The PACS Selection Blueprint: What Every Imaging Leader Gets Wrong | with Dr. Alex Towbin

Choosing a PACS can shape the next 10 years of your imaging department. Yet many leaders still rely on gut feel, vendor hype, or checklists that do not reflect real clinical operations. In this episode of Imaging Informatics Unplugged, I sit down with Dr. Alex Towbin, Professor of Radiology and the Neil D. Johnson Chair of Radiology Informatics at Cincinnati Children’s Hospital, to break down the complete PACS selection process behind his team’s widely referenced study. 
The PACS Selection Blueprint: What Every Imaging Leader Gets Wrong | with Dr. Alex Towbin

We cover every stage of the journey. The politics, the data, the shortcomings of vendor demos, and the real-world constraints that most hospitals underestimate. Dr. Towbin explains how his team evaluated ten PACS vendors, how they neutralized bias in the committee, why radiologists often stay attached to their first PACS, and what PACS 3.0 will require as AI-driven workflows mature.

If you are a PACS admin, enterprise imaging strategist, IT architect, radiology leader, or anyone preparing for an upcoming procurement, this episode will give you a clear and practical blueprint to follow.

📝 Read the full published paper
https://link.springer.com/article/10....

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In This Episode

• How Cincinnati Children’s designed a transparent and data-focused PACS selection process
• Why radiologists become “imprinted” on their first PACS and how that shapes department culture
• The hidden cost of switching PACS and why minor improvements may not justify a complete replacement
• How real anonymized data exposed major weaknesses in vendor demos
• What to expect in the shift toward PACS 3.0 with AI-enabled and automated workflows
• Why database access, technologist workflows, and support models often matter more than shiny features
• How to scale your procurement approach based on the impact of the system
• What imaging leaders should rethink heading into their next PACS evaluation cycle

Chapters
0:00 When your PACS feels tired – episode setup
2:09 Meet Dr. Alex Towbin and the PACS selection study
2:39 Why Cincinnati Children’s re-evaluated their PACS
3:41 How radiologists get “imprinted” on their first PACS
5:32 Alex’s journey across three generations of PACS
6:14 Principles for a fair and transparent PACS selection
8:53 Equal voice for radiologists, technologists, and IT
11:24 Balancing data, emotion, and gut feel in decisions
14:03 Sticking with the incumbent and the real cost of switching
17:42 Asking vendors to load real anonymized pediatric data
24:22 Lessons learned and how they would run the next RFP
25:42 Support models, database access, and working with vendors
30:50 Final advice

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