- By Miriam Friedmann
The future of PACS in hospitals: these options are available
Local, hybrid or completely in the cloud? The choice of the right PACS determines how flexible and fail-safe the imaging and diagnostic in your hospital is. While local, fully integrated solutions have been working reliably for years, VNA (Vendor Neutral Archive) and flexible cloud solutions offer new possibilities. But which strategy suits your facility? Time to make an informed decision.
Nothing works in imaging without the PACS
Every doctor or radiologist knows that nothing works in imaging without a PACS.
But how do you ensure that your system will continue to work reliably in the future, support digitization and keep pace with growing data volumes and availability requirements?
While local PACS systems are often still the standard in hospitals and radiology practices, partially or fully cloud-based solutions are becoming increasingly important. We have compared the various options for you.
1. Local PACS (on-premises): Proven concept with limitations
Local Picture Archiving and Communication Systems - PACS for short - are usually classic server-client systems. The image data generated by these systems is transmitted to a central server and stored there.
Access is via (fixed) workstations to which the desired images are routed for viewing. Various storage systems such as RAID, SAN or tape are used for the downstream long-term archiving of image data, which serve the PACS via individual interfaces when retrieving long-term archived images.
These server-client systems are still common as on-site PACS installations in hospitals, but they have advantages and disadvantages.
Advantages
- Familiar system: Hospitals have often been working with their PACS for years. Staff and IT teams are familiar with the functions.
- Stable performance: Local PACS generally run independently of external factors such as internet connections. If the data is available on fast storage devices, the local network connection generally results in fast loading times and low latency.
- Offline availability: Even without Internet access, the image data stored on the PACS server can be retrieved internally at any time.
- Full data control: Your hospital has the data on site under control and within reach - but must also take care of the corresponding availability and all data protection issues as well as information security.
Disadvantages
- Limited flexibility: Access to the PACS is often only possible via certain devices with single-user licenses. In view of the increasing consolidation of facilities, on-call duty and working from home, this is no longer up to date.
- Security risks: Cyber attacks on local networks are on the rise. Having a local system protected by your own IT department is more time-consuming and labor-intensive than using the security concepts of large cloud providers.
- Kostenfaktor:Cost factor: Apart from the high initial investment, there are high costs for in-house operation. The hospital's own IT team has to block out time for updates, backups and hardware replacements.
- Failover concept and operational readiness: A total failure of the local PACS server can paralyze the operation of the entire hospital. KRITIS hospitals in particular must therefore ensure a comprehensive failure concept as part of their cyber security.
- Scaling effort: If the image data volume grows, additional hardware is required. This requires more space, more maintenance and data migrations.
2. Hybrid solutions: Local PACS with cloud archive
There are different variants in the area of hybrid PACS solutions. A first step towards a hybrid PACS is the combination of a local PACS and cloud-based storage, which is connected by the respective PACS provider instead of a RAID or SAN, for example. This means that in this PACS setup, the data is stored directly from the local PACS in an external cloud storage instead of on a local server.
The second hybrid solution goes one step further in the direction of cloud PACS: In this hybrid set-up, image data is not only stored in a vendor-neutral cloud archive (VNA) independent of individual PACS installations, but can also be viewed via the internet in any standard web browser - independent of individual workstations, effectively as a PACS from the cloud. Many Telepaxx customers are already using this option or are currently switching to it.
In general, a hybrid solution enables a gradual entry into the cloud, allowing hospitals and medical practices to gain initial experience before switching completely to a cloud infrastructure. For example, data that is more remote from treatment, such as older radiology images from the hospital's own PACS archives, can initially be migrated to a long-term archive in the cloud.
Advantages
- Flexibility for doctors: access from other locations, during ward rounds or from home is possible. This is particularly relevant for background services or part-time staff. Doctors can view findings from the cloud and make decisions without necessarily having to be on site at the hospital - this makes day-to-day work and collaboration across different locations easier.
- High reliability: A cloud PACS is an ideal backup in the event of technical faults. As it can be accessed from network-independent devices, this increases business continuity.
- Performance optimization: Frequently required or current image data can remain on local servers in parallel for fast access and maximum control. Less critical or archived data, on the other hand, is stored in the cloud.
- Independence from individual viewers: Hospitals can use different DICOM viewers to access the image data in the cloud. This means that multiple or newer viewers can be used without a great deal of effort for medical staff - a frequent request from our customers.
- Scalability: Cloud storage systems can be easily scaled as data volumes grow or requirements change, without the need to purchase and administer new hardware.
Disadvantages
- Internet dependency: Bandwidth and network stability must guarantee access to the cloud image data at all times. However, this can be solved with mobile hotspots, for example.
- New ways of working: Employees have to get used to an additional interface. Familiarization can take time and initially slow down individual work steps.
Tip for secure cloud use
Data security and reliability: In view of their social and societal importance and the strict EU data protection directives, there are high security hurdles for providers.
Hospitals should only use providers with a C5 certification.
3. Pure cloud PACS: the future?
With a fully cloud-based PACS, image data is transferred to the cloud immediately after it is generated. Only a lean gateway is operated on site at the facility, without local storage. However, such an approach requires fundamental strategic changes to a hospital's IT infrastructure. Once these have been implemented, such a cloud PACS offers considerable advantages over local solutions.
What needs to be implemented before the PACS move to the cloud:
- Ensure accessibility: A stable internet connection must be guaranteed at all times - even if, for example, cables are damaged during construction work or cyber criminals hijack the connections. Redundant internet lines are essential.
- Emergency strategies: One solution could be backup lines or mobile hotspots for outage scenarios. However, both initially require a considerable reorganization of internal structures and set-ups.
The pure cloud PACS has these advantages
- Simple scalability on demand: storage and computing capacities can be flexibly adapted without having to purchase all of your own hardware.
- Cost efficiency: Hospitals and radiologists only pay for what they actually need and use. Thanks to pay-as-you-go models, hospitals also save on part of their IT infrastructure.
- Reduced IT workload: Cloud PACS providers like us at Telepaxx keep the systems technically up to date at all times. This means that the hospital's own IT department no longer has to worry about software updates and security patches.
- Flexible access: Doctors can access the image data anytime and anywhere with a PACS viewer. There is no need to be tied to fixed workstations. It is also easier to switch to a different DICOM viewer.
- Cyber security: State-of-the-art encryption and access controls offer the highest security standards beyond the capabilities of local PACS.
- Easy integration: Cloud PACS are easier to connect with other digital healthcare solutions, such as AI-supported diagnostics.
Conclusion: The optimal PACS strategy
There is no one-size-fits-all solution - the best strategy depends on a hospital's individual requirements. A hybrid solution currently combines the advantages of both worlds best. Pure cloud concepts are a long-term target concept that requires a number of structural and strategic decisions to be made and implemented before it can be realized.
Companies like Telepaxx enable a secure and future-proof approach with cloud-based archives and flexible viewer options. Because the PACS strategy of the future must be one thing above all: flexible, secure and available at all times.
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