Cloud PACS vs Onsite PACS. Which is Best for Your Medical Imaging Solution?

September 19, 2022

Hospital administrators, radiology groups, and medical facilities face a common dilemma when choosing the future of their medical imaging solutions. They grapple with the choice of using a cloud PACS or an onsite PACS. Both solutions offer benefits for advancing the quality of patient care. Medical imaging is a key part of a patient’s health record, and speed, security, and cost-effectiveness are key measurements of an effective imaging solution, whether in the cloud or onsite. To help decision-makers gain a better understanding of which approach might be right for their organization, we will discuss the benefits and disadvantages of a cloud PACS versus an onsite PACS and offer resources for the best medical imaging solution to ease decision-making.

What is Cloud PACS?

A cloud-based PACS is a Picture Archiving and Communication System running on remote cloud computing services. In this system, third-party healthcare IT professionals are responsible for the system’s deployment, support, upgrades, system maintenance, and updates, allowing  physicians to focus solely on patient care rather than worrying about IT issues.

Cloud PACS consolidates multiple imaging systems with one flexible, customizable, and low-maintenance platform. Cloud PACS systems are highly scalable, catering to rapidly growing health systems or imaging practices. Designed to be highly flexible, cloud PACS systems enable healthcare providers to view medical images on more devices, including mobile devices. Modern healthcare facilities are making the shift to cloud-based PACS to improve security and scalability and to reduce the burden on IT staff to maintain the imaging system. Learn more about Cloud PACS solutions.

Benefits & Disadvantages

Whether choosing an onsite PACS system or migrating to a cloud-based system, there are a variety of issues to consider. Staffing an internal IT department in a medical setting can be costly. Keeping the system operating smoothly while avoiding vulnerabilities can be challenging. Let’s look at some of the advantages and limitations of local onsite versus cloud PACS:

Benefits of Local Onsite PACS

Assuming the PACS has already been installed in the healthcare facility, it’s safe to assume implementation, hardware, maintenance, IT staff, and redundancy costs have already been factored into the fiscal budget. The medical facility can reap the benefits of an onsite PACS by utilizing its existing IT staff’s expertise with regard to existing software and hardware infrastructure.

Disadvantages of Local Onsite PACS

A traditional PACS save time and money compared to storing film jackets, of course. However, onsite PACS have been susceptible to siloing data, and they can be expensive when adding staff, technical support, and storage expansion. Furthermore, some onsite PACS solutions have difficulty sharing secure data outside of their local environment due to security and privacy protocols.

Benefits of Cloud PACS

More healthcare practices are realizing the cost savings, remote accessibility, speed, security, and scalability advantages of cloud-based PACS.

Cost Reduction

The cost savings alone is a major deciding factor for most medical administrators when deciding to shift from a traditional onsite PACS to a cloud-based PACS. With the introduction of cloud services, onsite IT staff are no longer faced with managing the data center, software implementation and updates, hardware maintenance and technical support, data backup, and recovery. These core responsibilities are that of the cloud vendor allowing the IT staff to focus on internal customer needs and longer-term IT strategy.

Shifting to a cloud-based solution offers advantageous pricing models, including the fee-per-study model, meaning that the facility can pay per medical image. They can benefit from flexible storage options as opposed to purchasing more redundant hard drives with the onsite PACS solution.

Remote Accessibility

As previously mentioned, a traditional PACS can become susceptible to siloed data. When compounding the limitations of universal data access with security and privacy protocols, accessing vital patient data outside of the local medical facility can be challenging for some IT administrators. By default, cloud-based PACS solutions are designed for remote access. This directly improves the speed and quality of patient care.


Implementing cloud services into your medical imaging solution offers faster patient care. For example, a radiologist does not have to be physically present in the medical facility to access a workstation to diagnose images. They can access medical images from anywhere they have to an internet connection, including on their mobile device. Ease of access helps alleviate radiologists’ workload stress. Thus, they have more time for quality patient care.


In a recent data breach, millions of American medical imaging records and data were leaked on the internet. In the investigation conducted by the German broadcaster Bayerischer Rundfunk and ProPublica, they “identified 187 servers — computers that are used to store and retrieve medical data — in the U.S. that were unprotected by passwords or basic security precautions.” What made this leak particularly egregious was the security failure occurred simply from a lack of adequate security protocols. As one cybersecurity researcher, Jackie Singh described the scenario, “It’s not even hacking. It’s walking into an open door.”

In contrast, Cloud PACS vendors adhere to strict security and privacy protocols. Instilling password-protected connections, encrypted sessions, and automatic logout of the session once the medical image viewer browser disconnects are only part of the story.  Cloud-based vendors delve deeper by providing network and role-based access controls, antivirus and malware protections, cyber threat detection, mandating strong passwords, and much more.


Shifting to the cloud for medical imaging affords the facility the benefit of elasticity. Meaning, that if your cloud storage needs to grow (or shrink), your pricing plan with the vendor can adjust accordingly.

Disadvantages of Cloud PACS

One of the biggest challenges to transitioning to a cloud-based imaging strategy is the hesitancy to change. However, like many technology transitions, advancement is inevitable. For example, our financial data and banking began with paper slips filled in at a bank window, and now nearly all transactions are digital, often managed directly from our mobile devices. Likewise, printed film once dominated radiology scans, then transitioned to high-quality digital scans, and now they can be viewed from any device and anywhere with a zero-footprint viewer from the cloud. The cloud server does the heavy processing work, while the client-side merely operates as a secure viewing device.

The Bottomline

So, which is best for your medical imaging solution? Cloud-based PACS solutions offer many benefits over an onsite PACS, but both solutions have a place in modern healthcare. Cloud PACS is becoming more popular in the medical field. It is important to weigh the pros and cons of both cloud and onsite PACS before deciding which solution is best for your practice. This piece has provided plenty of considerations for the decision maker(s) to ponder. If you are looking for a more cost-effective and secure way to manage your medical images, contact our sales team today for a demo of Intelerad Cloud. We believe that this solution will provide great value to your organization and improve patient care.