The promise of picture archiving and communication systems (PACS) is, as yet, unrealized. Manufacturers provide what they can make rather than what radiologists and clinicians need. A failure to understand that a PACS is merely a tool in the health care enterprise, not an end in itself, has stifled development. The problem is compounded by a misunderstanding of the role of technology in personal services and the application of an erroneous analogy to productivity growth in the larger economy. Only by focusing on the goals of a radiology department-patient care and physician service-can radiologists overcome these difficulties and use PACS technology advantageously. The interaction between the system and its users must be the primary emphasis.Technology has evolved a great deal in the past several years, but humans have not changed for millennia. Significantly, each of the components of the telecommunication and information processing revolution of the past two decades has been available for quite a long time, but their efficiency has improved greatly. Permanent storage media were achieved with stone and clay tablets [1].
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