Essay: Picture Archiving and Communication System (PACS)

Picture Archiving and Communication System (PACS) is a system for radiologists at the hospital which allow them to see filmless images of patient’s X-rays, MRI, etc. PACS has become a big part of the health industry as more hospitals use this system to read images, not only is it in the radiology department, but it has spread through many other departments in the hospital. Picture Archiving and Communication System has also allowed users (authorized workers at a hospital) to be able to share these images. Every system has a flaw, with PACS, it stores vulnerable images of patients. It is important to assure that patients are receiving correct results, are ensured privacy of these results, and being able to store this data. Another flaw not being able to work at home, since a radiologist will not have access to the medical images. What if the radiologists needed can’t come into work because something more concerning came up and that radiologist had to be home? With cloud computing, patients will be ensured privacy, receive more confirming results as images are much more clear, and users will be able to work from home using the Picture Archiving Communication System.
Picture Archiving and Communication System and Cloud Computing are two different systems, however when they come together they improve a system as a whole. According to Jorewekar, et al., Picture Archiving and Communication System “means of acquiring, archiving, and communicating all forms of radiology imaging,” (abstract). The system itself is not cheap, but it is worth the buy for hospitals, especially in the radiology department. A study is conducted about hospitals going filmless, and how PACS impacts them in their daily use at the hospital. Observed by Jorewekar, et al., from one hundred users who tested the Picture Archiving and Communication System, eighty five percent found PACS to be user friendly, ninety four percent found PACS to be helpful in their daily use for the hospital, with fifty one percent of users claiming the quality of the images to be delightful to very delightful, while only forty nine percent of users found the images to be appalling to very appalling (abstract). PACS makes it easier to organize images, access the images electronically, since it is an electronic system, and be able to transfer images easily. Defined by Kharat, et al., Cloud computing accesses data, and allows to store data of patients, and it is known for allowing users to easily find the system to access it (150). Cloud Computing gives benefits to PACS, showing the idea of two systems coming together as one. Specifically, for PACS, cloud computing will allow the system to use a private cloud to allow only hospitals to access the data (Kharat, et al., 151), be able to store data where it can be retrieved later to be viewed, and the data can be accessed seconds after the image has been taken (Kharat, et al., 153).
Cloud Computing ensures privacy. According to Kharat et al., hospitals use “private clouds” (152). There are multiple kinds of clouds, and since hospitals need privacy of images, the best cloud to use are the private clouds; since the only people who will have access to PACS are authorized workers of the hospital. Allowing only minimal people to have access to a system like this. It’s always possible to hack into a system regardless of the high security a system might have, with that being said; the system cloud computing takes into consideration of an incident like this happening. When someone hacks into the system, there is a component in the cloud computing system where it detects when PACS is being hacked into it. The user of PACS would be aware of this incident, they would be able to know the time and date and exactly what data was seen. So, when this happens; the user which is an authorized worker would notify the patient that got hacked into, and the proper action is taken accordingly. This is known as “[P]rivacy [B]reaches,” (Singh and Goel, section III). Privacy is also ensured for patients even when medical images need to be shared with another user. According to Pan et al., it’s important to add “partial encryption and watermarking” (252), as this assures images to be transferred safely to the other user. According to Pan, et al., there are four qualities to having medical images secured, “Medical Images (MI), Hospital Information System (HIS), Cloud Information System (CIS) and Interconnection Network (IN),” (253). Since this research essay has a focus on PACS, which is medical imaging, a table shows that the availability of MI is high, the Integrity is high, the confidentiality is high, and the traceability is high, (253). From this, we learn that privacy is important and every and any kind of threat needs to be covered to prevent anything bad happening to the patients. Pan, et al., have considered five actions that should be taken to protect medical imaging, the five are making sure that any access to the medical images will be supervised, a patient is guaranteed of honesty of their medical images, medical imaging is open to use when needed, and finally; medical images should be verified as well as they should be able to be traceable regarding changing systems (253). As a result, because of cloud computing, patients are ensured privacy through the Picture Archiving and Communication System.
Although Picture Archiving and Communication System improves images of scans, with cloud computing there are compatible options to using PACS. With this option, it gives radiologists a better idea of what’s going on in images. With cloud computing in PACS radiologists will be able to store more data, and be able to easily access these images anytime they want. (Kharat, et al., 153). Not only will users be able to see images in two dimensional, they will also be able to see these images in three dimension, and four dimension as well (Philbin, rebuttal section). Four dimensional is when there is two of three dimensions, with lines connecting them together. An example of this would be two cubes parallel to each other with lines connecting them together. This is what makes four dimension, which is also known as the tesseract. With Cloud, it assures that PACS is working accordingly and everything shown is shown accurately. Since one is able to store more data because of cloud, it also makes it easier for users to open past medical images, and have these images render and be viewed at. Radiologists have been improved their work because of cloud computing. Noted by Kharat, et al., the cloud is virtual, radiologists wouldn’t have to worry about how to get a system opened and processed to work. This saves time, and it’s seen to give accurate results (152). To summarize, because of cloud computing, images are even more accurate because of the different dimensions that could be looked at by a radiologist.
Users can now work from home at ease. Like mentioned in the introduction, users who use PACS to view medical images can easily access these images from home. Internet issues have prevented radiologists from viewing medical images outside of the hospital. Thanks to the cloud, it allowed users to be able to access medical images from PACS outside of the hospital. This is known as the cloud acting as “a teleradiology unit,” (Kharat, et al., 152). To be able to access cloud outside of a hospital, it is important to have a working internet connection to be sure that it works properly, and results are shown to users with clear images and are easy to access (Kharat et al., 154). Since this is possible for users, radiologists can work at home, giving them more flexibility to their work schedule. They are also capable of opening medical images onto a tablet or a phone, not just laptops.
From the research that was done, cloud computing shows many benefits to the Picture Archiving and Communication System. Because of cloud computing, it improves privacy concerns, shows multiple variables of medical image, and the capability to look at medical images from PACS outside of the hospital. According to the data collected at Pravara Rural Hospital, most users of PACS found the system to be useful to them, also mentioning that PACS has excellent quality(abstract). While the quality of PACS is great without the cloud computing, Philbin mentions how cloud computing will allow users to view images in two dimensional, three dimensional, and four dimensional for the user’s convenience when looking at a medical image (rebuttal). Not only does cloud computing allow users to view in these dimensions, but it also gives the capability of storing data, so it can be looked at later. Privacy is also improving as users share the images with encryption and watermark, and when the PACS is being hacked privacy breaches allow cloud computing to track all changes that happen and patient is aware of the situation. Being able to access PACS outside of the hospital allows users to from home.