PACS

Introduction

PACS connects imaging modalities to your organization’s study archive so captured DICOM flows back into Avara for reading, sharing, and patient access.

In the Clinical Platform, that connection starts with a modality machine — a room extended with PACS identity. Together, rooms and PACS tie appointment scheduling to real-world imaging workflows — from a single boutique scanner to hospital-scale volume.

PACS is configured under Operations → PACS by users with Can Manage PACS. See Inviting Users for permission details.

Modality Machines

A modality machine is an extension of a room object. It is still a schedulable room — appointment types attach it the same way they attach any other room — with the DICOM identity the scanner needs:

• Name — How the machine appears on the calendar and in Operations
• AE title — The Application Entity title the modality uses on the imaging network
• IP address — The machine’s local static IP on the clinic LAN when using an on-prem server, or the facility’s public static IP (NAT egress) when using cloud PACS
• On-prem PACS server — Optional pairing to an Avara-managed routing appliance at the site

Because modality machines are rooms, the scheduling engine treats them as shared resources. A machine assigned across several appointment types will never be double-booked. That reserved slot is what the scanner’s worklist query resolves to.

Enabling PACS for a Modality Machine

When you create a modality machine, PACS is enabled. Two node options are available:

• Cloud PACS — Available for connecting quickly during setup and recommended for testing purposes only. Useful for validating workflows before go-live.
• On-prem PACS server — Strongly recommended for clinical deployment. An Avara-managed on-prem server at your site is a secure routing node — it processes and encrypts DICOM so studies can be securely sent over the internet to Avara’s cloud archive, while staying integrated with Clinical Platform services.

Each modality machine has a DICOM node configuration sheet — the IP, AE title, and port to enter on the scanner so worklist queries and C-STORE send reach the correct Avara node.

For production imaging, on-prem PACS provides a secure, site-local path from your modalities to Avara’s study archive. Cloud PACS remains a convenient path for trials and integration checks.

How PACS Integration Works

Connecting a PACS node — cloud or on-prem — is what allows the modality to participate in your full imaging workflow:

1. Worklist — The modality pulls the worklist for its scheduled appointments from Avara, so technologists see the correct patients and study details at the scanner without manual re-entry.
2. DICOM send — After acquisition, the modality sends DICOM data back to the Avara PACS so studies are stored, indexed, and available in the platform.
3. Study access — Once ingested, studies can be served to radiologists, referring providers, patients, and any other authorized user in your organization — for reading, reporting, sharing, and portal delivery according to your workflow rules.

This end-to-end path — schedule → worklist → capture → archive → read — is what links your calendar to your imaging floor. Appointment types with DICOM imaging enabled define which visits generate worklist entries and how reports and notifications are routed after studies arrive.

Related PACS configuration lives on dedicated pages:

• On-prem servers — site-local routing appliances
• Workstations — third-party specialty viewers over a dedicated gateway
• Specialty modules — optional add-ons to Avara’s built-in viewer

Unmatched Studies

Most studies match an appointment automatically: the modality pulled a worklist entry, the technologist selected that patient, and the C-STORE arrived with identifiers Avara can reconcile.

That path breaks when the worklist cannot be pulled. Common cases:

• No internet (or no path to Avara) at the time of the exam
• Emergency or trauma workflows where the technologist cannot wait on a worklist query
• Any other outage or scanner-side failure that forces a manual entry on the modality

The exam still happens. The modality still sends DICOM to Avara. Because the study was entered by hand, it does not match a scheduled appointment — and it appears under Operations → PACS → Unmatched Studies.

Authenticated C-STORE studies that do not match an appointment stay on this list until someone processes them. From Manage, you can:

• Review patient, study description, modality, and timestamps
• Accept a suggested appointment when Avara is confident in a name and date-of-birth match — validate it before assigning
• Search confirmed, pending confirmation, or attended appointments on a room and assign the study
• Assign to an appointment on a different clinic that shares PACS, when your organization uses that layout
• Delete the unmatched study if it should not be kept

Studies still being received cannot be assigned or deleted until processing finishes. Matching an unmatched study attaches the imaging to the appointment so reading, reporting, and patient access proceed as if the worklist path had succeeded.

Setup and Support

Avara is built to make PACS setup straightforward. Our team assists at every step — networking, node configuration, modality worklist and send settings, and go-live validation — so you get a seamless, robust integration without navigating it alone.

Whether you are standing up your first scanner or expanding an existing imaging network, we work with your IT staff and modality vendors to get modality machines and PACS connected correctly.

Pricing and Commitment

There are no PACS setup fees, no long-term contracts, no commitments, and no minimum spending required to use Avara PACS.

We serve organizations of every size and specialty:

• Hospitals and health systems
• Radiology groups
• High-volume imaging centers
• Boutique and specialty imaging centers
• Specialist providers with in-office imaging

Avara handles any volume of imaging — from one study per month to tens of thousands of studies per month — with the same platform and support model. Scale up or down as your practice grows; you are not locked into tiered minimums or enterprise-only terms.

Study ingest and storage pricing is on Pricing — PACS.