UK Digital Imaging Forum

RIS to In-Pacs Reporting

We are in the process of moving PACS suppliers (we are keeping our RIS) with an intention to move towards In-PACS reporting.

I just wondered what other trusts experiences of this were?

In particular did you implement In-PACS reporting at ‘go-live’ or delay until Radiologists were confident using the new PACS?

Did you encounter any unexpected problems at ‘go-live’?

Pro/cons for RIS or In-PACS reporting

Any feedback appreciated!


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Hi Zoe, we use RIS reporting and are hopefully moving to PACS driven reporting at the earliest opportunity. Our RIS has been unstable for over 2 years and the supplier has shown to be incapable of solving key issues. Every release introduced more problems. Part might be caused by the fact that the RIS supplier has no test environment linked to our PACS. That means we essentially do the application testing for them.
My hope is that by moving to PACS driven reporting the Radiologist have to deal with one product and one company. Forwarding the report to another system is tried and tested via HL7.


We implemented PACS based reporting in July 2019 as part of our PACS replacement project. We still report Obs US in RIS as the templates and charting availability is not available in PACS, but all other reporting is done in PACS.
Integration and data migration is key. On reflection, from necessity to stay on track with a regional deployment program we didn’t spend long enough reviewing importing data and testing.
Three years on we still have a few problems related to the RIS/APCS integration. Because only certain RIS messages update PACS workflow RIS record updates and post processing is crucial and even slight deviations can mean studies do not appear on reporting lists, or reports can be made in PACS on studies that have been deleted in RIS meaning reports do not go back to RIS or onwards to downstream Trust systems (It was decided existing routing of reports via RIS would be used rather than EI feeding downstream systems directly).
It is not all bad however. Our PACS has better functionality than the old system and we have seen a ten fold (at least) increase in system stability one we got through the initial go live period.
We did encounter problems at go live. At the time this was due to the supplier not fully understanding the new product and viewing it as an upgrade to the previous PACS rather than a completely different beast. Because of the regional deployment we ended up going live with a combination of UK and global supplier personnel supporting meaning inconsistent messages were received depending on the apps specialist user talked to. This also meant apps specialists made changes to work already done by other specialists as they based their work on previous experience without understanding our particular site.
There were other go live problems such as the RIS provider applying the filter relating to flow of reports in the new workflow too early then bulk sending all reports once the issue was identified.

Now that our hospital is thinking about PACS driven reporting, can I ask if others, who made this switch, went to to a full VR driven report workflow or still use a digital dictation alternative for the farmer-plough-no-internet scenario (our VR is online). What would be a full no VR business continuity scenario?

Have any reporting radiologists / radiographers here used both RIS based reporting and PACS based reporting?

Can anyone comment on productivity/user experience and reliability between the two approaches? Any other issues that it would be useful to be aware of when considering which way to go?

Hi Frank

CAM are still plodding through this, and we do have one trust still using digital dictation we would like all users to use VR full pacs driven workflow otherwise it’s too difficult a beast to manage several workflows and make sure from a safety point of view all reports get to exactly where they need to be and Royal Liverpool site have virtually achieved this

Chester & Mid Cheshire also have full PBR but they started with this when they changed their pacs – a much easier sell than trying to wrench people off existing safe workflows for what they see as no good reason

I can give you some contacts at those sites who would be willing to provide feedback I’m sure

Message me on –



Bonnie O’Sullivan

PACS & RIS Manager

( 0151 556 3846 (internal 63846)

The Walton Centre NHS Foundation Trust,
Lower Lane, Liverpool, L9 7LJ

Advance notice of leave – 22nd August to 2nd September


I am the Transformation Lead for the Southwest London Radiology RIS/PACS programme in which we are merging all the radiology systems and workflows across the NHS in the Southwest of London. I also used to be a reporting radiographer using both RIS and PACS based reporting. On the whole, I think PACS based is going to be better for seamless integration of advanced tools like AI, but RIS based can be very useful for some types of reporting like US. So, I think we should support mixed models, with an emphasis on PACS based reporting.