The PACS Workstation: A Theory of Evolution

David Weiss, MD


Appl Radiol. 2008;37(8):24-29. 

In This Article

Future Design

Scientists and engineers at Intel are excitedly anticipating the Era of Tera. New hardware and software developments will allow terabyte per second bandwidth and teraflop per second performance. The implications of these advancements on end-user functionality are obvious. More robust computing power will allow faster reconstruction for advanced visualization with the capability of even thinner clients for enterprise distribution of volume image rendering and manipulation.

The concept of pervasive computing is also anticipated. This will allow wireless access to powerful server technology anywhere within the geographic confines of a healthcare facility. A hand-held intuitive user-interface device will navigate images on existing monitors orperhaps will project images onto a wall or screen anywhere in the enterprise and beyond. This degree of mobility, with automated biometric security, will allow all healthcare providers instant access to images and data with minimal geographic restrictions.

The user interface, graphic and mechanical, will become more critical as users have more access to images and data. Current PACS software was designed around the already antiquated keyboard/mouse combination. The marvelous mechanics of opposable thumbs, a gargantuan genetic advantage shared by few other species, is being sorely underutilized with such conventional hardware. The alternate mechanical user-interface devices currently being used are an improvement but are ultimately a retrofit to this arguably flawed software. The innovative designers at Apple have taken a step in the right direction with the iPod, an elegant design that simultaneously marries conceptually new hardware and software. Microsoft has progressed similarly with its Surface computer interface, a completely smooth horizontal surface that responds to touch and placement of other devices. This and the newer iPhone interface might seem ideal for PACS use, but this may not be the case. Our workflow requires our eyes to be riveted on the images and not on the interface. Haptic feedback is still needed in any combination of graphic and mechanical user interface for radiology; however, the concept itself–that of combined and simultaneous softwareand hardware design–should still be emulated within our own industry.

With these hardware and software technology advances, it is likely that radiologists will spend more time in image viewing and less in other tasks. The frailty of our own bodies may very likely become the limiting factor in maximizing efficiency. For some time,researchers have been interested in minimizing the physical and mental impact of the daily interpretation of thousands of images–asituation in which the implications of an error could not be greater.[9,10]Like a baseball player at the end of a long season, the wear and tear on our bodies and minds is taking its toll.[11]Attention to such details as lighting, temperature control, background noise, and proper body position will be an increasing factor in workstation and reading room design.


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