PACS and Digital Medicine: Essential Principles and Modern Practice, 1st Edition (Hardback) book cover

PACS and Digital Medicine

Essential Principles and Modern Practice, 1st Edition

By Yu Liu, Jihong Wang

CRC Press

367 pages | 136 B/W Illus.

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pub: 2010-11-05
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To improve efficiency and reduce administrative costs, healthcare providers, insurance companies, and governments are increasingly using integrated electronic health record (EHR) and picture archiving and communication systems (PACS) to manage patients’ medical information. Reflecting the latest applications of PACS technology, PACS and Digital Medicine: Essential Principles and Modern Practice discusses the essential principles of PACS, EHR, and related technological advancements as well as practical issues concerning the implementation, operation, and maintenance of PACS and EHR systems.

The book focuses on various components of PACS that use state-of-the-art technologies. The authors first present topics to consider prior to implementation, including design principles for PACS components and theory. They also cover post-installation quality control; security and privacy policies; maintenance, including upgrade/integration with other information systems; and governing standards. Each chapter includes an introduction to basic concepts and principles relevant to the topics, before exploring challenges that PACS users may encounter in daily work. Discussions are supplemented with more than 130 illustrations, along with case studies of implementation in two organizations.

A useful guide and broad overview of the field, this book presents key principles and practical steps for PACS and EHR implementations and maintenance. Although the technology and standards of healthcare IT will evolve over time, the theory and practical advice found in this text will remain pertinent in the future.


For someone … looking for a concise summary of PACS, its environs (both departmental and enterprise), components, and support issues—this book would be an excellent choice.

—Steve G. Langer, Medical Physics, October 2012

… a thorough and practical reference for radiologists, administrators, engineers, and others who might create, manage, or use such a system. …

SciTech Book News, February 2011

Table of Contents


History of PACS: The Transition to Digital Medicine

Technology Advancements Enabling Today’s PACS

Defining PACS

Current Status

PACS Servers and Workstations

PACS Server

Types of Image Display Workstation in PACS

PACS Workstation Architecture

Environment for PACS Workstations

Radiology Workflow

Speech Recognition for Report Dictation

New Developments

Image Display Devices in PACS


Softcopy Image Display System

Overview of Image Display Technologies

Quality Standards for Display Devices

Quality Control and Quality Assurance for Image Display Devices in PACS

Networking Technologies

Ethernet Local Area Network and TCP/IP

Wide Area Network

Network Topology

Network Design Consideration

Optical Fiber Communication

Network Security

Wi-Fi and Wireless Local Area Network

Backup and Alternative Network Using the Internet

Data Storage

Data Storage Media Types

Digital Storage Device Interface

Data Storage Attaching Configurations

Redundant Arrays of Independent Disks

Image Data Compression

Content Addressed Storage

Short-Term and Long-Term Storage for PACS/Electronic Health Record (EHR)

Healthcare Information Integration

Health Level 7 (HL7)

Digital Imaging and Communications in Medicine (DICOM)

Integrating the Healthcare Enterprise (IHE)

IHE Technical Frameworks


Teleradiology Overview

Technical Considerations for Teleradiology Implementation

Teleradiology Quality Control

Legal and Social Considerations

Challenges and Future Trends in Teleradiology

Practical PACS Implementation

Financial Analysis

Planning and Development

PACS Equipment Selection and Contract Preparation


Case Studies

Upgrading and Replacing Legacy PACS

Legacy System and IT Infrastructure Assessment

PACS/Radiology Information System (RIS) Upgrade Considerations

PACS Replacement Planning

Network Infrastructure Upgrade

Legacy PACS Data Migration

Replacement System Go-Live and Training

Future Development

Enterprise PACS


Cardiology PACS

Pathology PACS

Radiation Oncology PACS

Endoscopy and Other Visible Light Specialties

Electronic Health Record and Personal Health Record Implementation


HL7 EHR Model

HL7 Personal Health Record (PHR) System Model

Standards Used in EHR and PHR

Guide for EHR Implementations

Health Information Exchange at Regional and National Levels

Quality Control, Security, and Downtime Management

PACS Patient File Reconciliation and Quality Control

Downtime Planning

Health Insurance Portability and Accountability Act (HIPAA)

Contingency Plan and Disaster Recovery

Security Management Process

Device and Access Control

DICOM and IHE Security Mechanism


A Bibliography appears at the end of each chapter.

About the Authors

Yu Liu, Ph.D., DABR, is a senior imaging physicist certified by the American Board of Radiology. He works in the radiology department at St. Luke’s Medical Center of Aurora Healthcare in Milwaukee, Wisconsin. Since 1997, he has been involved in PACS implementation and operation. He earned his Ph.D. in biomedical engineering from Duke University.

Jihong Wang, Ph.D., DABR, is an associate professor at the MD Anderson Cancer Center in Houston, Texas. He implemented the first major PACS system for the University of Texas Southwestern Medical School in Dallas while he was a faculty member there from 1996–2004. He earned his Ph.D. in medical physics from the University of Colorado at Boulder.

Subject Categories

BISAC Subject Codes/Headings:
MEDICAL / Oncology
MEDICAL / Radiology & Nuclear Medicine
SCIENCE / Physics