Successful implementation of a picture archiving and communication system (PACS) requires extensive planning and the input of the users in the planning and evaluation stages. System design is conducted in nine stages: systems analysis, stages 1-4; system design, stages 5 and 6; and system implementation, stages 7-9. Users of the PACS are actively involved in systems analysis. At stage 1, problems are identified, project scope is defined, and whether the problems can be successfully addressed with a PACS is determined. If the project is feasible, current systems are studied at stage 2. Data are collected on the volume of image data to be transmitted, stored, retrieved, and displayed; distribution of imaging through the day; radiologists' reading patterns and volumes; job functions of technologists; characteristics of images to be included; types of equipment to be interfaced; physical placement of cables, connections, and equipment; and operational restrictions. All these data and more are used in stage 3 to specify requirements of the PACS. Rigorous specifications are needed to ensure that the final system performs at the desired level. At stage 4, users evaluate alternative solutions to problems. Although consultants and equipment manufacturers do much of the design, implementation, and installation, users must understand project scope and limitations of the technology and must ultimately be responsible for planning a system that meets their needs.
