Tuesday, December 31, 2019

Spending bill includes $50 million for healthcare data initiative

PARCA eNews – Dec. 31, 2019 – Lost in all the other things going on in Washington, D.C. at the end of 2019 was the $1.4 Trillion spending package Congress passed and the president signed to fund the US Government through September 2020.

Included in the bill was $50 million for the first year of the Data: Elemental to Health Campaign, a multi-year initiative aimed at modernizing public health data systems, including surveillance and analytics at the CDC as well as state and local health departments.

Thursday, December 19, 2019

Researchers produce first laser ultrasound images of humans

Photo courtesy MIT News
PARCA eNews – Dec. 19, 2019 – MIT engineers have demonstrated an alternative to conventional ultrasound that doesn’t require contact with the body to see inside a patient.

In a paper published Dec. 19, 2019 in the Nature journal Light: Science and Applications, the researchers scanned the forearms of several volunteers and observed common tissue features such as muscle, fat, and bone, down to about 6 centimeters below the skin. The images were judged comparable to conventional ultrasound, but were produced without patient contact using remote lasers focused on a volunteer from half a meter away.

Thursday, December 5, 2019

Risks of AI pose complex challenges to deployment in healthcare

Professor Nicholson Price, University of 
Michigan. Credit Petrie-Flom Center - 
Harvard University
Nicholson Price is a professor of law teaching and writing in the areas of intellectual property, health law, and regulation, particularly focusing on the law surrounding innovation in the life sciences. He previously was an assistant professor of law at the University of New Hampshire School of Law, an academic fellow at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, and a visiting scholar at the University of California, Hastings College of the Law. Previously, he clerked for the Hon. Carlos T. Bea of the U.S. Court of Appeals for the Ninth Circuit. He received a JD and a PhD in biological sciences from Columbia University and an AB in biological sciences from Harvard College.​  PARCA eNews spoke to Mr. Price following an article he wrote for Brookings about the risks and remedies for AI in healthcare to get his perspective on those risks with regard to radiology and PACS administrators.

Wednesday, December 4, 2019

RSNA launches initiative to boost imaging sharing

Credit RSNA 2019
PARCA eNews – Dec. 4, 2019 – The RSNA and Carequality announced the addition of a supplement to the Imaging Data Exchange Guide at a town hall event at its 2019 RSNA’s 105th Scientific Assembly and Annual meeting in Chicago in December. 

The supplement expands the scope of the Carequality Interoperability Framework to detail technical standards for exchanging medical images.

Monday, November 25, 2019

AI in healthcare is here to stay

The online magazine AI in Healthcare in collaboration with Pure Storage have released results of their AI in Healthcare 2020 Leadership Survey Report.

The survey questioned 1,238 healthcare providers, executives and IT leaders about artificial intelligence in healthcare.

The goal of the survey was to gain a deeper understanding of the current state of artificial and augmented intelligence in use and what is being planned across healthcare in the next few years.

Office 365 target of Phishing Scams

PARCA eNews – Oct. 1, 2019 – Two new scams targeting Office 365 users have been making the rounds since last July.

One dubbed Trickbot Trojan uses an authentic-looking domain that has all the typical elements of a genuine Microsoft website, including links to Microsoft resources. 

Philips recalls gamma camera for faulty support component

PARCA eNews – Nov. 7, 2019 – The FDA has issued a Class I recall for the Philips Medical Systems Forte Gamma Camera System manufactured between 1998 and 2008.

A Class I recall is the most serious recall type due to the potential for serious injury or death. In this case, a defect has been discovered that can allow an internal component to fail resulting in the gamma camera detector dropping. The 660 pound component could crush or trap a patient resulting in serious injury or death.

DICOM releases Realtime Video standard

Credit - Siemens Healthcare GMBH
PARCA eNews – Sept. 30, 2019 – The DICOM Standards committee released its realtime video standard in September. 

The new standard describes several new DICOM IODs and associated transfer syntaxes for the transfer of realtime video, and or audio along with associated medical data.

ONC names Robert Anthony to head Certification & Testing Division

PARCA eNews – Oct. 28, 2019 – The Office of National Coordinator has named Robert
Anthony as the director of the Certification & Testing Division in ONC’s Office of Technology, where he will oversee the ONC Health IT Certification Program. 

Anthony previously served as a senior policy advisor in the Office of Clinical Quality and Safety and as senior strategic advisor in the Office of Technology at ONC. 

Senator Mark Warner calls on HHS to act to prevent breaches of medical imaging

PARCA eNews – Nov. 11, 2019 – In the wake of a report by ProPublica and German public broadcaster Bayerischer Runkfunk in September showing that millions of medical images were vulnerable to hackers, the US Senate Cybersecurity Caucus heads by Mark Warner, D-Virginia is asking the Department of Health and Human Services to explain why nothing has been done about it.

Failure to do risk assessment most common HIPAA violation

PARCA eNews – Oct. 30, 2019 – Failure to conduct a risk assessment as required by HIPAA is among the most common cybersecurity violations healthcare organizations are charged with according to the Office of Civil Rights.

Recognizing that organizations often struggle with compliance, the Office of the National Coordinator for Health Information Technology (ONC), in collaboration with the HHS Office for Civil Rights (OCR), has released an updated downloadable Security Risk Assessment (SRA) tool free to healthcare organizations.

Friday, September 27, 2019

Widespread lack of security found in medical imaging archiving systems

PARCA eNews – Sept. 17, 2019 – Millions of medical images are vulnerable to hackers according to a joint report by ProPublica and Bayerischer Rundfunk, a public broadcaster in Munich Germany.

The joint research project identified 187 servers used to store and retrieve medical data in the US that were unprotected by passwords or basic security precautions. The computer systems from Florida to California were primarily used by doctor’s offices, medical imaging centers and mobile x-ray services.

The security on these servers was found to be so lax that Jackie Singh, a cybersecurity expert said it didn’t even require hacking to view images on some of the servers.

Blockchain: What is it, how will it be used in healthcare and medical imaging?

Woojin Kim, MD, is a diagnostic radiologist with fellowship training in musculoskeletal radiology and imaging informatics. As an entrepreneur, he co-founded Montage Healthcare Solutions, a healthcare search and analytics company that provided enterprise search and data mining within healthcare systems for clinical decision support, research, business intelligence & business analytics, and clinical quality analytics. When the company was acquired by Nuance Communications in 2016, Kim became Chief Medical Information Officer for Nuance Communications. A recognized expert in imaging informatics with a focus on healthcare search, data mining, business intelligence and analytics, clinical quality analytics, blockchain, and machine learning/deep learning. He serves on the Board of Directors for the Society of Imaging Informatics in Medicine (SIIM) and is a much sought-after speaker for imaging informatics and blockchain technology with more than 170 abstracts, presentations, and talks. He spoke with PARCA eNews by phone about blockchain in healthcare.

Senate Bill maintains ban on unique patient identifier

PARCA eNews – Sept. 26, 2019 – The ban on a national patient identifier is expected to continue for at least another year. 

The ban first placed on the Health and Human Services in 1999, has been extended in the Senate version of the bill funding Departments of Labor, Health, and Human Services, and Education through September 2020. 

Account Takeover email attacks on the rise

PARCA eNews – Aug. 15, 2019 – A number of cybersecurity companies are warning that the use of email account takeover is a rising security threat. 

Agari a cybersecurity company specializing in email cyber threats issued a report in April 2019 showing a 126 percent increase month to month in targeted email attacks that exploit account takeover tactics since the beginning of 2018.

Survey finds cyber risk prioritization but lower confidence in resilience

PARCA eNews – Sept. 19, 2019 – While companies have prioritized cybersecurity to a greater degree over the past two years, confidence in their ability to to manage cyber risk has declined, according to a report by Marsh and Microsoft.

The 2019 Global Cyber Risk Perception Survey released Sept. 18, 2019, is based on a biennial survey of business leaders from a range of countries and industries including healthcare, to assess the cyber risk perceptions and risk management have shifted over time.

Hackers target healthcare info that can be monetized

PARCA eNews – Sept. 24, 2019 – A total of 169 million Americans had personal information compromised in 1,461 data breaches at healthcare organizations over the last 10 years, a news study shows.

The study in the Sept. 24, 2009 Annals of Internal Medicine analyzed healthcare data breaches that occurred between October 2009 and July 2019 that impacted more than 500 individuals and were reportable incidents under the HIPAA and HITECH Act.

Thursday, September 26, 2019

DICOM Cyber security threats: Myths and Truths.

by Herman Oosterwijk

A report by Cylera labs identified a potential cyber security threat in DICOM files that are exchanged on media such as CD, DVD, flash or through email, as well as through DICOM web service communications (DICOMWeb).

The threat was taken seriously enough by the DICOM committee that it issued a FAQs document to address this potential issue. This threat exploits the additional header that is created for media, email and web exchange. Before discussing the potential threat and what to do about it, let’s first discuss what this header looks like and how it is used.

Tuesday, July 23, 2019

In the Enterprise Imaging era where are we with PACS?

Michael J. Cannavo is known industry-wide as the PACSman. After several decades as an independent PACS consultant, he worked as both a strategic accounts manager and solutions architect with two major PACS vendors. He has now made it back safely from the dark side and regularly shares his observations on AuntMinnie.com.

PARCA eNews spoke to Mr. Cannavo by phone to get his perspective on the status of PACS systems and PACS administrators as medical imaging has evolved and moves into Enterprise Imaging.

His healthcare consulting services for end users include PACS optimization services, system upgrade and proposal reviews, contract reviews, and other areas. The PACSman is also working with imaging and IT vendors developing market-focused messaging as well as sales training programs. He can be reached at pacsman@ix.netcom.com or by phone at 407-359-0191.

SIIM 2019 wraps up with continuing upbeat atmosphere

Photo courtesy Aunt Minnie
PARCA eNews – July 1, 2019 – The SIIM 2019 Annual Meeting held June 26-28 at the Gaylord Rockies Resort in Aurora, Colorado continued the success of last year’s meeting based on the number of attendees and vendors. 

It also continued the upbeat atmosphere of the Society for Imaging Informatics in Medicine (SIIM) that had been severely depressed in the dark days of the 2008 recession, according to PARCA founder Herman Oosterwijk, who attends the meeting every year.

Who owns patient data?

PARCA eNews – June 27, 2019 – That was the topic of a panel discussion on the ethical issues of Artificial Intelligence in radiology at the recent SIIM 2019 conference, held June 26-28.

At the heart of the discussion is the need for patient data for development of algorithms for artificial intelligence. AI requires data, a lot of it, consequently vendors developing proprietary AI solutions for healthcare are beginning to pay for it and hospitals are more than willing to sell de-identified patient data. The problem with imaging data is whether it can truly be de-identified.

Another imaging source on the way?

PARCA eNews – July 1, 2019 – Engineers have demonstrated feasibility to guide a tiny robotic capsule inside the colon to take micro-ultrasound images.

The pill-sized device, called the Sonopill, being developed in a collaboration of researchers at the University of Leeds in London and the University of Glasgow in Scotland uses magnetic forces and artificial intelligence to maneuver the device through the gut.

Making endoscopes obsolete

PARCA eNews – July 17, 2019 – Researchers at Carnegie Mellon University have demonstrated a new technique for using ultrasound to non invasively take optical images inside the body. The researchers say the method has the potential to eliminate the need for endoscopic examinations.

The researchers describe the method in a paper published in the journal Light: Science and Applications. Led by Maysam Chamanzar and Matteo Giuseppe Scopelliti, the team demonstrated using ultrasound to create a virtual "lens" within the body, rather than implanting a physical lens. 

Reports and complaints about data protection nearly double in one year

PARCA eNews – July 9, 2019 – Helpline and written advice services topped 471,224 contacts in 2018-19 according to the Information Commissioner’s Office (ICO), that compared to 283,272 contacts the year before, a 66 percent increase. Data protection complaints filed with the ICO more than doubled up from 21,019 in 2017-18 to 41,661 in the current reporting period.

Europe is serious about enforcing the GDPR

PARCA eNews – July 9, 2019 – The UK’s Information Comissioner’s Office (ICO) the UKs independent policing arm for the EU’s General Data Protection Regulation or GDPR regulation that rolled out many revisions to the privacy regulations launched last year has already levied a fine totaling $230 million on British Airways.

Now the ICO is proposing a fine of $123 million for Marriott’s breach involving 339 million customer records.

Thursday, May 23, 2019

Healthcare needs to adopt zero trust strategy and software-defined perimeters

Brigadier General Gregory Touhill (ret.)
Brigadier General Gregory J. Touhill (ret.), CISSP, CISM, serves as President of Cyxtera Federal Group, which offers data center services and cybersecurity capabilities to federal agencies and departments. Prior to retiring, Brigadier General Touhill served as a U.S. Air Force officer and combat veteran in several commands around the world including U.S. Transportation, Central, and Strategic Commands, and led the creation of the Air Force’s cyberspace operations training programs. He was appointed by President Barack Obama as the nation’s first ever Federal Chief Information Security Officer in 2016, where he was responsible for ensuring that the proper set of digital security policies, strategies and practices were adopted across all government agencies. He is a sought-after speaker and author within the information technology industry, where he is best-known for his “Cybersecurity for Executives: A Practical Guide,” which is used widely at colleges and universities across the country. He is also a faculty member at Carnegie Mellon University’s Heinz College, where he teaches Cyber Risk Management. PARCA eNews spoke with him about cyberthreats to healthcare.

Forescout report finds healthcare IT cybersecurity lacking

PARCA eNews – May 15, 2019 – In a survey of more than 430,000 devices on 1500 medical virtual local area networks (VLANs), Forescout Technologies found that healthcare IT continues to increase in diversity while too many networks continue to rely on legacy Windows operating systems and lack sufficient segmentation strategies.

Forescout Technologies, a provider of device visibility and control services for large enterprises and government agencies, issued its report of healthcare cybersecurity May 15, 2019.

Top cybersecurity challenges in healthcare

PARCA eNews – May 17, 2019 – A survey commissioned by Infoblox to see what has changed in the two years since WannaCry, shows healthcare IT organizations are very confident in their ability to respond to cyber attacks.

Infoblox is a network security company specializing in DDI with its Secure Cloud-Managed Network Services. The company commissioned the survey to follow up on its survey last year to look into how healthcare organizations are adapting to protect themselves from cyber threats.

The new survey found that healthcare industry leaders have taken notice of major events such as WannaCry and have gone as far as to make cybersecurity a leading priority.  

The research revealed: 

April sets record for healthcare breaches

PARCA eNews – May 22, 2019 – Nearly 700,000 healthcare records may have been compromised in 44 data breaches reported to the Office for Civil Rights in April 2019, making the highest total number breaches ever reported in a month since OCR began issuing its breach report in 2014.

HHS revises penalty table for HIPAA violations

PARCA eNews – April 30, 2019 – The Department of Health and Human Services (HHS) issued a change regarding civil penalties for HIPAA violations as amended by the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Under the current regulation penalties for HIPAA violations are levied on four tiers based on the level of knowledge of the breach by the covered entity ranging from 1-4:

OCR issues warning for ATP and zero-day exploits

PARCA eNews – April 9, 2019 – The Office of Civil Rights (OCR) warned HIPAA covered entities about advanced persistent threat (ATP) attacks and zero-day exploits in its Spring 2019 Cybersecurity Newsletter.

The newsletter points to the dangerous combination of ATP and zero day attacks that can threaten data all over the world.

Patch Tuesday: Microsoft, Adobe and Apple release security patches

PARCA eNews – May 14, 2019 – Microsoft released patches for 79 security flaws in its May 2019 Patch Tuesday update.

Two of the most significant patients involved a zero-day vulnerability and a security advisor for dealing with the latest wave of Intel CPU flaws that came to light only a few hours before the patch release.

DHS identifies vulnerability for Phillips Tase EMR, issues advisory

PARCA eNews – April 30, 2019 – The Department of Homeland Security issued an advisory to users of the Phillip Tasy electronic medical records on April 30, 2019. The advisory noted that the EMR system was vulnerable to low-skill-level exploitation and outlined steps users can take to mitigate the problem.

Philips Tasy EMR is a comprehensive healthcare informatics solution that integrates all areas of the healthcare environment, connecting clinical and non-clinical domains within a hospital system.

HiMSS redefines interoperability

PARCA eNews – April 28, 2019 – One of the major changes that came out of the HiMSS19 annual meeting last February was an effort to redefine what interoperability really means.

The organization produced a proposed definition and invited comment from industry professionals.

Tuesday, March 26, 2019

Image system monitoring that tells you what you really want to know

Kyle Henson, CEO of Intelligent
Kyle Henson’s career spans than evolution of radiology from PACS to VNAs and enterprise imaging. He started as an IT project manager at Humana, and AGFA, before becoming a consultant for a number of IDNs (Integrated Delivery Networks) including installing the first virtual McKesson servers at a site in Boise, ID. He has been a partner at Secant Healthcare managing data migrations and more recently served as director of enterprise imaging for Tenet Healthcare, a Dallas-based healthcare system operating more than 500 healthcare facilities nationwide. Last July, he and his partner Mike Dolan recently left institutional imaging to form a new company, Intelligent Imaging. Together they have developed an end-to-end proactive DICOM diagnostic and monitoring tool they call Heartbeat. It is an advanced web-based platform designed to support the imaging ecosystem; from imaging center, to hospital department, to healthcare enterprise. The beta-version was well received at RSNA last fall the company launched the product at HiMSS 2019 to much acclaim. The company will exhibit at SIIM 2019 at booth 607.

SIIM 2019 Annual Meeting set for Jun 26-28

What: SIIM 2019 Annual Meeting
When: Wednesday, June 26, 2019 to Friday, June 28, 2019
Where: Gaylord Rockies Resort & Convention Center Denver, CO
Register: www.siim.org

The Society for Imaging Informatics in Medicine (SIIM) is the leading healthcare professional organization for those interested in the current and future use of informatics in medical imaging. The society's mission is to advance medical imaging informatics across the enterprise through education, research, and innovation in a multi-disciplinary community. 

A major topic of the conference will focus on blockchain technology and what radiologists need to know about it.

Phillips acquires Carestream’s healthcare IT business

Philips will feature Carestream’s cloud-based 
enterprise imaging platform as part of its 
expanded portfolio – Photo courtesy Phillips
PARCA eNews – Mar. 7, 2019 – Royal Philips, parent of Phillips Healthcare, today announced that it has signed an agreement to acquire the Healthcare Information Systems business of Carestream Health Inc., a US-based provider of medical imaging and healthcare IT solutions for hospitals, imaging centers and specialty medical clinics.

“This acquisition will enhance our ability to provide flexible solutions to hospitals and health systems,” said Robert Cascella,

HSS agencies propose open access rules for patient health information

CMS and ONC rules align to advance interoperability

PARCA eNews – Mar. 21, 2019 – The U.S. Department of Health and Human Services (HHS) recently proposed new rules issued by ONC and CMS aimed at providing seamless and secure access, exchange, and use of electronic health information (EHI).

The ONC proposed rule is designed to increase innovation and competition by giving patients and their healthcare providers secure access to health information and new tools, allowing for more choice in care and treatment.

HiMSS19: Focus on unblocking patient information

PARCA eNews – Mar. 1, 2019 – The mammoth HiMSS19 annual meeting wrapped up Feb. 15, 2019 in Orlando, Fl with more than 43,000 attendees, 1200 vendors and a wide array of panel discussions and educational meetings. 

Key themes of the meeting continued from years past with unblocking patient information, interoperability, workflow, and technology to improve healthcare vying for the spotlight.

Shifting legal landscape for personal data privacy

Image courtesy NCSL
PARCA eNews – Feb. 8, 2019 – By an unanimous vote the New Jersey Assembly passed bill that expands the types of personal information that require notifications to be sent to consumers following a data breach.

The new law requires businesses and public entities to send notifications to consumers if there has been a breach of their Social Security numbers, driver’s licenses or a bank account number if they are accompanied with a password that would allow the account to be accessed.

A group of international radiology societies take aim at AI ethics

PARCA eNews – Mar. 1, 2019 – The American College of Radiology, European Society of Radiology, Radiology Society of North America, Society for Imaging Informatics in Medicine, European Society of Medical Imaging Informatics, Canadian Association of Radiologists, and American Association of Physicists in Medicine collaborated on a 34-page draft statement concerning ethical issues surrounding the use of AI in radiology.

The preliminary draft has not been endorsed by any of the sponsoring societies, rather the draft was published to spur debate and discussion among all interested parties, who are encouraged to submit comments by April 7, 2019.

Mobile devices and laptops continue to pose major cybersecurity risks for healthcare

PARCA eNews – Mar. 1, 2019 – A survey of company IT executives reveals that 33% of companies have suffered security breaches involving mobile devices, according to Verizon’s Mobile Sec Index 2019.

Overall, the report on all types of businesses show that security risks continue to rise while company defense implementations are failing to keep up. Focusing on mobile device security, 85 percent of organizations said they need to take mobile device security more seriously. 

FDA issues cybersecurity warning on Medtronnic ICDs

Image courtesy Medtronic Public

Warning highlights need for greater attention to medical device security

PARCA eNews – Mar. 21, 2019 – The FDA issued an alert Mar. 21, 2019 regarding cybersecurity vulnerabilities of a list of Medtronic implantable cardiac devices. Both implantable cardioverter defibrillators (ICDs and cardiac resynchronization therapy defibrillators (CRT-Ds) were identified in the alert.

Friday, February 1, 2019

Interoperability heavy weights join forces

 Updated 2/5/19
Last November Life Image and DICOM Systems announced a strategic partnership aimed at streamlining clinical content access within and across provider organizations and health systems. Life Image is the world’s largest global network for sharing clinical and imaging data. DICOM Systems is the leader in enterprise imaging interoperability and workflows. PARCA eNews spoke with Life Image CEO Matt Michela to learn more about the partnership and what it means to PACS administrators and healthcare IT professionals, and how it advances interoperability, and ultimately patient care.

Wednesday, January 30, 2019

HiMSS19 set to get underway Feb. 11-15

PARCA eNews – Jan. 21, 2019 – The annual conference of healthcare IT professionals is set for a four-day run at the Orlando-Orange County Convention Center in Orlando, Florida. 

The annual meeting brings together more than 45,000 professionals from healthcare IT, imaging, health information and technology to share and exchange information about how information technologies are transforming healthcare.

This year’s theme is Champions of Health Unite. The theme is intended to spur information professionals to think about the role they play in innovating and advancing healthcare safety, efficiency and quality of care.

Chain Reaction: How Blockchain Technology Brings Value to Healthcare

HiMSS symposium

PARCA eNews – Jan. 24, 2019 – What is blockchain and how might it be used in healthcare? 

If you are intrigued by the blockchain movement in healthcare, HiMSS is sponsoring a daylong symposium on the value blockchain may bring to healthcare.

The preconference symposium will be held, Feb. 11, 2019 at the Orlando-Orange County Convention Center.

Survey shows high cost of cyberattacks

PARCA eNews – Jan. 15, 2019 – The average cost of cyberattacks over the past two years topped $1.1 million, according to Radware, a cybersecurity provider.

The company issued its 2018-2019 Global Application and Network Security Report that shows for organizations that calculate (versus estimate) the cost of an attack, the average cost was $1.67 million. Most of that cost (54%) were in operational and productivity losses. The report also estimated the cost of negative customer experience.

HIPAA fines don’t stop with OCR

PARCA eNews – Jan. 15, 2019 While most of the new about fines levied against healthcare organizations focus on those imposed by the federal government’s Office of Civil Rights (OCR), the enforcement arm of the Department Health and Human Services, the fines don’t stop there.

First iPad Pro-based system for diagnostic reading of radiology images

PARCA eNews – Jan. 10, 2019 – EBM Technologies today announced that its vendor neutral, remote reading system Rad@ has been granted Class II FDA clearance for diagnostic reading of radiological images. 

This clearance has the potential to change the way radiologists work, freeing them from traditional fixed workstations and paving the way for greater work flexibility and financial efficiencies.

US Hospital increasing PACS installation with 3D image technology

PARCA eNews – Jan. 6, 2019 – More than 40 percent of US hospitals have installed radiology 3D image/display technology, a new survey by HiMSS Analytics has found.

In addition, adoption of 3D image/display technology nearly doubled between 2012 and 2017 and that number is expected to increase over the next few years, with nearly 50 US hospitals responding that they are very likely to purchase a radiology 3D image/display solution. The survey found that vendors Terarecon, GE Healthcare, and Toshiba dominate the market.

PACS still largest image management systems in global medical imaging market

PARCA eNews – Jan. 5, 2019 –The global medical image management market is expected to grow at a compound annual growth rate of 7.7% over the next six years, according to a report by ResearchAndMarkets.com

The review of medical imaging management systems found that PACS are widely adopted in radiology departments where the majority of imaging studies are handled, managed and stored. In addition there is an increasing incorporation of PACS into other specialties such as cardiology, ophthalmology, oncology, endoscopy, tele radiology, dermatology, pathology, neurology and dentistry