PACS Migration: A Complete Guide to Changing Systems Without Losing Studies or Interrupting Operations

Migrating a PACS involves much more than installing a new platform and moving images from one server to another. It requires preserving patients’ diagnostic histories, maintaining the relationship between studies and reports, rebuilding integrations, and ensuring that the radiology service can continue operating throughout the transition.

A poorly planned migration can result in incomplete studies, duplicate patients, hard-to-locate prior exams, performance issues, or workflow interruptions. By contrast, when the process is organized in stages, the institution can modernize its infrastructure without compromising access to clinical information.

A PACS migration is a technological, clinical, and operational project. Its success is measured not only by the number of files transferred, but also by the ability of professionals to correctly find, open, compare, and use studies in the new environment.

What Is a PACS Migration?

A PACS migration is the process of transferring medical images, studies, metadata, and other content from one picture archiving and communication system to a new platform.

It may be carried out when an institution replaces an obsolete PACS, changes providers, modernizes its infrastructure, adopts cloud storage, or needs to unify operations across multiple sites.

Depending on the existing architecture, the project may involve:

medical images;
patient data;
studies, series, and instances;
radiology reports;
associated documents;
key images;
annotations and measurements;
user settings;
access permissions;
acquisition modalities;
portals and external systems;
clinical and administrative integrations.

The objective is to ensure that the transferred information retains its clinical usefulness. Confirming that a file reached its destination is not enough: the study must be complete, linked to the correct patient, and available within the workflow.

To understand the role this platform plays in a healthcare institution, also read What Is a PACS in Radiology and How Does It Transform Your Institution’s Operations?.

Why Might an Institution Need to Change Its PACS?

The volume and complexity of medical images continue to grow. Infrastructure that worked properly several years ago may no longer meet the current needs of the service.

The need to migrate often arises when the PACS shows one or more of the following signs:

slow study opening or retrieval;
difficulty accessing the patient’s history;
storage capacity approaching its limit;
outdated infrastructure or complex maintenance requirements;
insufficient visualization tools;
lack of integration with other platforms;
excessive manual tasks;
difficulty working across sites;
limitations for remote work;
limited traceability of actions;
dependence on outdated components;
rising maintenance costs;
inability to support growth in studies or users;
insufficient support for the institution’s needs.

In some organizations, the problem is not concentrated in a single failure. The PACS continues to operate, but the workflow depends on increasingly complex processes: manual searches, multiple access points, additional servers, or constant intervention by the technology team.

In this context, continuing to expand the existing infrastructure may solve isolated difficulties, but it does not necessarily address the underlying cause of the problem.

Migration makes it possible to review the entire environment and determine which technology the institution truly needs for the coming years.

>> Is your current PACS limiting the growth of your service? Talk to a Pixeon specialist and assess the needs of your radiology operation.

Migrating a PACS Is Not Simply Copying Images

A medical image is not an isolated file. It is part of a structure that identifies the patient, organizes the exam, and maintains the relationship among all the elements that make up a study.

In simplified terms, the information can be organized into different levels:

Patient: the person to whom the information belongs.
Study: an exam performed on a specific date and within a specific context.
Series: a set of related images within the study.
Instance: each individual stored image or object.

A computed tomography study, for example, may contain different series and hundreds or thousands of instances. If part of this structure is lost or linked to incorrect data, the study may reach the new system but still be clinically unusable.

In addition, some content associated with interpretation is not always stored in the same repository. Reports may be stored on another platform, measurements may depend on the viewer, and certain documents may be retained outside the DICOM format.

For this reason, a migration must answer at least four questions:

What information exists?
Where is it stored?
How is it related to the rest of the data?
How will it be verified that it remains available after the change?

The project should not begin by moving files. It should begin by understanding the ecosystem to be migrated.

What Information Can Be Included in a PACS Migration?

The scope depends on each institution. However, the assessment should consider much more than the primary diagnostic images.

DICOM Images

These include objects generated by modalities such as radiography, computed tomography, magnetic resonance imaging, ultrasound, mammography, nuclear medicine, and other diagnostic areas.

Patient and Study Metadata

These are the data used to identify, search, and classify information, such as:

patient identification;
name;
date of birth;
medical record number;
study date;
modality;
exam description;
study identifier;
unique series and instance identifiers.

Consistency across these fields is essential to prevent a person from appearing more than once or a study from being linked to the wrong patient.

Radiology Reports

Reports may be:

embedded within DICOM objects;
stored on a reporting platform;
stored in a clinical or administrative system;
retained as PDF documents;
distributed across different databases.

Before migration, the institution must define the official source of the report and how its link to the images will be preserved.

Supplementary Objects and Documents

The archive may also contain:

DICOM Structured Reports;
key images;
presentation states;
secondary captures;
measurements;
annotations;
encapsulated documents;
non-DICOM studies;
videos;
files imported from external media.

Not all of these objects are transferred, interpreted, or displayed in the same way. Their compatibility must be verified before assuming that they will be available in the new PACS.

Settings and Integrations

The following should also be reviewed:

connected modalities;
AE Titles;
worklists;
routing rules;
users and profiles;
permissions;
portals;
reporting platforms;
clinical or administrative systems;
integrations with other systems used by the institution.

Depending on the existing architecture, these connections may involve an RIS, an HIS, an electronic health record, or proprietary or third-party platforms. Mentioning them as part of the institutional ecosystem does not mean that they are included in Pixeon’s portfolio available in Latin America.

Is It Necessary to Migrate the Entire Radiology History?

Not necessarily.

Moving the entire archive may appear to be the simplest option from a clinical perspective because it consolidates prior exams in a single environment. However, it can also increase the duration, cost, and complexity of the project.

Before making a decision, the institution should analyze:

the age of the historical archive;
total volume;
access frequency;
clinical relevance;
data quality;
retention policies;
requirements applicable in each country;
storage capacity;
connectivity;
the cost of maintaining the previous system;
the possibility of retrieving studies on demand.

For example, recent exams are generally accessed more frequently than exams performed many years ago. An institution could prioritize their initial transfer and temporarily retain the remainder of the history in an accessible archive.

However, a selective decision requires an answer to one fundamental question:

How will a professional access a study that was not included in the first stage of the migration?

Prior exams that have not been migrated should not become hidden, depend on informal searches, or require excessively slow processes.

What PACS Migration Strategies Are Available?

There is no universal strategy. The decision must be adapted to the volume of information, the infrastructure, the timeline, and the required level of continuity.

Strategy	How does it work?	Main advantage	Main challenge
Full migration	The entire historical archive is moved to the new environment.	Consolidates the information on a single platform.	May require more time, capacity, and validation.
Selective migration	Specific time periods, sites, modalities, or study types are moved.	Reduces the initial volume of the project.	Requires the non-migrated information to remain accessible.
On-demand migration	Prior exams are transferred when they are accessed again.	Prioritizes the studies that are actually used.	May cause delays during the first retrieval.
Hybrid migration	Combines an initial load with gradual or on-demand transfer.	Balances access, time, and resources.	Requires coordination of multiple retrieval routes.

Full Migration

It may be suitable when the archive is manageable, the institution needs to fully retire the previous system, or prior exams are accessed frequently.

Its main challenge is that the larger the volume, the more rigorous the inventory, transfer, and validation processes must be.

Selective Migration

It allows rules to be defined, such as:

studies from the most recent years;
priority modalities;
specific sites;
active patients;
studies relevant to certain specialties.

The criteria should be clinical and operational, not solely technical.

On-Demand Migration

In this approach, historical studies initially remain in their repository and are transferred when they are requested again.

It can reduce the volume of the first stage, but it requires a reliable connection between the previous archive and the new environment.

Hybrid Migration

It usually combines:

preloading of recent prior exams;
parallel operation;
progressive migration of the historical archive;
on-demand retrieval of less frequently accessed studies.

This option allows the project to move forward without waiting for the entire archive to be transferred, provided that clear controls identify which information is located in each environment.

How to Plan a PACS Migration Step by Step

Each project requires its own methodology, but ten stages can help reduce risks.

1. Form a Responsible Team

The migration should not be left exclusively to the technology department.

The team may include representatives from:

diagnostic imaging;
technology;
administration;
information security;
quality;
institutional management;
clinical users;
the source PACS provider;
the new platform provider;
integration teams.

Each area identifies different risks. Technology may confirm that the images arrived, while a radiologist may detect missing series or determine that comparison with prior studies is not working as expected.

The institution must also define who makes decisions when an exception arises.

2. Establish Objectives, Scope, and Success Criteria

Before starting, the institution must agree on:

which systems will be replaced;
which information will be transferred;
which information will be excluded;
which sites will participate;
which integrations must be rebuilt;
the planned transition date;
the required level of availability;
the conditions that will allow the change to be approved.

The objectives must be verifiable.

“Moving the archive” is too general. A more useful success criterion might be:

Authorized users can find, open, compare, and use the migrated studies in the new PACS, together with their related data and reports, within the defined operational timeframes.

3. Create an Inventory of the Current Environment

The institution needs to know what it has before deciding how to move it.

The inventory should include:

number of patients;
number of studies;
number of series;
number of images or objects;
storage volume used;
monthly or annual growth;
age of the historical archive;
modalities;
sites;
connected systems;
formats;
reports;
additional documents;
archiving rules;
access frequency;
available infrastructure.

Measuring only terabytes is not enough.

Two archives of the same size may require very different processes. One may consist of a few large studies, while the other may contain millions of small objects distributed across numerous series and patients.

4. Assess Data Quality

Systems used for many years often accumulate inconsistencies.

These may include:

duplicate patients;
- different identifiers for the same person;
- names entered in different ways;
- incomplete medical record numbers;
- incorrectly assigned studies;
- exams with insufficient data;
- damaged images;
- incomplete series;
- unlinked reports;
- private tags;
- fields that do not follow the expected structure.

These situations must be identified before or during the process. Migrating disorganized information without reconciliation rules may simply move the problem to the new platform.

5. Review DICOM Interoperability

DICOM makes it possible to produce, store, query, send, retrieve, and display medical images and other related objects. However, the fact that two systems claim DICOM compatibility does not mean that all their functions are automatically interoperable.

Each implementation may support different:

services;
objects;
modalities;
transfer syntaxes;
query levels;
optional fields;
behaviors;
security mechanisms.

For this reason, the DICOM Conformance Statements of both the source and destination systems must be reviewed.

These statements help explain which capabilities each platform supports, but they do not replace real-world testing.

6. Select the Migration Strategy

With the inventory and quality assessment complete, the institution can decide:

what to move first;
what to retain temporarily;
what to transfer on demand;
how to divide the process;
which modalities or sites to prioritize;
how long to keep both environments;
how to manage exceptions.

The strategy must also account for new studies generated while the historical migration is still in progress.

7. Prepare Infrastructure, Connectivity, and Security

The transfer must be sized according to:

information volume;
network speed;
available bandwidth;
latency;
peak usage periods;
source and destination capacity;
encryption;
access controls;
monitoring;
event logging;
retry mechanisms;
contingency plan.

A migration that consumes the full capacity of the network may affect other institutional operations. For this reason, it may be necessary to establish limits, transfer windows, or specific routes.

8. Run a Pilot Test

Before moving the entire archive, it is advisable to select a representative sample.

The pilot should include:

different modalities;
recent and older studies;
cases with many series;
studies with reports;
special objects;
different sites;
patients with extensive histories;
potential inconsistencies.

The test makes it possible to identify compatibility, performance, and quality issues while they can still be corrected without affecting the entire project.

9. Transfer, Monitor, and Reconcile the Information

During execution, each item should be classified as:

transferred successfully;
transferred with warnings;
rejected;
pending;
duplicate;
damaged;
incompatible;
excluded based on the defined scope.

There should not be a generic “error” category without additional information.

Reconciliation compares the source with the destination, identifies differences, and makes it possible to determine how each case should be handled.

10. Validate, Transition, and Monitor

Once the transfer meets the agreed criteria, the operational transition stage begins.

This phase may include:

routing modalities to the new system;
activating new integrations;
changing access points;
training;
user support and guidance;
enhanced support;
performance monitoring;
incident tracking;
temporary access to the previous environment.

The migration does not end on the go-live date. The institution must observe how the new environment performs during the first few weeks and correct any points of friction.

>> A secure migration begins before the first study is transferred. Request an assessment to learn how to prepare the evolution of your radiology environment.

PACS Inventory: What Must Be Known Before Moving Data

A complete inventory helps size the project and prevents new information sources from being discovered after the migration is already underway.

Volume and Structure

In addition to the space used, it is advisable to measure:

patients;
studies;
series;
instances;
reports;
associated documents.

These levels allow more precise comparisons after the transfer.

Modalities

All sources that generate or send images must be identified:

radiography;
computed tomography;
magnetic resonance imaging;
ultrasound;
mammography;
nuclear medicine;
cardiology;
endoscopy;
other connected modalities or areas.

Equipment that is used infrequently should also be included.

Growth

Knowing the current size is not enough. The institution must estimate how quickly the archive is growing and how much capacity it will need in the future.

Access Frequency

This information helps distinguish between:

frequently accessed studies;
historical prior exams;
information that could be stored in different tiers;
content that must be available immediately.

Integrations

It is necessary to document:

which systems send information to the PACS;
which systems query it;
how patients are identified;
where reports are generated;
which portals distribute results;
which processes depend on the current system.

A simple workflow diagram may reveal dependencies that were not visible when analyzing only the PACS.

Data Quality: The Problem Many Institutions Discover Too Late

The quality of the archive largely determines the complexity of the migration.

Duplicate Patients

The same person may appear under different identifiers because of system changes, registration errors, or differences between sites.

Without a reconciliation rule, prior exams may be split across different records.

Inconsistent Identifiers

Names may vary, but identifiers are the elements systems use to maintain relationships.

The institution should pay particular attention to:

Patient ID;
- medical record number;
- accession number;
- Study Instance UID;
- Series Instance UID;
- SOP Instance UID.

Unique identifiers should not be modified without a controlled strategy because other objects may reference them.

Incomplete Studies

A study may appear in the inventory even when series or images are missing. For this reason, the study count must be supplemented by a review of its structure.

Damaged or Inaccessible Files

Some objects may exist in the database but no longer be available in physical storage. Others may have become corrupted over time.

These cases must be documented transparently. A migration cannot automatically recover information that was already damaged at the source.

Private or Nonstandard Tags

Some manufacturers use private fields to store specific information. The new system may not interpret these fields in the same way.

Before removing or transforming them, the institution must assess whether they contain data required for visualization or the clinical workflow.

Reports Without a Clear Relationship

If the report is stored outside the PACS, the institution must define how to identify its corresponding study.

The date or patient name may not be sufficient. The link must be based on consistent identifiers and a clearly defined official source.

DICOM Interoperability: What Must Be Reviewed During Migration

DICOM is the international standard for medical images and related information. Its scope includes production, storage, query, retrieval, processing, and visualization.

During a migration, certain concepts are especially relevant.

AE Title

This is the logical identifier of a DICOM application within the network.

The modalities, source PACS, routers, and new system must be configured to recognize and communicate with one another correctly.

C-FIND

This service makes it possible to query what information exists in another DICOM application.

It can be used to search for patients, studies, series, or instances, depending on the supported model.

C-MOVE

This service makes it possible to request that an application send specific objects to another DICOM destination.

The application receiving the request initiates the operations required to transfer the identified objects.

C-STORE

This is the service used to send and store DICOM objects in another system.

During a migration, it may be used to transfer objects from the previous PACS to the new environment.

DICOM Conformance Statement

This document describes the capabilities an implementation declares that it supports.

Reviewing it makes it possible to compare:

services;
roles;
objects;
modalities;
transfer syntaxes;
expected behavior;
security and communication.

However, a statement alone does not guarantee that two systems will work correctly in every situation. It must be complemented by interoperability testing and real-world cases.

Patient Reconciliation

When identifiers change or duplicate records exist, the institution must define how to update the information without losing relationships.

This task requires coordination with the systems that manage demographic data and with institutional policies.

How to Transfer Large Volumes of Images

The transfer method depends on the archive size, connectivity, available time, and system capacity.

Network Transfer

Studies are sent electronically from the source to the destination.

It may be suitable when:

sufficient connectivity is available;
the volume is manageable;
the transfer can be carried out in stages;
new information must be synchronized.

It must be monitored to prevent it from competing with daily operations.

Dedicated Connection or Channel

For higher-volume projects, reserved network capacity may be used to reduce interference and improve predictability.

Transfer Using Encrypted Physical Media

For very large archives, the institution may consider a controlled export to storage devices followed by upload at the destination.

This method requires strict security, chain-of-custody, encryption, and validation protocols.

Hybrid Strategy

It may combine different mechanisms:

recent studies transferred over the network;
historical archive transferred in bulk;
incremental synchronization of new exams;
on-demand retrieval of specific prior exams.

The decision should not be based solely on theoretical speed. Retries, failures, processing capacity, and validation must also be considered.

How to Maintain Operational Continuity During Migration

An institution cannot stop providing care for weeks while it waits for the historical transfer to be completed.

Continuity must be designed from the outset.

Define a Transition Date

The cutover date establishes when the new PACS begins receiving production studies.

This does not mean that the previous system must be shut down immediately.

Maintain Temporary Access to the Previous PACS

For a controlled period, the previous system may remain available for consultation of prior exams that have not yet been migrated.

Its use should be monitored to identify which information is still needed.

Parallel Operation

During the transition, both systems may coexist:

the new system receives current studies;
the previous system retains part of the historical archive;
integrations are tested;
users validate the workflow.

The period should be long enough to reduce risks, but not so long that it creates an indefinite dual operation.

Contingency Plan

It should establish:

responsible parties;
communication channels;
priorities;
the procedure for studies that cannot be found;
actions in the event of network failures;
an alternative interpretation route;
conditions for stopping or reversing the change;
how incidents will be recorded.

Internal Communication

Users need to know:

when the transition will occur;
what will change;
where to find prior exams;
how to request assistance;
which system to use at each stage.

A lack of communication can cause errors even when the infrastructure is functioning correctly.

How to Validate That the Migration Was Successful

Validation must be quantitative, technical, clinical, and operational.

Quantitative Validation

It compares the source and destination based on:

patients;
studies;
series;
instances;
reports;
documents;
rejected items;
pending items;
duplicates.

A different count does not necessarily mean that the entire project failed. It may result from duplicates, agreed exclusions, or invalid records. The difference must be explainable.

Integrity Validation

It confirms that:

the images can be opened;
the series are complete;
the objects are not damaged;
the metadata were preserved;
the relationships between objects are valid;
the identifiers remain consistent.

Clinical Validation

The team that will use the system must participate.

Professionals should verify:

patient search;
study opening;
comparison with prior studies;
visualization quality;
series availability;
access to the report;
key images;
measurements;
post-processing tools;
response times.

Integration Validation

It must be confirmed that the following work correctly:

reception from modalities;
worklists;
reporting platforms;
portals;
clinical systems;
data updates;
results distribution.

Sampling-Based Validation

It is not always possible to review every image manually. Therefore, the sample must be representative and risk-based.

It may include:

all modalities;
different sites;
different time periods;
small and large studies;
cases with multiple series;
studies with special documents;
duplicate or reconciled patients;
cases that generated errors during the transfer.

Acceptance Criteria

Documented conditions must be in place before the previous system is deactivated.

For example:

critical integrations approved;
- pending errors within the agreed threshold;
- trained users;
- priority studies available;
- procedure for exceptions;
- active operational support;
- responsible parties authorized to approve the transition.

The decision should not depend solely on the statement that “the migration is complete.”

Common Errors When Migrating a PACS

1. Failing to Define the Scope

If the institution does not agree on what must be migrated, it will be impossible to determine whether the project was successful.

2. Measuring Only the Volume in Terabytes

Size does not reflect the number of studies, objects, or relationships that must be processed.

3. Assuming That the Archive Is in Good Condition

Historical issues often emerge during the transfer. Quality must be assessed beforehand.

4. Ignoring Reports

The images may be complete and still lose part of their clinical context if the report is not available.

5. Overlooking Non-DICOM Content

Videos, PDFs, documents, captures, measurements, or other objects may require different handling.

6. Relying Only on the Study Count

Two systems may show the same number of studies even when some series or images are incomplete.

7. Failing to Run a Pilot

The initial test makes it possible to correct issues before they affect the entire archive.

8. Shutting Down the Previous PACS Too Soon

The source system should remain available until validation is complete and the agreed exceptions have been resolved.

9. Overlooking Integrations

The new PACS may store information correctly, but the workflow will remain interrupted if modalities or external platforms cannot communicate with it.

10. Underestimating Connectivity

Speed, latency, and everyday network usage affect the actual transfer time.

11. Failing to Involve Users

A technically correct migration may fail operationally if professionals cannot find the information or do not understand the new workflow.

12. Failing to Document Exceptions

Damaged, incompatible, or excluded studies must be recorded and assigned a defined treatment.

13. Migrating Everything Without Assessing Its Value

Moving unnecessary or duplicate information can increase complexity without improving care.

14. Reproducing the Same Previous Workflow

A migration is an opportunity to correct problems, not merely move them to a new platform.

PACS Migration and DICOM Cloud Storage

DICOM cloud storage may be part of a modernization strategy, but it should not be confused with the complete migration process.

It can help to:

expand storage capacity;
reduce dependence on local physical infrastructure;
organize recent and historical studies;
support volume growth;
define archiving policies;
facilitate access across sites;
keep prior exams available to the PACS.

However, several concepts must be distinguished.

Storage

This refers to where images and other objects are retained.

PACS

It manages functions such as the reception, organization, visualization, query, and distribution of medical images.

Backup

It maintains copies intended to recover information after specific incidents.

Disaster Recovery

It defines how systems, information, and operations will be restored after a serious disruption.

Using cloud storage does not automatically mean that a complete backup or recovery plan is in place. Each strategy requires its own objectives and controls.

Aurora Drive is Pixeon’s solution for complementing the radiology ecosystem through DICOM image storage in the cloud. It supports the growth of the historical archive and the application of storage policies without requiring constant expansion of local infrastructure.

To explore this topic in greater depth, read:

Migration as an Opportunity to Redesign the Radiology Ecosystem

Replacing the PACS should not mean reproducing exactly the same workflow on a new platform.

The institution can use the project as an opportunity to review how the following stages are connected:

image acquisition;
reception and organization;
visualization;
comparison with prior exams;
report production;
task distribution;
storage;
remote access;
results delivery;
collaboration among sites and specialists.

When these stages are fragmented, delays, duplicate tasks, loss of traceability, and difficulty accessing the patient’s complete context may arise.

A connected operation allows the image, history, and report to move through the same workflow.

Pixeon Aurora PACS

Pixeon Aurora PACS makes it possible to manage the capture, visualization, interpretation, and distribution of medical images.

Its features include:

access to the patient’s history;
comparison with previous studies;
post-processing tools;
resources for different specialties;
digital distribution;
continuous evolution of features.

Reporting Center

Pixeon’s Reporting Center is a cloud-based platform integrated with the PACS for creating, managing, and delivering radiology reports.

It offers features such as:

voice recognition;
templates;
inclusion of key images;
configurable worklists;
distribution of studies among professionals.

Aurora Drive

Aurora Drive complements the environment with scalable DICOM image storage in the cloud.

The combination of these solutions connects:

image visualization and management → report production → historical archive storage

The appropriate architecture will depend on the volume, modalities, sites, connectivity, and workflows of each institution.

The migration must begin with an assessment of these needs rather than an isolated technology decision.

To understand how these stages are connected, read How to Connect PACS, Reporting, and Storage to Improve the Radiology Workflow.

>> Discover how Pixeon Aurora PACS, the Reporting Center, and Aurora Drive can help your institution evolve toward a more integrated, scalable radiology operation that is prepared for growth. Request a demonstration with our specialists.

Checklist for a Secure PACS Migration

Before starting, verify whether your institution can answer the following questions:

Scope

Has the information to be migrated been defined?
Has the content that will be excluded been identified?
Have the success criteria been agreed upon?
Are responsible parties assigned to approve the transition?

Inventory

Is the number of patients, studies, series, and images known?
Has archive growth been measured?
Have all modalities and sites been identified?
Have reports and associated documents been located?
Have the integrations been documented?

Quality

Have duplicate patients been analyzed?
Have inconsistent identifiers been reviewed?
Have incomplete or damaged studies been detected?
Has the handling of private tags and exceptions been defined?
Has the official source of the reports been identified?

Interoperability

Have the DICOM Conformance Statements been reviewed?
Have compatible services, objects, and syntaxes been verified?
Has a real-world test between the systems been performed?
Have special and non-DICOM contents been tested?

Execution

Has a migration strategy been defined?
Has a pilot been run?
Have transfer windows and limits been established?
Is there a detailed record of errors and pending items?
Has the synchronization of new studies been planned?

Continuity

Has the transition date been defined?
Will the previous PACS remain temporarily available?
Is there a contingency plan?
Do users know how to request assistance?
Have alternative routes been defined for incidents?

Validation

Will studies, series, and instances be compared?
Will radiologists and end users participate?
Will the integrations be validated?
Will performance be tested?
Has the point at which the previous system can be deactivated been documented?

If several of these answers are still unclear, the institution needs to deepen its planning before beginning the transfer.

Conclusion

Migrating a PACS means moving much more than images.

The process must preserve the diagnostic history, maintain relationships among the data, rebuild integrations, and ensure that professionals can continue working throughout the change.

When migration is approached solely as a transfer task, essential aspects may be overlooked, including archive quality, access to prior exams, reports, interoperability, and the user experience.

By contrast, a planned strategy makes it possible to:

understand the current environment;
define which information has value;
reduce risks;
maintain continuity;
validate clinical usefulness;
correct historical limitations;
prepare the operation for growth.

The final objective should not be simply to install another PACS.

It should be to build an environment in which images, reports, and the historical archive are better connected, available, and prepared to support the institution’s evolution.

Frequently Asked Questions About PACS Migration

What Is a PACS Migration?

It is the process of moving medical images, studies, metadata, reports, and other content from one PACS to a new platform. The objective is to preserve the radiology history and keep clinical information available during and after the change.

Why Might an Institution Need to Change Its PACS?

An institution may consider a change when the current PACS has performance problems, integration difficulties, storage limitations, dependence on obsolete infrastructure, or insufficient capacity to support growth in studies, users, and sites.

Does Migrating a PACS Consist Only of Copying Images?

No. In addition to the images, the relationships among patients, studies, series, instances, identifiers, and reports must be preserved. Integrations, permissions, and workflows must also be rebuilt.

Is It Necessary to Migrate All Historical Studies?

Not necessarily. The institution may choose a full, selective, on-demand, or hybrid migration. The decision depends on volume, access frequency, clinical needs, archive quality, and retention policies.

Can a PACS Be Migrated Without Stopping Radiology Operations?

Yes. A phased strategy may include preloading prior exams, incremental transfer, parallel operation, and a planned cutover date. A contingency plan must also be in place to resolve incidents.

How Long Can a PACS Migration Take?

It depends on the number of studies, total volume, data quality, connectivity, modalities, integrations, and the selected strategy. Each project requires a specific assessment.

How Can the Institution Verify That No Studies Were Lost?

Validation must compare patients, studies, series, instances, reports, and documents between the source and destination. Clinical and functional tests must also be performed across different modalities, sites, and time periods.

What Happens to Radiology Reports During Migration?

The institution must determine where they are stored, their format, and how they are linked to the images. It must also define the official source of the report and whether it will be transferred or remain available through an integration.

Does DICOM Compatibility Between Two Systems Guarantee the Migration?

No. DICOM facilitates information exchange, but the capabilities of each implementation may vary. The Conformance Statements must be compared, and real-world interoperability tests must be performed.

What Happens to Incomplete, Duplicate, or Damaged Studies?

They must be identified, documented, and handled according to previously defined rules. The migration can also be used to reconcile duplicates and improve archive quality, although it cannot recover information that was already damaged at the source.

Does a PACS Migration Necessarily Mean Migrating to the Cloud?

No. It can be carried out to another local environment, a hybrid architecture, or a cloud-based solution. The appropriate option depends on the infrastructure, connectivity, institutional policies, and project objectives.

Does DICOM Cloud Storage Replace the PACS?

Not necessarily. The PACS manages the reception, organization, visualization, and distribution of images, while a DICOM cloud storage solution can complement the environment with scalable capacity for retaining the historical archive.

When Can the Previous PACS Be Deactivated?

After validating the transferred information, confirming the integrations, resolving critical pending items, and verifying that users can access the necessary prior exams. There must also be a strategy for any content that was not migrated.

Who Should Participate in a PACS Migration?

Representatives from radiology, technology, management, information security, and clinical users should participate, together with the providers responsible for the source, destination, and integrations.

What Other Pixeon Content Can Help Modernize Radiology Operations?

To explore PACS operation, report production, DICOM storage, and radiology workflow integration in greater depth, read the following content:

About Pixeon

We are the company with the largest software portfolio for the healthcare market.

Our solutions serve hospitals, clinics, laboratories, and diagnostic imaging centers in both management (HIS, CIS, RIS, and LIS) and the diagnostic process (PACS and laboratory interface), ensuring greater efficiency and high performance for healthcare institutions.

Our Pixeon Aurora PACS has been recognized four times by KLAS Research. In addition, our diagnostic medicine management system, Pixeon Korus, serves nearly 2 million patients and processes more than 9 million exams annually.

More than 3,000 clients in Brazil, Argentina, Uruguay, and Colombia already trust our technologies. Request commercial contact and discover everything our PACS can do.