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Picture Archiving and Communications Systems (PACS)

TriMark Publications
September 1, 2011
298 Pages - SKU: TRI6576765

Abstract Table of Contents Related Reports

Picture Archiving and Communications Systems (PACS)

During the past 35 years, ultrasound and nuclear medicine were introduced into clinical medicine, computed tomography (CT) revolutionized diagnostic procedures and magnetic resonance imaging (MRI) emerged, bringing new diagnostic information at the cellular level. X-ray morphed from analog films to digital, and virtually all medical images became "soft" files on the electronic networks. As imaging departments in healthcare facilities have migrated from film to digital, the display and storage systems have had to migrate too. These new digital imaging storage and display systems are called picture archiving and communication systems (PACS). Most PACS handle images from various medical imaging instruments, including ultrasound, MRI, positron emission tomography (PET), CT, endoscopy, mammograms, etc. The focus of this TriMark Publications report is to analyze and describe the PACS market segments. PACS market penetration in the U.S. healthcare space has been significant, at almost 90%. A PACS network typically consists of a central server that stores a database containing the images connected to one or more clients via a local area network (LAN) or a wide area network (WAN) that provides or utilizes the images. More and more PACS utilize Internet-based technologies as their means of communication. This allows remote viewing and diagnosis with implications for both civilian and military healthcare facilities. Since radiology departments dominate the production of images, interconnections with radiology information systems (RIS) are also looked at in this study.

1. Overview: 1.1 Statement of Report; 1.2 About This Report; 1.3 Scope of the Report; 1.4 Objectives; 1.5 Methodology; 1.6 Executive Summary
2. Picture Archiving and Communication Systems (PACS): An Overview: 2.1 Components and Architecture of PACS; 2.2 Communication Protocols; 2.3 Current PACS Products and Software; 2.4 Future Trends and Developments in PACS
3. Medical Image Management in Healthcare Enterprise: 3.1 PACS and Medical Images; 3.2 HIS/CMS and Electronic Patient Record
4. Processing of Medical Images: 4.1 Medical Image Management and Image Data Mining; 4.2 Bioimaging; 4.3 Virtual Reality in Medical Visualization; 4.4 Neuroimaging; 4.5 Software Techniques Coping with Large Data; 4.6 Utility of PACS in Medical Imaging; 4.7 Need for a PACS System; 4.8 Clinical Applications on PACS; 4.9 PACS in HER Architecture; 4.10 PACS Benefits
5. Other IT Solutions in Hospitals: An Overview: 5.1 Commonly Used Information Technologies in Clinical Setting
6. Market Analysis: 6.1 Global Opportunities in Medical Imaging; 6.2 Global Market for PACS; 6.3 U.S. Market for PACS; 6.4 PACS in Canada; 6.5 Brazilian PACS Market; 6.6 European Market for PACS; 6.7 PACS in the Italian NHS; 6.8 PACS in Developing Countries
7. Global Healthcare Information Technology (HIT) Market: 7.1 HIT Adoption; 7.2 Adoption of HIT in Primary Care; 7.3 Global Market for Health Information Technology (HIT); 7.4 U.S. HIT Industry; 7.5 Healthcare IT in European Hospitals; 7.6 Healthcare IT Adoption in Asia
8. Selected Company Profiles: 8.1 Agfa Healthcare; 8.2 Aspyra, Inc.; 8.3 Avreo, Inc.; 8.4 Carestream; 8.5 Cerner Corporation; 8.6 DR Systems, Inc.; 8.7 Fujifilm Corporation; 8.8 GE Healthcare; 8.9 INFINITT Healthcare, Co, Ltd.; 8.10 LUMEDX Corporation; 8.11 McKesson Corporation; 8.12 Meditech; 8.13 Merge Healthcare, Inc.; 8.15 Philips Healthcare; 8.16 Sectra Medical Systems S.L; 8.17 Siemens Healthcare
APPENDIX: Appendix 1: Picture Archiving and Communication Systems (PACS): Myths and Facts; Appendix 1.1: Myth: PACS are Complicated and Expensive; Appendix 1.2: Myth: PACS Require Workstations; Appendix 1.3: Myth: Client License Required; Appendix 1.4: Fact: Planned Obsolescence; Appendix 1.5: Fact: DICOM and World Wide Web; Appendix 1.6: Facts: PACS Increases Referral Volume; Appendix 1.7: Fact: Arrival of Electronic Medical Records; Appendix 2: Cloud Infrastructure in Vendor Neutral Archive Configurations; Appendix 2.1: The concept of Vendor or PACS Neutral Archive; Appendix 2.2: Early VNA Configurations; Appendix 2.3: Market Description; Appendix 2.4: Leading Edge Innovations in Storage Solutions; Appendix 2.5: HTTP Access Methodology; Appendix 2.6: Metadata; Appendix 2.7: Introduction of MINT; Appendix 2.8: Market Adoption; Appendix 2.9: General Description of EMC; Appendix 3: Self-Funding Transition Plan to Electronic Health Records; Appendix 3.1: The High Cost of Record Keeping; Appendix 3.2: The Enormous Challenge to Maintain Hospital Records; Appendix 3.3: The Plan Needed to Meet the Challenges; Appendix 3.4: Three Phases of Transition; Appendix 3.5: Developing a Self-Funding Transition Plan; Appendix 3.6: Designing the Pathway; Appendix 3.7: Measuring the Results; Appendix 4: The Health IT Workforce; Appendix 4.1: Quantities and Staffing Ratios; Appendix 4.2: Workforce Roles; Appendix 4.3: Growth and Gaps; Appendix 4.4: Leadership Qualifications; Appendix 4.5: Education and Competencies; Appendix 5: Glossary of Terms: PACS
INDEX OF FIGURES: Figure 3.1: Patient Work List and Image Display; Figure 3.2: Enterprise Level Web-based Image/Data EPR Server with Archive; Figure 4.1: Content-Based Medical Image Retrieval Using the IRMA Framework; Figure 4.2: Visualization of MRI (blue) and PET (ocher) Data Sets with Two Different 1D Transfer Functions; Figure 4.3: Components of a Picture Archive and Communications System; Figure 4.4: Schematic of “Before PACS” Processes; Figure 4.5: Schematic of “After PACS” Processes; Figure 4.6: PACS as part of the Electronic Health Record Architecture; Figure 5.1: Major Perceived Barriers to Adoption of Electronic Health Records (EHRs); Figure 5.2: Perceived Facilitators of Adoption of Electronic-Records Systems; Figure 6.1: Global Market for Medical Imaging Equipment by Geography, 2010; Figure 6.2: Global Medical Imaging Market Share by Modality, 2010; Figure 6.3: Utilization Rates for X-Ray, CT and Ultrasound in the U.S.; Figure 6.4: Utilization Rate for CT in the U.S.; Figure 6.5: Utilization of MRI in the U.S., 2007-2010; Figure 6.6: Global PACS Market, 2010-2017; Figure 6.7: PACS Web Server Concept; Figure 6.8: U.S. Market for PACS, 2010-2017; Figure 6.9: U.S. Hospitals with PACS Installed; Figure 6.10: Total Number of Hospitals vs. Hospitals with PACS Installed; Figure 6.11: Replacement and New PACS Purchases in the U.S. Hospitals; Figure 6.12: PACS Installations by Bed-size in the U.S. Hospitals; Figure 6.13: PACS Modalities Installations in the U.S. Hospitals; Figure 6.14: PACS Company Market Share in the U.S.; Figure 6.15: PACS Image Distribution in Hospital Departments in the U.S.; Figure 6.16: PACS Image Accessibility by Physician in the U.S.; Figure 6.17: RIS and PACS Interface in the U.S.; Figure 6.18: PACS Market: Revenue Forecasts (Brazil), 2010-2015; Figure 6.19: PACS Market: Company Market Share by Revenues (Brazil), 2008; Figure 6.20: European PACS Market, 2010-2017; Figure 6.21: Major PACS in U.K.; Figure 6.22: European Radiology PACS Market, 2010-2017; Figure 6.23: European Cardio PACS Market, 2010-2017; Figure 6.24: RIS/PACS Market in India; Figure 6.25: Total PACS Market in India; Figure 7.1: Percent Revenue Spent on IT by Different Industries; Figure 7.2: HIT Adoption Rate; Figure 7.3: Primary Care Physicians Using Electronic Health Records (HER); Figure 7.4: Global Market for HIT, 2010-2017; Figure 7.5: North American HIT Market ($2.7 Billion), 2010; Figure 7.6: U.S. Market for HIS, 2009-2016; Figure 7.7: Percentage of U.S. Physicians Using EMRs/EHRs, 2001- 2009; Figure 7.8: U.S: Changes in EHR Adoption Rate, 2008-2009; Figure 7.9: Increased IT Budgets in the U.S. Hospitals; Figure 7.10: PACS Utilization by Imaging Modality; Figure 7.11: CPOE Adoption in U.S. Hospitals; Figure 7.12: CPOE Adoption in Academic and Non-Academic U.S. Hospitals; Figure 7.13: EMR Adoption in U.S. Hospitals; Figure 7.14: Changes in Electronic Health Record (EHR) Adoption Rate from 2008 To 2009; Figure 7.16: Primary Driver for HER Implementation; Figure 7.17: HER Adoption Leaders; Figure 7.18: Distribution of Non-Profit and For-Profit Hospitals on Clinical HIT Sophistication Scale; Figure 7.19: HIT Adoption by AHA Hospital Bed Size Category; Figure 7.20: Clinical HIT Adoption in Hospitals of Medicare and Medicaid Discharges; Figure 7.21: HIT Adoption by the Size of Hospital’s System and in Stand-Alone Hospitals; Figure 7.22: HIT Adoption in Contract-Managed Hospitals; Figure 7.23: Adoption in Systems and Hospitals with a Primary Care Department; Figure 7.24: Adoption of EMR in Ambulatory Practices by Size; Figure 7.25: HER Functions and Communication Capabilities; Figure 7.26: Sample Connection Points between EHR and Other Systems within the Hospital; Figure 7.27: Percentage of Hospitals that Have Implemented Select Electronic Capabilities, 2009; Figure 7.28: Percentage of U.S. Hospitals that Have Implemented Medication Safety Alerts, 2009; Figure 7.29: Percentage of U.S. Hospitals that Use Bar Codes to Identify Patients and Medications, 2009; Figure 7.30: Percentage of Hospitals that Expect to Incur a Financial Penalty for Failing to Demonstrate Meaningful Use by 2015; Figure 7.31: Sample EHR Implementation Process; Figure 7.32: Sample Workflow Process for Medication Order before Redesign; Figure 7.33: Sample Workflow Process for Medication Order after Redesign; Figure 7.34: Percentage of Hospitals Reporting Change in Access to Tax-exempt Bonds, January 2009; Figure 7.35: Percentage of Hospitals Reporting Change in Ability to Access Capital Since December 2008; Figure 7.36: IT Budget as % of Total Hospital Budget per Country in Europe; Figure 7.37: External IT Budget as % of Total Hospital IT Budget per Country in Europe; Figure 7.38: Expected Evolution of Hospitals’ IT Budget, 2008-2012; Figure 7.39: Anticipated Growth of Hospital IT Budget, 2008-2012; Figure 7.40: Perceived Impact of Economic Downturn in Europe; Figure 7.41: Hospital IT Market by Market Segment in Europe, 2008; Figure 7.42: Use of EHR Systems by Primary-care Physicians, 2009; Figure 7.43: EMR Adoption and Use in Industrialized Countries; Figure 7.44: Growth Rate of Chinese HIT Market Investment; Figure 7.45: Investment Structure of Chinese HIT Market; Figure 7.46: Singapore’s HIS Market; Figure 7.47: Australia’s Health IT Market; Figure 7.19: Key Australian Health IT Players; Figure 7.48: Implication on India HIT market by U.S. Service Providing Penetration; Figure 7.49: Indian IT Market in Healthcare Sector, 2010-2017; Figure App. 2.1: Atmos High-Level Service Oriented Architecture; Figure App. 3.1: The Three Phases of Transition
INDEX OF TABLES: Table 4.1: Examples of Large Medical Image Data; Table 5.1: Examples of Health Information Technology for Hospitals and Physicians; Table 5.2: HIMSS Definitions of Health Information Technology Applications; Table 5.3: Selected Electronic Functionalities and Their Level of Implementation in U.S. Hospitals; Table 5.4: Electronic Requirements for Classification of Hospitals as Having a Comprehensive or Basic Electronic-Records System; Table 5.5: Adoption of Comprehensive and Basic Electronic-Records Systems According to Hospital Characteristics; Table 5.6: The Difference between EMR and HER; Table 5.7: Top Ten eMAR Installed and Contracted Systems, 2009; Table 6.1: Display Resolution Comparison in PACS Image Viewing; Table 6.2: PACS Radiology Workstation Tools for Image Manipulation; Table 6.3: PACS Radiology Workstation Tools for Image Measurement; Table 6.4: PACS Radiology Workstation Tools for Advanced Visualization; Table 6.5: Hospital Adoption Timing/Incentive Payout; Table 6.6: Medicare Incentives for Physicians; Table 6.7: Impact of Top Four Industry Challenges (Brazil), 2010-2015; Table 6.8: Market Drivers Ranked in Order of Impact (Brazil), 2010-2015; Table 6.9: Market Restraints Ranked in Order of Impact (Brazil), 2010-2015; Table 6.10: PACS Ownership in the National Health Service; Table 6.11: PACS Installation by Geographical Area; Table 6.12: Level of PACS Integration; Table 6.13: Strategies for the Future; Table 7.1: U.S. HIT Market Size, 2009; Table 7.2: Selected EHR Functions and Implementation in U.S. Hospitals In 2009; Table 7.15: Hospitals That Adopted 1-9 “Core” Meaningful-Use Objectives, 2009; Table 7.3: Potential Savings from Clinical HIT Applications in Major Cost Categories; Table 7.4: Adoption of HIT Applications and Systems in For-Profit and Non-Profit Hospitals; Table 7.5: Clinical HIT Adoption in Acute Care Hospitals of Various Types; Table 7.6: HIT Adoption by Location; Table 7.7: EMR Adoption Model Trends, 2008-2009; Table 7.8: EMR/SEHR Adoption Model Scores, 2009; Table 7.9: Hospital IT Market Size in Europe; Table 7.10: Main Media for Storing and Archiving Medical Records in Europe; Table 7.11: Areas Where Hospital IT Systems are in Place in Europe; Table 7.12: Challenges for HIT Adoption in China; Table 7.13: Computerization of Chinese Medical Institutions; Table 7.14: Current Hospital MIS Situation Statistics in China; Table 7.15: Hospital MIS Implementation Situation Statistics in China; Table 7.16: Annual Average Investment in Computerization of Chinese Hospitals as a % of Revenue; Table 7.17: Key E-Health Players in Malaysia; Table 7.18: Key E-Health Players in Malaysia; Table 7.20: Key Contributors of Telemedicine in India; Table App. 3.1: Operational Costs Reduced Through Transition Planning

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