EHR-PACS Integration: Why we're struggling to connect healthcare records and medical images

Electronic Health Records (EHR) and Picture Archive and Communication Systems (PACS) have followed very different paths resulting in structures that inherently don’t play well together. In fact, the original development of the first EHR and PACS were separated by over twenty years and several technological generations.

EHR systems are predominately built to manage textual records like doctor’s notes, patient demographics, and vitals. They don’t lend themselves to complex data sets like medical images. Some EHR vendors have tried to shortcut the distance between the two by attaching picture files like JPEGs or BMPs right into their patient records, ignoring PACS functionality designed specifically to manage medical imaging studies.

Many PACS vendors are opposed to the regulations laid out by meaningful use on link- ing medical imaging systems with EHRs be- cause it has been exceedingly difficult for PACS to communicate with each other, let alone to an EHR.

Yet there is a straightforward method of meaningfully integrating EHRs and PACS: simply link records using common elements like patient IDs or encounter numbers (also referred to as accession numbers). Once you get past all the rhetoric and political posturing, linking medical images and patient records can be accomplished.