Start here: the PACS comparison mindset

When clinics compare PACS, they often compare feature lists. The better approach is comparing
workflows.

Before you evaluate anything, define your “non-negotiable moments”:

• ER case lands → images need to load immediately
• Doctor asks for last year’s rads → priors need to appear instantly
• Send to teleradiology → sharing needs to be simple and trackable
• Multi-doctor / multi-site review → access must be consistent across devices

If you want the foundational “what a veterinary PACS is (and why human PACS often fails)” pillar, link it right here:

Veterinary PACS: What Clinics Actually Need (And Why Human PACS Fall Short)
.

1) Speed that holds up under pressure

Speed isn’t a nice-to-have. It’s the difference between “quick consult” and “we’ll come back to it later.”

What to look for

• Fast study load times (not just “fast on the demo laptop”)
• Fast search by patient name, ID, owner, or visit
• Fast priors retrieval with minimal clicks
• Performance at peak hours (multiple users, multiple studies)

How to test it in a demo

• Ask the rep to open a study with a large image set (not a tiny sample)
• Ask them to pull priors from 12+ months ago
• Ask what happens when 10 users are logged in at once

If you’re weighing cloud options, this supporting post pairs well:

Cloud-Based Veterinary PACS: Pros, Cons, and Common Myths
.

2) Organization that matches veterinary reality

Veterinary clinics are multi-species, multi-modality, and often multi-location. The PACS has to keep up without
turning file management into a hobby.

What to look for

• Clear study naming and timestamps
• Easy filtering by modality (rads vs ultrasound vs CT)
• Logical patient records (especially for long-term repeat imaging)
• Tools that prevent “duplicate patient” chaos

3) Priors & comparisons (where time disappears)

Priors are where clinics lose time—quietly, constantly. If your PACS makes priors hard to find, slow to load, or awkward to compare,
your team will start skipping comparisons or doing them “when we have time.” (Spoiler: you won’t.)

What to look for

• One-click access to priors from the current study
• Side-by-side comparison views that actually work
• Sync tools (zoom/pan) so comparison isn’t a manual chore
• Clear labeling so nobody compares the wrong series

Demo test

Bring a scenario: “Chronic cough, repeat thoracic rads over 18 months.” Ask them to pull priors and compare. Time it.
If it takes longer than it should, it will take even longer when you’re busy.

4) Sharing & teleradiology workflows

In vet med, teleradiology and specialist collaboration aren’t edge cases—they’re everyday medicine. Your PACS should make sharing fast, secure,
and trackable. Not “export, zip, email, hope.”

What to look for

• Secure sharing links or streamlined sending to partners
• Easy inclusion of relevant history (without retyping everything)
• A clear audit trail: what was sent, when, to whom
• Support for receiving and attaching reports back to the case

Demo questions

• “Show me exactly how we send a case to a teleradiologist.”
• “What happens if the radiologist needs priors?”
• “How does the report come back and attach to the record?”

5) Integrations (the hidden dealbreaker)

A PACS can be “great” and still fail if it doesn’t integrate with how your clinic runs. Integrations determine whether your team works once—or twice.

What to look for

• Practice management system compatibility
• Modality connectivity (your DR/CR, ultrasound, CT)
• Teleradiology partner workflows
• Single sign-on or simplified user management (where available)

Point readers to your integrations page:
Asteris Integrations.

6) Reporting & dictation support

Imaging doesn’t end when the study loads. Reporting is the finish line—and the finish line is where clinics get stuck.

What to look for

• Easy attachment of reports to studies
• Workflow support for preliminary reads vs final reports
• Dictation that fits veterinary language and speed expectations
• Clean export/sharing of reports with clients or referral partners

If you want to naturally introduce Omni without hard-selling, link it as “reporting workflow support”:
Keystone Omni (Veterinary Dictation).

7) Access, permissions, and security basics

“Any device, anywhere” is useful only if it’s secure and controlled. You want sensible permissions, clear user roles,
and dependable access that doesn’t require your team to invent workarounds.

What to look for

• Role-based permissions (tech vs doctor vs admin)
• Simple user management (adding/removing staff shouldn’t be a project)
• Audit logging (helpful for accountability and troubleshooting)
• Clear backup and retention policies

For clinics looking for a baseline ethical reference, the AVMA Principles of Veterinary Medical Ethics is a useful anchor:

AVMA Principles of Veterinary Medical Ethics
.

8) Implementation & support (don’t skip this)

Here’s the unsexy truth: a “good” PACS with bad implementation becomes a bad PACS.
Support determines whether you’re up and running smoothly—or stuck in limbo.

What to look for

• Clear onboarding plan (timeline, responsibilities, milestones)
• Training that fits veterinary staffing reality (short, practical, repeatable)
• Real support response expectations (what’s the SLA, really?)
• Help with migration: priors, patient matching, historical studies

Ask this directly

• “What does migration look like for a clinic our size?”
• “Who owns patient matching and cleaning duplicates?”
• “What happens if something breaks during ER hours?”

9) Total cost (what vendors “forget” to mention)

When clinics talk about PACS price, they often talk about the subscription number—and miss everything around it.
Total cost includes time, training, hardware, downtime, and the ongoing effort required to keep the system usable.

Cost questions that matter

• Are there charges for storage tiers or large studies?
• Are there fees for additional users, locations, or modalities?
• What costs are tied to integrations?
• Is support included, or “included unless…”?
• What hardware is required (if any), and who maintains it?

Demo questions and requests you should actually use (copy/paste)

Use these in every PACS demo. They force the vendor to show workflow—not just features.

1. Speed test: “Open a large study and pull priors from 12+ months ago.”
2. Comparison: “Show side-by-side comparisons with synced zoom/pan.”
3. Search: “Find a patient by partial name, then filter by modality and date.”
4. Sharing: “Send this case to teleradiology and show what the receiving workflow looks like.”
5. Integrations: “Show how patient data flows from our PMS into the PACS (no double entry).”
6. Reporting: “Show how reports attach to studies and how we share them back to the clinic team.”
7. Support: “What happens when something breaks after hours? Walk me through the process.”
8. Migration: “How do you migrate priors and prevent duplicate patients?”
9. Costs: “List every cost that could change in year 2: users, storage, locations, integrations.”

If your clinic wants the “big picture” guide to what PACS should be doing, send them back to the pillar:

Veterinary PACS: What Clinics Actually Need (And Why Human PACS Fall Short)
.

FAQ

What’s the most important feature in a veterinary PACS?

Speed and ease of access. If images don’t load quickly, priors aren’t instant, and sharing is painful, the system becomes a bottleneck.

Is a DICOM viewer the same as a PACS?

Usually not. A viewer helps you view images. A PACS stores, organizes, retrieves, shares, and integrates imaging into your clinic’s workflow.
For DICOM background, the official standard reference is:
dicomstandard.org.

Cloud vs on-prem: what should clinics prioritize?

Reliability, predictable costs, sensible security, and workflow fit. Cloud often improves remote access and reduces server maintenance.
On-prem can help when internet is unreliable and local IT support is strong.