A Picture Archive and Communication System (PACS) is more than just hardware and software: it requires a set of policies that govern and describe what its users should do, not only for routine operations (such as Quality Assurance (QA)/Quality Control (QC), merging images, burning CDs, and so on), but even more importantly for exception cases (such as backup procedures, shutdown, and downtime procedures). A proper set of PACS procedures should be derived from a policy that includes a mission statement, governance with well defined responsibilities, and clearly defined boundaries for the procedure.

If a PACS lacks proper policies and procedures, it will often result in the system operating sub-optimally, and it could ultimately impact patient care. A PACS is rather flexible and is not necessarily "self-maintaining". If there is a not a policy and procedure for tasks such as regularly checking certain error logs, exception files, or audit trails and if someone does not clean the CR cassettes, computer fans, calibrate the monitors, back-up the database and images, one can only expect disaster to strike.

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