In researching another post, I ran across this article from Imaging Economics about the history of PACS. It is a very brief synopsis of the path to today’s filmless world of Radiology. I won’t try to summarize the summary, but suffice it to say that PACS (although they didn’t call it that until fairly recently) had its start at several centers around the world, with the perseverance of a number of true visionaries. Probably the most important single milestone was the development of the DICOM standard which (at least in theory) allows scanners from Manufacturer A to communicate with viewers from Manufacturer B. Before DICOM, everyone had a proprietary code for everything, and the PACS pioneers actually had to reverse-engineer and decode tapes, which must have been just a load of fun.
My brief contact with the “Great Ones” of PACS occured in 1992, and it was the idea of a local businessman. This gentleman owned the storage facility in which we archived the zillions of films taken over the years. He had heard of the work Bernie Huang, PhD, was doing at UCSF, and decided to see it for himself. He was so impressed that he took a couple of us radiologists, and a hospital administrator out to see Dr. Huang.
In 1992, there was no such thing as the PACS we have today. Dr. Huang’s operation consisted of what we might call today a couple of mini-PACS operations, without much standardization. There was a tape jukebox sitting in the middle of the lab, workstations here and there, digitizers, and whatnot everywhere. But Dr. Huang’s vision was clear…this was the future, and film was not.
When we returned home from UCSF, our “patron” asked what we thought of the whole thing. I responded, “It’s great, it’s obviously where we are headed, but…. The hospital isn’t going to buy, let alone be able to maintain, a system comprised of loose pieces of technology. Someone has to put it all in one box before it will become practical.” I’m not sure if our friend agreed or not, but he never did approach us with any proposal.
A year later, we were in negotiations with Agfa for our first PACS, and we were on our way to becoming one of the first filmless departments in the country.