing on multiple levels. Insights into Imaging,”, vol 2, no. 2, pp 141-148, 2011. F.Tang, M.Y.Law,A.C Lee and L.W.Chan, ” A Mobile Phone Integrated Health Care Delivery System of Medical Images”, Journal of Digital Imaging, vol. 17, no. 3, pp 217-225, 2004. D.Ivetic, and D.Dragan, ” Medical Image on the Go,” J Med Syst., vol. 35, pp 499-516, 2011. M.Santos, L.Bastlao, C.Costa, A.Silva, and N.Rocha, “DICOM and clinical data mining in a small hospital PACS: A pilot study”, in Proc CENTERIS 2011, Vilamoura, Portugal, 2011, pp 254-263. C.Hsiao, c. Shlao, Y.Liu,M.M. Chao, C.Lien, C. Chen, S.Yen, and S.Tang, “Use of a Rich Internet Application Solution to Present Medical Images”, Journal of Digital Imaging. ,vol. 24, no. 6, pp 967-978, 2011.