Abstract
Background The picture archiving and communication system (PACS) has already replaced classic
hard copy film technology. With new functions of PACS under consideration, attention
turns to the sharing of medical images between different institutions. The Czech Republic
is one of the few countries using a nation-wide medical images exchange system known
as ePACS. It is based on dedicated hardware and one central router, although theoretical
models tend to prefer cloud-based sharing.
Objective Despite its simple design and lack of advanced features, this system has successively
evolved into a widely used tool. The aim of this article is to offer an overview of
its use and functions and to show that even a simple system can be widely used.
Methods Using data from the producer of ePACS (the ICZ company) and from other sources, the
system was described and data about its performance have been obtained.
Results Every acute-care hospital (140) and about a quarter of outpatient facilities (105)
in the Czech Republic are now equipped with ePACS and are therefore able to share
medical images. The number of studies transmitted rises every year, from 12,000 in
2008 to more than 640,000 in 2018, which is approximately 4% of all studies produced.
The system was primarily designed and is used to share images between acute-care hospitals
but a very special usage has also evolved, as it is employed in a teleradiology service
with private enterprises too.
Conclusion ePACS is expanding in the Czech Republic despite having only limited functions and
despite its principle that simply copies a classic workflow when sending studies on
Compact Discs. Although other systems for image sharing might be more advanced, ePACS
brings to the Czech health care system the capability to exchange medical images on
a national level.
Keywords
DICOM - PACS - information systems - cloud computing - radiology information systems
