PACS in Japan and progress of technology assessment

The statistics of PACS installations in Japan and the progress of key technologies over the past 13 years (1985-98) are described. The total number of installations of more than 557 is comparable with that (517) of hospital information systems (HIS), because advanced electronic technologies have brought a rapid spread of PACS for these 13 years. Examples of large sized PACS in Japan are discussed and a method for integrating HIS and RIS (Radiological Information System) is described. Standardization activities on PACS in Japan 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 realization of DICOM in Japan is also described. Technology assessment of PACS is discussed in terms of methods and the results of measurement. Examples in the Osaka University Hospital over 6 years (1992-98) are presented. In order to figure out the effectiveness of PACS itself, the HIS/RIS contribution to radiological examination and reporting was measured before PACS was implemented. The total aim of the whole system operation is to maximize the effectiveness of HIS/RIS/PACS integrated each other. The results of time study, character counting in radiological reports, network loading study and other measurements are employed to expand the size of PACS in Osaka University which has 20 terminals at present