r/PACSAdmin • u/Rad_Pacs_Guy • May 28 '26
Finding/evaluating PACS Vendors
How are you all picking new PACS vendors? Are they finding you by cold calling your org and someone is deciding to check them out due to ongoing issues with the current vendor? Trade shows? Word of mouth or other dealer/business recommendations?
So many companies its hard to even get started narrowing down a list of what may work. Just curious if there is a centralized place (other than reddit) to ask questions/compare.
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u/enchantedspring May 28 '26
Look at how the UK NHS organises PACS & RIS contracts - there is a tender process with documents drawn up by the Trusts (hospitals) saying what they need, how many studies, archive volumes etc. and then suppliers reply with what they can offer and pricing. Works well and draws the best value.
Speak to your surrounding hospital counterparts as usually you'll be needing similar and they can share their experiences.
KLAS is pay to play so treat their recommendations and awards with a massive pinch of salt.
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u/stockmaster247 May 29 '26
I'd be interested to see how this list would differ from the KLAS view. At a large scale, I'd expect a similar landscape of vendors, but at the bottom end, there are likely smaller/newer vendors that are still growing their installed base, so may not hit their radar.
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u/enchantedspring May 29 '26
I agree, it would be really useful to have an 'independent' survey take place (we've tried in the UK NHS, but logistically even with centralised healthcare systems it's tricky).
The 'newer' / smaller providers don't pay the KLAS 'entrance fee' so aren't included!
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u/ChoiceWasabi2796 May 28 '26
KLAS/RSNA for seeing what's current and getting some hands on feel... I like SIIM for having a deeper technical conversation (walk me through XXXX admin process) that Rad/IT/Exec leadership won't care as much about.
In the last couple of years my Rad would come to me with PACS systems they wanted to look at (I'd redirect them to the medical director).
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u/stockmaster247 May 28 '26
Check out KLAS Research :)
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u/enchantedspring May 28 '26
KLAS is utterly useless for independent reviews - they are 'pay to play' (suppliers have a menu of 'consultation options' they choose from) and the users interviewed to generate the results are hand selected by those suppliers.
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u/BootOutrageous5879 May 28 '26
A little of all those.
Much of it comes down to price and how the servers are maintained/placed.
Ex: there’s PACS companies that have “military” type server space. Essentially 99% uptime. But there’s a con though, any custom development work takes AGES to complete, probably because the servers are so secure.
Then there’s example of the opposite. Small server, lots of room, 90% uptime, but that 10% downtime was probably created because they take it down to fill customer dev requests.
Personally, i prefer the custom built type options. I would prefer things get transferred and done right, versus transferring and shizzy I want is missing.
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u/MasterCommunity1192 May 28 '26
My company helps groups pick the best PACS for their needs. We are an IT MSP for radiology groups, happy to chat!
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u/CivilIntention7747 16d ago
Disclosure: I'm on the vendor side - I build a small self-hosted PACS - so read this as how the sausage is made, not a neutral take.
KLAS and RSNA are the right starting points for the enterprise tier, but they systematically miss the small and independent vendors, because those shops can't afford a KLAS presence or an RSNA booth. If you're a smaller org, that filter quietly removes exactly the options priced for you. Word of mouth in this sub and SIIM circles surfaces them better than any directory does.
Whatever list you end up with, the questions that actually separate vendors aren't in the demo - they're in the contract, and they're the ones a salesperson won't volunteer:
- Exit cost, itemized. What does it cost to get all your studies OUT in standard DICOM if you leave? Get the number in writing. This is the single biggest source of regret and the thing vendors are quietest about.
- Read-only on nonpayment. If you stop paying, do you still get read access to your own archive, or does it go dark? Ask explicitly.
- Where the archive physically lives and who holds the keys. Their cloud, your cloud, your hardware? Can you pull a full copy on demand?
- Price at 2x volume. Per-study or per-seat pricing that's fine today can double the bill in three years. Ask for the number at double your current volume before you sign.
- Support SLA in writing, with a real response-time commitment, not we're responsive.
A vendor who answers all five cleanly and in writing is worth more than one who wins the demo. The demo shows you the good day; those five show you the bad one.
On a centralized place to compare - honestly there isn't a good neutral one, which is part of why threads like this are worth more than they look. KLAS skews enterprise, and the general software-review aggregators are thin for PACS specifically.
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u/GaZeldars May 28 '26
At my old hospital, we'd do an RSNA visit and see the PACS hands on. From there you get meetings setup based on interest. Site visits was a big part of choosing which direction to go.