We illustrate that to benefit from the advantages of Picture Archiving
and Communication Systems (PACS) for the Intensive Care Unit (ICU), t
he PACS must be strongly integrated within the overall working environ
ment. This includes adaptation of the PACS toward specific working pat
terns and integrating it with the Hospital Information System (HIS). T
his is reflected in our prototype system in different ways. The user i
nterface of the viewing station is centered around often used patterns
in ICU viewing. Information about bed occupancy is retrieved from the
HIS and exploited in the viewing station. A digital connection betwee
n the phosphorplate scanner and the HIS ensures that images are correc
tly related to other patient information and to previous images. Using
minor adaptations to the existing HIS, PACS and HIS have been made to
cooperate in integrated presentation of images and radiological repor
ts, as a step towards a multimedia medical information system. We disc
uss the relation between PACS and the global information environment,
emphasizing organizational issues rather than technological aspects.