Development and operation of PACS/teleradiology in Japan

Progress of key technologies for the past 10 years and the state of realization of PACS and teleradiology in Japan are reviewed. Even though advanced electronic technologies have brought a rapid spread of PACS and teleradiology, the total number of installations is small compared with that of the hospital information system (HIS). The reason of this is a lack of economic incentives. The merits or benefits of PACS and teleradiology have to be appreciated and paid for by reimbursement of the associated costs from health insurance companies. The progress of PACS diffusion has been very rapid for these ten years in Japan, but most systems deployed are small-sized PACS. Examples of large PACS in Japan are presented and a method for integration with the HIS and RIS (radiological information system) is described. Standardization activities on PACS such as image data transfer and filing are also introduced. A unique domestic standard in Japan for IS&C (image save and carry) and electronic filing of medical images is presented. The Japanese equivalent of the American standard DICOM is also described. Technology assessment of PACS is an important theme of study and investigation. An example of the measurement of pre- and postoperation of these systems is discussed