A Decision-Maker’s Guide to Choosing the Right Cloud PACS 2025

Choosing a Picture Archiving and Communication System (PACS) is a critical technology decision for any healthcare organisation. It is a long-term investment that directly impacts clinical efficiency, financial health, and your ability to adapt to future demands. With the clear advantages of cloud technology, the question is no longer if you should move to the cloud, but how to choose the right partner and platform.

This guide provides a clear framework for evaluation. It outlines the five key areas to investigate and the crucial questions you must ask any potential vendor.

Before reviewing features, you must scrutinise the foundation. A cloud PACS is only as good as the infrastructure it is built on. A vendor simply stating “we are on the cloud” is not enough.

• Why it matters: Patient data security is non-negotiable. The platform must be robust enough to handle data redundancy, disaster recovery, and compliance with regulations. Scalability ensures the system can grow with your practice without requiring costly hardware overhauls.
• Key Questions to Ask:
  • Which major cloud provider do you use (e.g., AWS, Google Cloud, Azure)?
  • How is our data protected and encrypted, both in transit and at rest?
  • How is data replicated for disaster recovery? Is it stored in multiple geographic locations automatically?
  • What security and compliance certifications does your platform hold?

The price tag you see upfront is rarely the full story. The difference between a transparent pricing model and one with hidden fees can amount to tens of thousands of dollars over the system’s lifetime. Your goal is to understand the Total Cost of Ownership (TCO).

• Why it matters: You need to move PACS from a large capital expense (CapEx) to a transparent and manageable operational expense (OpEx). Hidden costs for support, data migration, user licences, and mandatory upgrades can destroy your budget.
• Key Questions to Ask:
  • Is your pricing a simple operational expense, or are there large upfront capital costs?
  • Are there additional fees for data migration, ongoing support, or system upgrades?
  • Do you charge per user or per device? Is there a model based on consumption (e.g., per study) that offers unlimited user access?
  • Can you provide a clear, all-inclusive cost estimate based on our projected study volume?

In a field that changes as rapidly as healthcare, agility is paramount. A restrictive, long-term contract can trap your organisation with outdated technology, preventing you from adopting more efficient solutions.

• Why it matters: “Future-proofing” your practice means having the freedom to adapt as your needs evolve. A vendor should have to earn your business continuously through performance, not rely on a multi-year signature.
• Key Questions to Ask:
  • What is the standard contract length? Is a no lock-in contract option available?
  • How does the system and its cost scale if our study volume doubles or halves?
  • Are there limits on the number of users who can access the system?
  • What is the process and cost if we decide to migrate our data away from your system?

A PACS does not operate in a vacuum. Its ability to communicate with your other systems—like your RIS or EMR—is critical for an efficient clinical workflow.

• Why it matters: Poor integration creates data silos, forces manual workarounds, and frustrates clinicians. The system must be vendor-neutral and built on modern standards to complement, rather than complicate, your existing IT ecosystem.
• Key Questions to Ask:
  • How does your PACS integrate with our specific RIS/EMR?
  • Are your modality connections vendor-neutral? Are there limits or fees for adding new modalities?
  • Is there a zero-footprint viewer for easy access on any web browser?
  • Does the system support mobile access for viewing images on tablets or phones?

Ultimately, the success of a PACS is determined by its adoption and use by clinicians. A feature-rich platform that is slow or clunky will hinder productivity and lead to user dissatisfaction.

• Why it matters: The primary purpose of a PACS is to deliver diagnostic-quality images to clinicians quickly and reliably. The user experience directly impacts diagnostic turnaround times and the quality of collaborative care.
• Key Questions to Ask:
  • What are the typical image loading and streaming times?
  • Can we speak with current clinical users about their day-to-day experience?
  • What collaboration tools are built-in for sharing studies and reports with referrers?

Choosing a cloud PACS is about more than features; it’s about choosing a partner. The right partner will offer a secure and scalable foundation, a transparent and flexible business model, and a user experience that empowers your team. By asking these tough questions upfront, you can ensure your next PACS is a catalyst for growth, not a barrier to it.

Ready to see how AdvaPACS answers these questions? Schedule a transparent, no-obligation demo with our team today.