What is the best PACS?
The short answer
There is no single best PACS. The right one reads fast at your volume, fits your RIS, EHR and dictation, gives remote and teleradiology readers quick access to images and priors, and comes with an uptime and downtime plan you can live with. KLAS publishes customer-satisfaction rankings by size of practice; for 2026 its Best in KLAS PACS awards went to Sectra PACS (large, 300K+ studies) and AGFA HealthCare Enterprise Imaging for Radiology (small, under 300K studies).
- 11PACS vendors in the table
- 3deployment models: on-premises, cloud, managed SaaS
- Oct 192026: every vendor site checked
The KLAS result is from its 2026 Best in KLAS PACS page. KLAS scores come from customer interviews, so they measure satisfaction, not fit for your department.
PACS vendors and products, compared
| Vendor (source page) | PACS product(s) | Deployment stated | Stated features | Notes |
|---|---|---|---|---|
| Agfa HealthCare | AGFA HealthCare Enterprise Imaging | “Cloud-Delivered, AGFA-Managed” | XERO Universal Viewer, vendor neutral archive, RUBEE AI | 2026 Best in KLAS, PACS (Small, under 300K studies), per KLAS |
| Fujifilm | Synapse Radiology PACS | Not stated on the page checked | “Zero-download viewer”; “more than 50 currently validated AI imaging algorithms” in the PACS workflow | |
| GE HealthCare | True PACS SaaS; Genesis VNA and storage | “The Genesis portfolio is built on AWS” | Cloud storage and VNA alongside the PACS | Owns Intelerad since March 2026 |
| Intelerad | IntelePACS, InteleViewer, InteleOne | Cloud Suite listed; AWS alliance announced 2025 | Unified worklist, viewer and dictation (InteleOne); InteleShare VNA | A GE HealthCare company. See Intelerad, explained |
| Merge | Merge PACS, Merge VNA, Merge Universal Viewer | “Cloud-based VNA and enterprise viewer”; hybrid cloud | Enterprise viewer and VNA | A Merative brand |
| Novarad | NovaPACS EI (PACS / Enterprise Imaging) | “Cloud, On-premises, Edge & Hybrid Solutions” | PACS and patient-management (RIS) products | |
| Optum | Stratus Imaging PACS | “A fully managed, cloud-native SaaS PACS” | All-in-one imaging platform for radiology workflow | Some Optum pages still use the earlier name, Change Healthcare Stratus Imaging PACS |
| Philips | Philips Image Management 15, “the next generation of Philips Vue PACS” | Cloud through Philips HealthSuite on AWS, with an on-premises option | Web-based diagnostic viewer | Announced November 24, 2025 |
| RamSoft | OmegaAI (“Cloud-Native RIS / PACS / VNA”); PowerServer (“Cloud-Based PACS Suite”) | Cloud | RIS, PACS and VNA in one platform; zero-footprint architecture | |
| Sectra | Sectra PACS; Sectra One Cloud | “A fully managed SaaS”, built in collaboration with Microsoft | Enterprise imaging with VNA | 2026 Best in KLAS, PACS (Large, 300K+ studies), per KLAS |
| Visage Imaging | Visage 7 | “Cloud-native, server-side platform for PACS and Enterprise Imaging” | Server-side architecture | A Pro Medicus company (investors page) |
Every vendor fact above is as stated on its site on October 19, 2026. Imaging software changes owners and names often: Intelerad became part of GE HealthCare in March 2026, and Optum sells Stratus Imaging PACS, which some of its pages still call Change Healthcare Stratus Imaging PACS. Confirm current product names, deployment options and support terms with each vendor. Some companies often named alongside PACS sell a neighbouring product instead; Hyland, for example, sells the Acuo vendor neutral archive, and many radiologists dictate in PowerScribe from Nuance, now part of Microsoft, whatever PACS they read on.
On-premises, cloud or SaaS PACS?
- On-premises
- Servers and storage sit in your data center and your IT team (or the vendor under contract) runs them. You control the hardware and the upgrade timing; you also carry the hardware refresh, the backups and the disaster recovery site.
- Cloud-hosted
- The same PACS software runs on a cloud provider’s infrastructure. Several vendors say their platforms run on Amazon Web Services or were built with Microsoft. Images may be cached locally so studies still open quickly when the internet link is slow.
- Managed SaaS
- The vendor runs and upgrades the whole system and you pay a subscription, sometimes per study. Sectra One Cloud and Optum’s Stratus Imaging PACS are described this way on their sites.
- Hybrid
- Recent studies on local servers for speed, the long-term archive in the cloud. Several vendors, including Novarad, Merge and Philips, describe hybrid options.
Whichever model you choose, a cloud provider that stores patient images for you is a business associate under HIPAA and needs a Business Associate Agreement. For the underlying terms, see what is PACS.
How to choose a PACS: 12 questions
- Speed at your volume: how long does a large CT or MRI take to open for an on-site reader, and for a remote one?
- Viewer: are hanging protocols, MPR and 3D, and mammography tools built in, or extra modules?
- Worklist: can one worklist cover several sites, subspecialty rules and STAT priority?
- Priors: are relevant priors fetched automatically, including from other facilities?
- RIS and EHR: which HL7 interfaces are included, and who builds them? See RIS vs PACS.
- Dictation: which speech-recognition and reporting systems are supported?
- Standards: DICOM, DICOMweb and HL7 support, in the vendor’s DICOM conformance statement. See DICOM and HL7.
- Archive and migration: who migrates your existing studies, at what cost, and can you leave with your data in standard DICOM?
- Uptime and downtime: the written uptime commitment, and how studies are read when the network or the PACS is down.
- Security: encryption, access controls, audit logs, independent security reports and a signed BAA.
- Teleradiology: how images and priors route to an outside reading group, and how signed reports come back.
- Total cost: licences or subscription, per-study fees, storage growth, interfaces, hardware and support over the full term.
Standards and references worth reading
Two neutral references help frame a PACS evaluation. The ACR–AAPM–SIIM Technical Standard for Electronic Practice of Medical Imaging (revised 2022) covers personnel, equipment, display, compression, quality control and remote distribution of images. The KLAS PACS rankings report customer satisfaction by segment. Your own reference calls with sites of a similar size, case mix and EHR are worth more than either: ask them what goes wrong at 2 AM and how the vendor responds.
Where teleradiology fits
If you use a teleradiology group, or plan to, put it in the PACS evaluation. The questions that matter are how quickly new studies and relevant priors reach the outside reader, and how signed reports flow back into your RIS and EHR. A teleradiology group can read on its own PACS: the hospital’s modalities or PACS send studies to it, and reports come back by HL7.
Orders come to us by HL7 and images by secure routing to our PACS. Signed reports go back into your system. We read on our PACS, so there is nothing for your staff to install or run. We sign a HIPAA Business Associate Agreement (BAA) with every hospital, and our technology runs on SOC 2-compliant platforms. Every TeleRads report is a signed final; we read finals only, never preliminaries.
Questions
What is the best PACS system?
There is no single best PACS for every hospital. KLAS’s 2026 Best in KLAS PACS awards went to Sectra PACS for large practices (300K+ studies) and AGFA HealthCare Enterprise Imaging for Radiology for small ones (under 300K studies), but the right system is the one that fits your volume, RIS, EHR, dictation and reading model.
Who are the main PACS vendors?
Well-known PACS vendors include Agfa HealthCare, Fujifilm, GE HealthCare, Intelerad (now part of GE HealthCare), Merge, Novarad, Optum, Philips, RamSoft, Sectra and Visage Imaging, along with many smaller companies.
What is a cloud PACS?
A cloud PACS stores and serves images from a cloud provider’s infrastructure instead of servers in the hospital. Some are fully managed software-as-a-service, where the vendor runs and upgrades the system; others are the same software hosted in the cloud. Many keep a local cache so studies open quickly.
How much does a PACS cost?
Pricing varies by vendor and model: perpetual licences with annual support, subscriptions, or per-study fees, plus storage, interfaces, migration and hardware. Ask every vendor for a total cost over the full contract term on the same volume assumptions.
What should I ask a PACS vendor?
Ask about image load speed at your volume, viewer tools, worklist rules, automatic priors, RIS and EHR interfaces, dictation support, DICOM and HL7 conformance, data migration and exit, uptime and downtime procedures, security and a BAA, teleradiology routing and total cost.
Do I need a new PACS to use teleradiology?
No. Teleradiology connects through standards. With TeleRads, orders come to us by HL7 and images by secure routing to our PACS, and signed reports go back into your system, with nothing for your staff to install.
How was this comparison made?
Each vendor row uses only what that company states on its own website, checked October 19, 2026, with the source page linked. Award lines come from the KLAS 2026 Best in KLAS PACS page.