The Real Cost of Your PACS: Why Your CFO, CIO, and COO Are All Solving the Same Problem

In leadership meetings across the country, a familiar scene is playing out. The topic is the Picture Archiving and Communication System (PACS), and everyone at the table has a different, pressing concern.

The Chief Financial Officer (CFO) sees a recurring, multi-million dollar capital expense that disrupts the budget. The Chief Information Officer (CIO) sees a growing security risk, a system becoming harder to defend. The Chief Operating Officer (COO) sees a bottleneck, a drag on the efficiency of the entire clinical team.

Each perspective is valid. Each problem is urgent. But they are not separate issues.

They are symptoms of a single, underlying problem: a traditional, on-premise imaging infrastructure that is no longer fit for purpose. It’s time to stop having three different conversations and start a unified one.

For the CFO, a legacy PACS represents financial volatility. The business is locked into a costly and unforgiving hardware refresh cycle every five to seven years. This isn’t a minor expense; it’s a massive capital expenditure (CapEx) that can derail other strategic investments.

Beyond the refresh cycle, there are the relentless operational costs: steep annual maintenance contracts, power and cooling for the data centre, and the specialised IT staff required to manage the complex hardware. Budgeting becomes a reactive exercise, making it nearly impossible to achieve predictable operational expenses (OpEx). The system isn’t just a tool; it’s a significant and unpredictable financial liability.

For the CIO, that same on-premise hardware represents an entirely different set of challenges. The infrastructure is a growing security risk. As hardware ages, it becomes more vulnerable to sophisticated cyber attacks, and patching legacy systems is a defensive game that gets harder to win every year. Protecting patient data becomes a constant battle against obsolescence.

Compliance is another significant burden. Adhering to evolving data security and privacy regulations requires constant attention and investment. Furthermore, disaster recovery for on-premise systems is often complex, expensive, and difficult to test effectively, posing a real threat to business continuity in the event of a failure or unforeseen event.

While the CFO and CIO focus on financial and security risks, the COO and Chief Medical Officer (CMO) live with the daily performance consequences. A slow, cumbersome PACS creates workflow inefficiencies that ripple across the organisation. Radiologists face diagnostic delays, referring physicians wait for critical images, and patient throughput is negatively impacted.

This operational drag leads to clinician burnout and frustration. It also stifles innovation and growth. Expanding services to new locations or launching a modern teleradiology program becomes a monumental technical challenge, if not an impossibility. The technology, meant to enable care, becomes a barrier to providing it effectively.

The breakthrough happens when these leaders realise they aren’t fighting separate battles. They are all wrestling with different heads of the same beast.

The CFO’s budget-breaking CapEx is for the same hardware the CIO struggles to secure. The operational bottlenecks frustrating the COO are caused by the same outdated technology that worries the CIO.

The moment this connection is made, the conversation shifts. It moves from departmental problem-solving to enterprise-level strategy. The question is no longer just “How do we fix the PACS?” but rather, “How do we adopt an imaging strategy that delivers financial predictability, robust security, and operational excellence?”

The answer does not lie in another round of hardware refreshes. It lies in fundamentally changing the model. A modern, cloud-native platform provides the unified solution that addresses every stakeholder’s concerns simultaneously.

The answer does not lie in another round of hardware refreshes. It lies in fundamentally changing the model. A modern, cloud-native platform provides the unified solution that addresses every stakeholder’s concerns simultaneously.

• For the CFO: Financial Predictability. The entire cost structure moves from unpredictable CapEx to a simple, scalable, pay-as-you-go Operational Expense (OpEx). You pay only for the storage and services you use, making costs predictable and manageable.
• For the CIO: Proactive Security. Security and compliance are built-in, not bolted on. Leveraging the world-class security posture of AWS, data is protected by a global team of experts, and the platform is always up-to-date, eliminating the risk of technological obsolescence.
• For the COO & CMO: Operational Agility. A cloud-native platform provides unparalleled performance and accessibility. Clinicians can access images securely from any location, enabling efficient workflows, supporting teleradiology initiatives, and allowing the organisation to scale services on demand.

By breaking down the silos and adopting a unified strategy, an organisation can transform its medical imaging infrastructure. What was once a shared financial, technical, and operational burden becomes a collective strategic asset—one that supports financial health, mitigates risk, and drives clinical excellence.

Ready to align your leadership team and build a unified imaging strategy?

A personalised demo is the perfect way to show your entire team—from the CFO to the CIO and COO—how a single platform can meet everyone’s strategic goals. Let us show you how. Request a demo