In the field of medical imaging, the global picture archiving communications system (PACS) market is expected to reach a value of $5.5 billion by 2016, experiencing a compound annual growth rate of 11 percent from 2010, according to market analysis organization GlobalData. The company noted that radiology PACS will continue to be the largest segment of the market and will see a compound annual growth rate of 10 percent from 2009 to 2016. The segment will be driven by replacement sales and government incentives for health care information technology. In July 2010, GlobalData published the report, Picture Archiving and Communication Systems (PACS) – Global Opportunity Assessment, Competitive Landscape and Market Forecasts to 2016, written by analyst Akanksha Jain. Shown are screen shots from GE Healthcare’s Centricity PACS-IW system designed for a variety of hospitals, including imaging centers and physician groups that perform imaging. The Web-based system can leverage Web 2.0 capabilities to go beyond radiologist reporting. The company also makes a system for large academic hospitals. Courtesy of GE Healthcare IT. Governments in countries such as the US, China and Canada are providing financial incentives for hospitals and physicians to adopt a robust information technology infrastructure, which requires a substantial amount of funding, according to the report. It noted that, in 2009, the US government dedicated a $19.2 billion stimulus package to health care infrastructure and Electronic Health Records implementation by both hospitals and physicians under the HITECH Act, GlobalData reported. “Mature markets such as Europe, Japan and even the US are witnessing more uptake of PAC systems at the small- and midsize hospital levels,” the report stated. “Independent physicians’ offices are an important unpenetrated market in these regions, and more companies are developing products specifically for their needs. “PAC system products for cardiology laboratories and mammography centers are also important drivers for the market. The cardiology PAC and other PAC systems markets are forecast to experience compound annual growth rates of 15% and 11%, respectively, to reach values of $1.3 billion and $825 million, respectively, from 2009 to 2016.” Mobile application of these imaging and communications systems is one of the main current advances in the technology. A number of companies, including Merge Healthcare, CoActiv Medical Business Solutions and TeraRecon, are now developing applications that enable physicians to access medical images remotely from “smart phones” such as the iPhone, the company reported. Medical images and reports are transmitted digitally via PACS and eliminate the need for manual film-based processing. PACS typically consist of an imaging modality such as CT or MRI, a secure network for transmitting patient information, workstations for interpreting and reviewing images, and archives for the storage and retrieval of images and reports. The standard protocol, known as DICOM (Digital Imaging and Communications in Medicine) is the universal format for PACS image storage and transfer. Automating work flow The systems can enable the replacement of film-based technology, remote access to medical images and data, an electronic platform for integrating radiology images with other medical automation systems, and radiology work flow management. “As their functionality increases, PAC systems are rapidly becoming decision support tools, providing physicians with information and enabling them to efficiently analyze medical images. Traditionally, the systems have been used as simple tools for viewing medical images. PAC systems have become increasingly valuable to clinicians, in part because of the high quality of images now captured by imaging modalities such as CT, MRI and PET,” GlobalData reported. The company predicts that newer tools will automate the PACS work flow to make the entire process more streamlined. “PET and MRI generate a huge volume of medical images that need to be processed before they can be meaningfully analyzed,” the company said. “Software that automates the rendering of large amounts of data and sends only the resulting images to the client computer saves time for radiologists. New technologies today are aimed at making image manipulation more intuitive, enabling radiologists to process studies more quickly,” GlobalData stated. There is a growing need for interoperability, the company said, when asked about which types of technical upgrades would be seen as older PACS are replaced with new ones. There is an increasing emphasis on improving patient mobility and on health care delivery by various professionals and organizations working from different locations. “Legacy PAC systems usually do not work on common standards and thus will have to be replaced by newer systems that are compliant,” the company said. In Europe, health care institutions in regional networks governed by one entity are adopting interoperable systems to allow for regional integration. Widespread adoption of standard file-sharing protocols such as DICOM and of Integrating the Healthcare Enterprise profiles such as Cross Enterprise Document Sharing enable institution-independent access to records, the report stated. GlobalData noted many other emerging PACS advances. Vendors are working to provide integrated one-desktop PACS that offer a point-of-access for all imaging and diagnostic processes within a hospital – rather than having separate PACS for each department. Some of these integrated advanced applications are orthopedic templating, mammography, vessel and cardiac analysis, virtual colonoscopy and 3-D visualization. The newer technology is integrating diagnostic applications into the common PACS platform and linking it to radiology. These capabilities allow technologists, radiologists, and referring physicians to share data without the need for separate workstations. Faster data transmission, easier-to-use interfaces and lower maintenance costs are among the technology improvements that we will see in the next few years. It is expected that PAC systems, many of which now require a specific browser, will soon be capable of running on most web-enabled devices equipped with standard web browsers. Newer PACS architectures and platforms are also likely to be vendor neutral, offering more flexibility.