PACS software and DICOM viewers for Indian hospitals and imaging centres

How a PACS system works

Modalities send images using the DICOM standard to the PACS server, which indexes them by patient and study. Radiologists open studies in a diagnostic viewer with measurement, windowing, MPR and comparison tools, while clinicians use a lighter web viewer. The archive keeps images for the retention period you set and moves older studies to cheaper storage. A RIS or HIS supplies patient details and receives the report.

Cloud PACS vs on-premise PACS

• On-premise: local servers, fast viewing inside the building, you manage hardware and backups
• Cloud: no servers to maintain, easy multi-centre and teleradiology access
• Cloud depends on upload bandwidth, which matters for large CT and MRI studies
• Hybrid: local cache for speed with cloud archive for backup and remote access
• Check data hosting location, encryption and who can access studies
• Plan how studies are exported if you change vendors

What to look for in PACS viewer software

• Zero-footprint web viewer that works on browsers and mobiles
• Diagnostic tools: MPR, MIP, 3D, measurements, hanging protocols
• Prior study comparison and key image marking
• Fast loading over typical Indian broadband
• Secure sharing links for referring doctors and patients
• Support for all your modality types, including mammography if needed

India-specific considerations

Many Indian centres depend on teleradiology, so remote access and bandwidth efficiency matter as much as viewer features. Hospitals should integrate PACS with the HIS so images open from the patient record and appear in insurance or PM-JAY claim documentation when needed. Ask whether reports and images can be shared with patients digitally, including through ABDM-linked records, and confirm how long studies are retained and at what storage cost.

Migrating to a new PACS

Migration means moving historical DICOM studies, which can be large; plan it in phases, starting with recent studies. Verify patient IDs are clean before migrating, because duplicates multiply. Reconfigure each modality to send to the new PACS, test worklists and viewing, and keep the old archive readable until migration is verified. Free open-source tools such as Orthanc and OHIF are useful for testing but still need someone to host and secure them.