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All the Differences Between RIS,

PACS, DICOM, and CIS

Within the healthcare environment, there are several

medical workflow management systems that are employed
on a daily basis. Many, if not all, are frequently found in
radiology practices and departments. Understanding RIS,
PACS, DICOM®, and CIS systems, the differences
between them, and how they work, individually and
collaboratively, requires a solid base of knowledge of each
system’s definition, their most prevalent usages, along with
the key benefits and advantages in their implementation.
Psst! Been hearing about the consolidation and seamless
connectivity of an Imaging EMR and how it can foster
patient-centric care and democratized healthcare? Learn
more about Imaging EMRs here.
Four of the most leveraged radiology systems include RIS,
PACS, DICOM, and CIS, which will be discussed in detail
within this blog through these questions:
What is RIS? Radiology Information System

What is PACS? Picture Archiving and Communication System

What is DICOM? Digital Imaging and Communications in Medicine

What is CIS? Clinical Information System

Ready to take the leap into the illuminating world of RIS,

PACS, DICOM, and CIS and identify the difference
between the systems.

What is RIS?

A Radiology Information System (RIS) is a root system

used for electronic management by imaging departments.
A RIS is a radiology-specific software solution geared to
procuring, storing, and sharing medical imaging data and is
used extensively throughout the healthcare sector.
Designed to optimize efficiency of radiology workflows, a
RIS can be used in conjunction with a Hospital
Information System (HIS) and/or Picture Archiving
and Communication System (PACS).
 RIS in the Hospital System

RIS is effectively used in hospitals for the tasks below:

 Patient Scheduling and Tracking – With a RIS, clinicians
can easily access patient medical histories, track treatment
statuses, process patient registrations as well as organize
appointment scheduling. Time-savings are considerable
with the reduction of paper-based documentation and a
simplified, automated booking process that a RIS can offer.
 Document Management – Since a RIS system is
constantly updated, patient data integrity is assured and
always ensures patient files are readily accessible when
needed by clinician teams. Interactive documents can also
be generated in a RIS which contributes to enhanced inter-
physician communication and more timely diagnosis
facilitation.
 Image Identification – A RIS system ensures patient data
is correctly attributed to the appropriate corresponding
images generated thereby allowing for easy identification
while minimizing the risk of study mix-ups.
 Billing and Reporting – A RIS plays a key role in
optimizing radiology-centered billing and reporting by way
of storing financial records, facilitating data analytics,
automating billing, and processing electronic payments.
 Modality Interfacing – Worklist utilization and modality
intercommunication is made more seamless in a RIS which
translates to faster processing of medical images and
superior quality control.

Together, the above RIS functions work to cultivate

streamlining the radiological diagnostic process towards
reducing waiting times, improving accuracy, and thereby,
foster the delivery of consistent, responsive patient care.
Let’s look more in-depth at the advantages that can be
expected from the application of a RIS:

The Benefits of a RIS

On the whole, the immediate benefits of utilizing a RIS

all culminate in a faster, more reliable way of
handling patient information — the process of
diagnostics is enhanced, risk of staffing shortages is
diminished, and data entry errors are tremendously limited
to include just a few!
A RIS can be essential towards providing a seamless,
comprehensive service model for patient care. RIS imaging
can be a profound asset in decentralizing radiology delivery
from expediting physician work and augmenting inter-
physician communications to enabling real-time patient
tracking towards better workflow management, all
resulting in quicker diagnoses. Innovations from using a RIS
allows a radiology practice to devote their focus to what
matters most: patient care delivery.
On the administrative side, by streamlining operational
procedures and implementing time-saving digitization of
paperwork, RIS systems can make things so much simpler
for a healthcare provider’s administrative team. This
includes managing supply budgets as well as radiology-
related materials.
And finally, cost reduction. All benefits as outlined above
contribute to increased revenues and a “healthier” bottom
line.

What is PACS?

Picture Archiving and Communication System

(PACS) is a medical imaging technology that provides data
storage and convenient image access from multiple
modalities. It is a common software solution used
predominantly by hospitals and healthcare organizations.
Built for to securely store and transmit electronic patient
images and data, a PACS system eliminates the need for
traditional methodologies involving manual file
management (e.g. film jackets) and delivery.
Though radiologists have been the main users of PACS
systems, as well as being leading generators of x-ray
images, PACS has also been implemented into other
health-related fields including cardiology, oncology,
dermatology, pathology, and nuclear medicine imaging. In
light of its prolific usage, a PACS is designed to handle
image formats produced from a wide variety of modalities
such as mammograms (MG), magnetic resonance (MR),
ultrasound (US), computed tomography (CT), and digital
radiography.
By leveraging a PACS, clinicians can easily access their
patient information digitally. Digital access signifies
accelerated and improve care, minimized chances of
treatment and prescription errors, in addition to the
circumvention of unnecessary testing performed.
DICOM, a worldwide-recognized standard protocol for the
administration and transmission of medical images and
data, is responsible for the present-day application of
PACS.

What is DICOM?

Digital Imaging and Communications in Medicine

(DICOM) is the globally recognized communication and
management standard for medical images and other
patient data. It is frequently utilized throughout the
medical field to store and transmit medical images
facilitating integration with medical devices and PACS
systems. Its broad clinical adoption includes hospitals,
radiology practices, and most recently, in doctors’ and
dentists’ offices.
 DICOM Standard
DICOM® is the global standard for medical imaging
transmission and storage. Since its establishment in 1993,
the DICOM standard has been the touchstone in the
transformation of the radiological practice from x-ray film
to a digitized workflow. The published standard, whose
copyright is held by The National Electrical Manufacturers
Association, was developed by the DICOM Standards
Committee (which consisted of many NEMA members).
DICOM is recognized as the ISO standard 12052.
DICOM Image
DICOM exists as both a communication protocol as well as
a format type. Saving medical images under the format
safeguards that all the data relating to a particular study
(i.e., patient information, medical image, etc.) remains
together, allowing for seamless transmission between
DICOM-compatible devices translating to easier patient
data sharing between clinicians and a quicker diagnostic
process.
DICOM File
A file is an image saved in the DICOM format. Within it, a
medical image generated from a modality (e.g., MRI,
scanner, ultrasound, etc.) is enclosed, along with metadata
tags. DICOM files are organized hierarchically as follows:
 Patient – A person or animal
 Study – A group of related imaging procedures
 Series – A single series of images, captured sequentially

How to View, Download, and Share DICOM Files?

DICOM files and images are generally saved with either a
DCM30 (DICOM 3.0) or DCM file extension however, some
may have no extension attributed. Stored DICOM files can
be viewed using a DICOM Viewer. The process of retrieving,
sending, and downloading files depends upon the design of
the DICOM Viewer being used.
PACS vs. DICOM?

The difference between PACS and DICOM is that PACS is a

medical image storage and archive hub, fed by
medical modalities such as X-ray scanners and MRI
machines, while DICOM represents the international
communication standard – not a device or structure –
used by healthcare professionals in storing, processing,
transmitting medical images and data.

Curious about the DICOM compliance of RamSoft’s

products? View our conformity statement.

What is CIS?

A Clinical Information System (CIS) involves networked

software solutions working together within a radiology
practice such as a RIS and electronic health record system.
Geared specifically towards clinical care usage (e.g.,
 Intensive Care Units), a CIS is an information system
networks with computer systems utilized in various
departments present-day hospitals. These departments
include cardiology, radiology, and pathology. A CIS gathers
patient data and transfers it into an electronic record which
an attending clinician can access while visiting the
patient’s bedside.
Through the healthcare organizations are aptly supported
in their operations, policy implementation, and patient data
stewardship

To understand why a CIS is an essential tool in the

provision of optimal patient care, let’s examine how the
ways it benefits both patient and clinicians. Leveraging a
CIS enables:
 Enhanced communication between the patient and their
healthcare teams as well as among the healthcare
professionals themselves
 Comprehensive knowledge transference to ensure
clinicians can make informed, sound decisions
 The facilitation of easy patient access to x-ray and scans
when required
 Effective quality improvement of care administration
and delivery
 An open door to advanced clinical research

Note: ‘Clinicians’ refers to care givers providing direct care

such as doctors and nurses. The term also incorporates
therapists, clinical psychologists, endoscopists, clinical
pharmacists, interventional radiologists, dietitians,
optometrists, clinical microbiologists, audiologists, etc.
Since a CIS captures and processes all relevant medical
information electronically, the need for paper-based
documentation is reduced, data entry errors are
diminished, ultimately resulting in considerable time (and
cost!) savings for healthcare organizations.
Thereby, providing positive impacts to the quality of
patient care being delivered.

In Review

As with everything, all things must come to an end!

Throughout this blog, we have studied the definitions of the
RIS, PACS, DICOM, and CIS systems as operating within the
healthcare background. Plus, we reviewed some top
benefits and advantages and use cases for each, while
having delved into a pointedly focused difference between
RIS, PACS, DICOM, and CIS.
Due to the inherent innovation built into each of these and
other systems, many healthcare organizations experience
superlative efficiency and operations with their workflows
every day. This enhancement of the diagnostic and
administrative processes has a direct correlating effect on
enabling these organizations to responsively meet the
needs of their patient base towards capably providing best-
value, consistent care.