A radiologist would traditionally would read a film from a light box, and would look through previous exams and reports in the patient file to look for relevant information on the study and record a diagnosis on a voice recorder. Now everything is being replaced by digital technologies such as Picture Archiving and Communication Systems (PACS). PACS is a system that is used for digital storage, transmission and retrieval of images and reports from different modalities such as computed tomography (CT), X-Ray (XR) magnetic resonance imaging (MRI) and ultrasound (UL). There are four components that PACS consists of: the image modality, a secured network for the transmission of patient data, a workstation for reviewing images, and the archive for the storage and retrieval of reports and images. PACS not only handles images in the radiology area, but it also handles cardiology, oncology and gastroenterology. Also, additional types of images are always being added. In order for PACS to work with no hiccups across different modalities there is a standard to be followed, and that standard is DICOM. The Digital Imaging and Communications in Medicine (DICOM) is the standard that contains the file format and the network communication protocol that handles, stores, prints, and transmits medical imaging information. The communication protocol in DICOM uses TCP/IP to communicate between systems. DICOM files can be exchanged between two systems that are capable of receiving image and patient data in DICOM format. DICOM is the universal format for all PACS image storage and transfer. PACS servers are usually located locally for image retrieval and storage but the Health Insurance Portability and Accountability Act (HIPPA) requires facilities to have a mean of recovering images in the event of an error or disaster. Images may be stored both locally and remotely on off-line media. Hard disks are commonly and widely used today to be compliant with HIPPA. This can be done configuring the hard drives and attach them to the PACS server in various ways, either as Direct-Attached Storage (DAS), Network-attached storage (NAS), or via a Storage Area Network (SAN). PACS has many advantages over the traditional film based reporting and some of those advantages are: * Cost reduction by eliminating hardcopy film and storage space. Digital storage cost has decreased over the years * Provides a faster and more reliable way of retrieving old images. * It enables remote access of images, which helps physicians. * Provides easy image integration into the hospital’s information system. * PACS provides security and HIPPA compliance. PACS sizing is very important. When planning a PACS it is important to be aware of the storage capacity that is required to handle respective amounts of image data. Many are unaware and do not plan accordingly and therefore there is a huge number of PACS worldwide, which are either too big (sometimes even offering five times the amount of storage needed) or too small and slow. With the digital world taking over basically everything, PACS is now important and essential not only for radiology but for many other departments and practices both small and large. It provides easy access to patient images, it is secure and complies with HIPPA regulations, and compiles all patient data digitally to save space and cost as opposed to film storage and printing. Over all, it makes lives of the people that save lives much easier.

References
About DICOM. (n.d.). Retrieved May 31, 2015, from http://dicom.nema.org/
Becker, S., & Arenson, R. (1994, October 1). The Cost and Benefits of PACS. Retrieved May 31, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC116218/pdf/0010361.pdf
Dresevic, A., & Mikel, C. (2013, April 1). New HIPPA Rules: A Guide for Radiology Providers. Retrieved May 31, 2015, from http://www.thehealthlawpartners.com/docs/hipaa_rules.pdf
Picture Archive and Communication System (PACS). (n.d.). Retrieved May 31, 2015, from http://www.fresno.ucsf.edu/housestaffportal/documents/synapse_pacs.pdf