Over the last several months a number of posts have shown up on auntminnie.com and pacs-admin@yahoogroups.com asking readers opinions on some of the smaller PACS solutions in the market. I assume that most of these questions are being posed by members of small imaging operations performing less than 40,000 procedures per year who assume that they can only afford the relatively inexpensive PACS solutions offered by the small vendors. In the past, this was probably the case, but that is no longer the case.
Today, several of the biggest vendors in the PACS market, creators of the really big and fully featured PACS, have achieved a scaling feature that allows them to offer effectively the same fully featured PACS at a price point within reach of even the smaller imaging operation.
These vendors have achieved this scaling by reducing the number of servers in the cluster, without eliminating robustness or reliability. They have retained the basic display features, including hanging protocols, but made many of the more advanced display features (like 3D) line item extra-cost options, so they can be added for a modest license fee if needed. They have made many of the professional services that were automatically included in the big system, line item options in the scaled down package. The site that can follow directions and set up their own modality interfaces, complete their RIS interface on their own, and perform their own network testing can save some money.
Perhaps the best feature of this new generation of scaled down PACS is that their upside potential is not artificially limited. If the study volume suddenly jumps by 100%, the small system can be expanded to accommodate growth, without a wholesale exchange of hardware or a whole new tier of software licensing. The user truly pays for only what they need, and only as they need it.
In this scenario, there is no reason for the smaller imaging organization to risk an investment in a fragile company and purchase a bargain-basement PACS with limited features and limited support. It is now possible to afford the economical version of the same PACS being used by the big boys.