Is Your Radiology PACS Futureproof?

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Picture of a physician holding a tablet with a globe in the background.
A medical professional holding a tablet with global healthcare connections, showing the growth of digital medical systems

Introduction

Medical imaging volumes have increased significantly over the past 5 years and will continue to increase, especially specialized imaging like CT and PET.  This has caused an exponential growth in storage requirements due to higher resolution modalities as well as overall patient volume. This rapid evolution raises a critical question for healthcare facilities: Is your current radiology PACS futureproof? As imaging technology continues to advance at an unprecedented pace, many healthcare organizations find themselves operating with systems that were designed for yesterday’s challenges, not tomorrow’s demands.

A modern radiology PACS must be capable of handling increasing volumes of complex imaging data while maintaining performance. The consequences of maintaining an outdated PACS infrastructure extend beyond mere technical limitations—they directly impact organizational risk, operational efficiency, clinical outcomes and ultimately, patient care.

This article examines the essential components of a futureproof PACS, identifies warning signs that your current solution may be approaching obsolescence, and provides actionable guidance for healthcare leaders navigating the complex landscape of medical imaging technology.

Evaluating Your Radiology PACS for Future Readiness

First things first, let’s define futureproof.  Futureproof is often used to describe IT systems, meaning they are guaranteed to not be superseded by future versions and new developments.  Developing solutions that can evolve as technology changes and anticipating what those future changes will be, along with minimizing the effects of updating the technology, guides developers to design solutions that stand the test of time. 

When evaluating your radiology PACS, consider both current functionality and future expansion capabilities. Today’s healthcare environment demands systems that can adapt to changing requirements without requiring complete replacement. The evolution of medical imaging PACS has transformed how healthcare facilities store, access, and share diagnostic images.

Below are several key indicators that your existing PACS may not be as futureproof as you think:

  • Limited interoperability with other clinical systems
  • Inability to handle increasing study volumes without performance degradation
  • Lack of support for emerging imaging modalities and formats
  • Restricted access options and workflows for remote radiologists and clinicians
  • Minimal or no AI integration capabilities
  • Aging hardware infrastructure with limited expansion options
  • Vendor roadmaps that show minimal innovation or development

A recent HIMSS cybersecurity report indicates that more than 39% of healthcare personnel are working with legacy systems of all types.  These solutions were designed before the adoption of cloud technology, widespread artificial intelligence (AI) solutions, and modern system interoperability. Are legacy systems holding your organization back?

Key Components of a Futureproof Radiology PACS

Investing in a futureproof radiology PACS requires careful consideration of vendor roadmaps and technology partnerships. The most resilient systems share multiple characteristics that position them for longevity in our rapidly evolving healthcare technology landscape.

Cloud-Native Architecture

Modern PACS solutions are leveraging cloud technologies to provide scalability, enhanced accessibility, and reduced infrastructure costs. Cloud-based PACS solutions offer significant advantages in terms of scalability and remote access capabilities and are critical for organizations that are moving to teleradiology workflows. These systems can dynamically adjust storage capacity based on demand, eliminating the need for costly hardware upgrades as imaging volumes increase.

Key benefits include:

  • Reduced on-premises hardware requirements
  • Automatic unlimited scaling to accommodate growing study volumes or peak/off peak demands
  • Enhanced disaster recovery and business continuity capabilities
  • Simplified system updates and maintenance
  • Support for remote reading and teleradiology workflows

Interoperability and Integration

Modern PACS solutions balance technical sophistication with intuitive user interfaces for clinical staff. True interoperability extends beyond basic DICOM compatibility to include:

  • Seamless integration with electronic health records (EHRs)
  • Support for emerging standards like FHIR
  • Cross-department image sharing capabilities
  • Integration with specialty clinical systems
  • Vendor-neutral storage (VNA) infrastructure
  • Standardized APIs for third-party integrations

Optimizing your PACS network connections is another area to address when modernizing your imaging technology stack.  Evaluate network performance during peak usage periods and adjust to ensure that as imaging volume grows, performance will not be impacted due to larger file sizes during transmission.

AI Integration and Advanced Analytics

Modern PACS solutions include advanced integration capabilities with artificial intelligence solutions for both clinical and operational workflows.  Consider the following when evaluating today’s modern solutions:

  • Automated image analysis for specific conditions based on algorithms that align with your patient population
  • Workflow prioritization based on AI findings (workflow orchestration)
  • Quality control algorithms to ensure optimal image acquisition
  • Predictive analytics for resource planning and utilization
  • Natural language processing for advanced report generation and analysis

By providing greater interoperability with 3rd party AI solutions, enhanced workflows, offering faster exam prioritization, can lead to radiologist efficiency and better patient outcomes.

Robust Security

We’re living in unprecedented times where almost daily healthcare entities are struggling with cybercrime, data breaches or ransomware attacks.  Solutions that put security as a priority and design and validate their solutions with the latest data security standards are extremely important to ensure your patient data will be safe and secure for years to come.  Data encryption (both at rest and in transit), HIPAA compliance, and certified validations (like SOC2 or HITRUST) are good indications you are investing in the safest solutions available on the market today.

Evolving From Departmental to Enterprise Workflows

Early PACS solutions focused on the radiology department. Today’s modern solutions have expanded workflows and capabilities to support more strategic enterprise imaging initiatives that encompass multiple specialties like cardiology, pathology, dermatology, ophthalmology, surgery, and wound care.

Some modern PACS solutions, like those developed by InsiteOne, use a vendor neutral back end for image archiving and provide a well-designed architecture that provide advanced workflows for the radiology department but accommodates enterprise workflows in other imaging specialty areas.  A key benefit of enterprise based PACS solutions is their ability to lower overall operational costs by consolidating image archiving into a single standards-based back-end infrastructure, while providing advanced clinical tools that address various workflow needs for the end users.  Offering a holistic longitudinal view of the patient’s imaging record in connection with their clinical record through the hospital’s EHR, provides improved clinical insight plus enhanced collaboration capabilities among clinical staff.

Cloud-Based vs. On-Premises PACS

Healthcare organizations face important decisions regarding deployment models for their imaging systems. Both cloud-based and on-premises approaches offer distinct advantages and limitations that must be evaluated in the context of specific organizational needs.

ConsiderationCloud-Based PACSOn-Premises PACS
Initial InvestmentLower capital expenditureHigher upfront costs
ScalabilityDynamic, on-demand scalingFixed capacity requiring planned upgrades
AccessibilityNative support for remote accessRequires VPN or additional security layers
Security ControlOften significantly more robust security than on-premises. Also can be a shared responsibility modelLocal control over security measures, which could be lest robust than those offered by native cloud solutions
MaintenanceVendor-managed updates. Can be offered as a full managed service model.Internal IT resource requirements. Can be offered as a shared or full managed service offering.
Network DependencyRequires reliable internet connectivity. Can also be offered as a hybrid configuration with local storage and network aware capabilities to access the fastest connection point.Functions within local network
Disaster RecoveryBuilt-in redundancy and failover. Can also provide enhanced business continuity options.Requires separate DR planning and infrastructure, oftentimes replicating the cost of your original PACS system.

Most cloud-based solutions offer hybrid configurations (providing some local storage) to provide uninterrupted access to patient images should internet access be temporarily disrupted. This is an especially important consideration when organizations offer emergency services, so patient care is not impacted.

Quantifiable Benefits of PACS in Radiology

As radiology transitioned from film to digital several decades ago, the benefits of PACS in this transition became apparent. Providing always available and device agnostic access to images was a key benefit, offering easier access, better collaboration, and enhanced patient care. Other quantifiable benefits that have been realized in this transition include:

  • Up to 30-50% reduction in report turnaround time
  • Average of 20-40% increase in radiologist productivity
  • Near elimination of lost or unavailable studies
  • Improved clinical collaboration
  • Enhanced patient satisfaction due to faster results delivery

Recommendations for Assessing Your Current PACS

To determine if your current PACS system is futureproof, consider conducting a structured assessment using these criteria:

  1. Technical Evaluation
    • Review system architecture against current industry standards
    • Assess hardware age and projected lifespan
    • Evaluate storage utilization and growth patterns
    • Analyze network performance during peak usage periods
    • Review system uptime and reliability metrics
  2. Clinical Workflow Assessment
    • Gather feedback from radiologists on system usability
    • Measure report turnaround times and identify bottlenecks
    • Evaluate remote access capabilities and performance
    • Assess integration with clinical decision support tools
    • Review image quality and visualization capabilities
  3. Strategic Alignment
    • Compare current capabilities with organizational growth plans
    • Evaluate vendor partnership and innovation roadmap
    • Assess total cost of ownership and ROI
    • Review compatibility with emerging technologies
    • Evaluate security and compliance capabilities

For even more guidelines on performing a PACS assessment at your facility, be sure to download our latest PACS Assessment guide.

Conclusion

The question “Is your PACS futureproof?” requires thoughtful consideration of both current capabilities and future requirements. As imaging technology continues to evolve, healthcare organizations must ensure their PACS infrastructure adapts to changing demands without requiring complete replacement.

A truly futureproof PACS combines technical excellence with workflow optimization, security, and scalability. By evaluating your current system against the criteria outlined in our PACS Assessment guide, you can identify potential gaps and develop a strategic plan for ensuring your imaging infrastructure remains capable of supporting excellent patient care for years to come.

The most successful organizations approach PACS futureproofing as an ongoing process rather than a one-time project. By continuously monitoring system performance, staying informed about emerging technologies, and maintaining strong vendor partnerships, healthcare leaders can ensure their imaging infrastructure remains aligned with both clinical needs and organizational objectives well into the future.

For more information on how InsiteOne can provide a tailored solution to meet your organization’s modern PACS needs, contact us at 866.467.4831or visit us here.

Teleradiology Takes Center Stage in Radiologist Shortage

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A person is looking at a brain scan on a computer monitor. The image is in black and white and shows a close up of the brain. The person is wearing gloves and he is examining the scan.
A person is looking at a brain scan on a computer monitor. The image is in black and white and shows a close up of the brain. The person is wearing gloves and he is examining the scan

Radiology Shortages

As the radiology workforce faces critical shortages, teleradiology takes center stage as a scalable solution to help healthcare organizations navigate and overcome the growing radiologist shortage. One solution to help decrease this trend is remote radiology.  With a growing population, over 56.4% of radiologists over the age of 55 (retirement is on the horizon), and a rising demand for imaging services, new solutions must be evaluated to alleviate the shortages being experienced. 

Teleradiology is one solution that can address many critical challenges. A growing shift is moving these services from providing preliminary reads to “final reads”.  In this blog, we explore some emerging trends and best practices that will shape radiology and highlight how Artificial Intelligence (AI) can help.

AI – Radiology’s Savior or Foe?

Radiology has led the way in approvals of AI algorithms cleared by the FDA.  In February 2025, there were over 778 approved algorithms for radiology alone.  But how does an organization or teleradiology practice decide which algorithms are best suited to their practice?

Recently, The Imaging Wire published an article suggesting that while some AI algorithms can improve radiologist workloads, the reality paints a different picture.  A survey published in 2022 polling 185 radiologists, suggested that only 22.7% experienced a workload reduction. Yet 69.8% reported there was no workload reduction at all.  As AI continues to mature, vendors must focus on fine tuning their AI solutions plus shorten the study processing time. Plus, workflow improvements should not further burden radiologists by extending interpretation time.

There are several areas where AI can help improve radiologist productivity in the field of teleradiology.

Subspecialty Matching

Subspecialty matching (matching cases with the appropriate radiologist) is one of the most significant advancements in teleradiology today.  AI would preview an imaging study, evaluate its findings, then match the exam with the appropriate reading specialist.  This model helps:

Health Equity: Rural hospitals often suffer since many times they are not tapped into the best specialists due to their location.  Providing highly specialized reading services for rural locations can improve care access for patients, improve their outcomes, and better normalize care across all imaging locations, regardless of geographic location.

  • Enhance Accuracy: Routing specific studies to the best qualified radiologist, based on their expertise, can improve patient outcomes.  The biggest challenge is ensuring study bias and workload continues to be balanced across the group.
  • Improve Efficiency: Automated matching reduces administrative overhead and accelerates report turnaround times since the best skilled radiologist is the one reading the study.

AI in Clinical Decision Making

Ensuring the correct radiology study was ordered initially goes a long way to reducing the cost of care while improving patient outcomes.  Decision support tools that assist clinicians in ordering the best imaging exam for a given condition can provide faster intervention and improve the patient’s health outcomes.  Modern algorithms can sift through a significant amount of patient history and suggest appropriate imaging exams in seconds, which may take caregivers hours to complete the same task.

AI in General Workflow

Artificial Intelligence solutions can review existing studies and flag/route the most critical cases to the top of a teleradiologist’s worklist.  This ensures faster reading time of studies that require immediate attention.  This not only improves patient care but removes normal studies from critical workflow paths. This allows radiologists to better prioritize their time and ensure critical patients get the care they need faster.

AI based Reporting

Advances in using AI based reporting solutions are improving how radiologists interpret studies.  Solutions by companies like RADPAIR and MD.ai are revolutionizing the way radiologists report studies.  Radiologists can use conversational discussions when reviewing patient exams and the AI understands what is clinically relevant and places that text where it should be placed in the radiology report, speeding up interpretation time.  Additionally, flagging clinical errors (like ensuring the dictated study matches the order – especially for left/right body parts) improves clinical accuracy. 

Providing real-time access to medical databases optimizes clinical follow-up, providing more value in final reports sent to the patient’s clinician.  Finally, AI can help add or identify relevant information from the EHR or prior exams as it relates to the patient’s history, ensuring radiologists focus on the most critical aspects of documented findings in a patient’s clinical evaluation.  Auto-impressions and routing reports for appropriate follow-up (flagging critical results) speeds up patient care intervention when needed.

Technology Can Save the Day

Technology is one way to combat the radiologist shortage. Teleradiology is an emerging workflow change that also alleviates bottlenecks and balances workloads.  By providing preliminary, after-hour coverage, peak time coverage, and final reads, teleradiology provides a host of benefits to hospitals struggling to attract qualified radiologists to support their imaging volumes.  Additional benefits include:

  • 24/7 Coverage: Teleradiology groups can provide remote reading services around-the-clock, alleviating the burden on in-house teams.
  • Load Balancing: Teleradiology networks can distribute workloads more evenly across time zones and regions with the radiologists they have contracted with.  Not only can this better distribute the workload, but it can also get the right exam to the right radiologist at the right time.
  • Rural Healthcare Support: Remote areas can now gain access to a pool of expert radiologists they would not normally have access to.  This can improve the diagnostic capabilities in underserved regions and ultimately provide enhanced patient care since studies with their condition (or subspecialty routing) can get routed to the radiologist who has the highest level of expertise with their condition or subspecialty.

Earlier in this blog, we mentioned the surprising findings that only a small percentage of radiologist’s experience productivity gains with technology, yet technology is required to accommodate the field of teleradiology.

Easy to use PACS solutions, automated study routing, AI-based exam assignments and preliminary study review, and AI-based report creation, are just a few areas of technology that can help drive better efficiency, speed, and accuracy.  Cloud-native PACS solutions allow anytime, anywhere access to imaging studies and is required for teleradiology to be efficiently managed.

Teleradiology – Better for Patients?

Not only can teleradiology improve handling imaging volumes but patient care can also benefit from this technology.

  • Rapid Turnaround Times: Oftentimes, faster diagnoses can occur since teleradiology groups may “follow the sun”, meaning staffed reading services are provided virtually 24×7. This leads to quicker treatment initiation and improved patient outcomes.
  • Second Opinion Services: Since the pool of radiologist expertise is greatly enhanced with teleradiology services, patients may have easier access to multiple expert opinions, enhancing diagnostic accuracy.
  • Integration with Patient Portals: Most PACS solutions provide some form of a patient portal.  Providing patients with direct access to their radiology reports and images improves engagement and understanding.  Some reporting solutions even produce patient friendly reports, further enhancing understanding.

Improving Work/Life Balance

One of the highest complaints among staff radiologists is burn-out.  Radiologists are burdened with tasks that do not directly relate to patient care and reading studies, causing lower productivity and a decrease in job satisfaction, which ultimately leads to burnout.  Teleradiology improves work/life balance by providing:

  • Flexible Scheduling: Radiologists can choose the hours they want to work and manage a schedule around their specific lifestyle, which can significantly improve work/life balance.
  • Remote Work Opportunities: The ability to work from any location can significantly expand career options and job satisfaction for many radiologists.  Not having to be present daily at a hospital may also increase efficiency and allow more studies to be read during a typical shift.
  • Reduced On-Call Burden: Again, since many teleradiology groups have a “follow the sun” business model, distributing specialists across multiple time zones can lead to more manageable schedules, reduced or no on-call responsibilities, and better workload management.

Best Practices for Teleradiology Success

To fully leverage these trends, healthcare organizations and radiologists should consider the following best practices:

  1. Invest in Robust IT Infrastructure: Ensure high-speed, secure connections and state-of-the-art Cloud-Native PACS systems to support seamless remote reading while providing enhanced data security.
  2. Prioritize Cybersecurity: Working with a cloud provider can provide better cybersecurity than on-premises solutions.  Using remote reading services is imperative that elevated security practices are followed and implemented to protect sensitive patient data.
  3. Quality Assurance: Establish rigorous QA processes at contracted hospitals to ensure the highest image quality is obtained the first time.  This leads to better diagnostic accuracy in remote settings and reduces patient call backs.
  4. Embrace AI Integration: Adopt AI tools that focus on workflow optimization, preliminary reads, and decision support to enhance efficiency and accuracy.  Make sure that any AI algorithms chosen are the right ones for your organization and work well with your patient population mix.
  5. Foster Communication: Implement systems that facilitate quick and clear communication between remote radiologists, referring physicians, staff technologists, and patients.  Keeping everyone in the loop and providing tools to allow easy communication can further improve patient care.

Conclusion

Teleradiology is one accepted method that can help address the radiologist shortage and expertise gap that plagues our industry today, while providing the ability to improve patient care and professional satisfaction. By embracing these trends and implementing best practices, healthcare organizations can position themselves to maintain high standards and potentially improve report turnaround times.

The teleradiology market is expected to continue to grow at a CAGR of 19.7% from 2024-2032. By providing an environment without geographic boundaries and properly outfitted with today’s leading technology, limitations to expert radiological care becomes a thing of the past.

InsiteOne offers a robust teleradiology solution that scales anywhere from small reading groups to large teleradiology practices with ease. Providing simplistic, yet effective workflows for small groups to offering AI integrated platforms, advanced AI reporting options, and optimized workload balancing for large practices, we can offer solutions that fit virtually any practice need and size. If your group is considering investing in new technology to help grow your teleradiology practice, be sure to reach out to the InisteOne team today to learn how our solution can help set new levels of productivity and efficiency for your teleradiology group today!