Niilo Saranummi

PACS in Japan and the Nordic Countries. First Japan-Nordic PACS Symposium

The ingredients seem to exist for switching from film-based radiology to digital radiology utilizing the concept Picture Archiving and Communication System (PACS). Why has this not happened? What are the barriers limiting the diffusion of PACS into health care? This was the theme of the 1st Japan-Nordic Symposium in PACS, which was held in Tokyo, March 29-30, 1990. Over 40 radiologists and technical specialists in PACS participated. The topics discussed ranged from the present status of PACS in Japan and the Nordic Countries, to functional specifications and user requirements for PACS, to organizational and other changes brought about by PACS and to teleradiology as a solution for communication of images over wide distances. The symposium was quite successful and will be followed by a 2nd symposium in Finland in the summer of 1991.

Round table discussions

The round table discussions dealt with standardisation and its role in PACS and medical imaging, and with the assessment of medical imaging and targeting R & D based on that. Two approaches to enable image files to be transferred were discussed in the standardisation session. Firstly, the standardisation efforts in Europe, USA and Japan which all focus on a single standard on image transfer and file format were discussed. A plea was made to merge these three approaches. It was also noted that the Japanese IS&C standard is essentially a standard for off-line PACS. Secondly, an argument was raised that as several image file formats are already in existence (because of the different computer platforms in use), what is needed are converters between these de-facto formats instead of striving towards one common standard. The round table on assessment focused on the changes in the radiological practices which are already emerging following the introduction of new digital imaging modalities. It was argued that PACS will cause further organisational changes because a hospital-wide PACS enables images to be viewed everywhere. The radiology meetings have been the mechanism for discussing difficult cases. In the PACS world their role may change. However, PACS will only diffuse when it offers clear advantages over the present procedures. This means that PACS, digital imaging and radiology practices evolve in parallel and incrementally.