The aim of this study was to compare the degrees of implementations of full and departmental Picture Archiving and Communication Systems (PACS), the usage of mini-PACS and to compare digital image equipment implementation rates in the countries of the European Union plus the Czech Republic, Cyprus, Malta, Norway, Poland and Switzerland. The degree to which Digital Image Communications in Medicine version 3.0 (DICOM 3.0) protocols are available for data exchange by different digital image equipment is surveyed, to assess underlying PACS preparedness. A questionnaire with an addressed reply envelope was posted to the heads of radiology of 1,594 hospitals in 19 countries in early 2000. Data returns were obtained from 17 countries. This indicates considerable variation in PACS implementation and preparedness between European nations. Possible reasons for this are discussed. The highest rates of PACS implementations have been in Austria, Norway and Sweden.
This paper is based on 4 years of practical experience with a developmental pre- Digital Imaging and Communications in Medicine (DICOM) picture archiving and communication system (PACS) plus analysis from the respecification study data for a DICOM/HTML PACS replacement. High-performance, but economic, workstations are required within PACS for radiologists to rapidly and accurately report images. For economic reasons such workstations should utilise standard landscape orientation monitors. They must have full Radiology Information System (RIS) integrated reporting functionality to optimise radiologists' work. The workstations must also be capable of displaying request data and both new and associated old images and image reports from multiple modalities. All images should be imported as "folders" according to semi-intelligent "knowledge table" based DICOM 3.0 standard Worklist control exerted by image management servers. This information can be obtained by relevant image lists and decision charts. A description of an optimal standard monitor workstation environment and related issues based on experience and literature review is given.
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