Picture Archiving And Communication System gear (PACSgear)

General Information

Technologies must be operated and maintained in accordance with Federal and Department security and privacy policies and guidelines. More information on the proper use of the TRM can be found on the TRM Proper Use Tab/Section.

Website:	Go to site
Description:	PACSgear Enterprise Server is a program that processes Digital Imaging and Communications in Medicine (DICOM) and non-DICOM medical data including patient demographics, images, videos, and Health Level Seven International (HL7) messages. It also handles user accounts, security, client configuration, and the flow of data between modalities and destination DICOM systems. PACSgear Enterprise Server exclusively supports PACSgear client products such as Electronic Health Record (EHR) Gateway, Image Link, Mobile Direct radiography (MDR) Video Touch and Web Forms. This entry covers the Desktop Edition of this technology and not any mobile versions. Please note that the implementation of mobile technology applications that operate on Mobile Operating Systems must be reviewed and approved by the Mobile Technology and Endpoint Security Engineering Team: https://dvagov.sharepoint.com/sites/OITMT/SitePages/MTHome.aspx The TRM decisions in this entry only apply to technologies and versions owned, operated, managed, patched, and version-controlled by VA. This includes technologies deployed as software installations on VMs within VA-controlled cloud environments (e.g. VA Enterprise Cloud (VAEC)). Cloud services provided by the VAEC, which are listed in the VAEC Service Catalog, and those controlled and managed by an external Cloud Service Provider (i.e. SaaS) are not in the purview of the TRM. For more information on the use of cloud services and cloud-based products within VA, including VA private clouds, please see the Enterprise Cloud Solutions Office (ECSO) Portal at: https://dvagov.sharepoint.com/sites/OITECSO
Technology/Standard Usage Requirements:	Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:	This technology has not been assessed by the Section 508 Office. The Implementer of this technology has the responsibility to ensure the version deployed is 508-compliant. Section 508 compliance may be reviewed by the Section 508 Office and appropriate remedial action required if necessary. For additional information or assistance regarding Section 508, please contact the Section 508 Office at Section508@va.gov.
Decision:	View Decisions

Decision Source:	TRM Mgmt Group
Decision Process:	One-VA TRM v24.5
Decision Date:	05/07/2024 at 03:25:32 UTC
Aliases:	Picture Archiving And Communication System gear (PACSgear) Enterprise Server
Introduced By:	TRM Request
Vendor Name:	Hyland Healthcare

Vendor Release Information

The Vendor Release table provides the known releases for the TRM Technology, obtained from the vendor (or from the release source).

Version	Release Date	Vendor End of Life Date	Vendor Desupport Date
4.2.x	05/01/2019
5.0.x	04/01/2020
5.1.x	10/01/2020
5.2.x	02/01/2021
5.3.x	11/01/2023

Current Decision Matrix (04/30/2024)

Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.

The VA Decision Matrix displays the current and future VA IT position regarding different releases of a TRM entry. These decisions are based upon the best information available as of the most current date. The consumer of this information has the responsibility to consult the organizations responsible for the desktop, testing, and/or production environments to ensure that the target version of the technology will be supported. Any major.minor version that is not listed in the VA Decision Matrix is considered unapproved for use.

Legend:

White	Approved: The technology/standard has been approved for use.
Yellow	Approved w/Constraints: The technology/standard can be used within the specified constraints located below the decision matrix in the footnote[1] and on the General tab.
Gray	Unapproved: This technology or standard can be used only if a POA&M review is conducted and signed by the Authorizing Official Designated Representative (AODR) as designated by the Authorizing Official (AO) or designee and based upon a recommendation from the POA&M Compliance Enforcement, has been granted to the project team or organization that wishes to use the technology.
Orange	Divest: VA has decided to divest itself on the use of the technology/standard. As a result, all projects currently utilizing the technology/standard must plan to eliminate their use of the technology/standard. Additional information on when the entry is projected to become unapproved may be found on the Decision tab for the specific entry.
Black	Prohibited: The technology/standard is not (currently) permitted to be used under any circumstances.
Blue	Planning/Evaluation Constraint:The period of time this technology is currently being evaluated, reviewed, and tested in controlled environments. Use of this technology is strictly controlled and not available for use within the general population. If a customer would like to use this technology, please work with your local or Regional OI&T office and contact the appropriate evaluation office displayed in the notes below the decision matrix. The Local or Regional OI&T office should submit an inquiry to the TRM if they require further assistance or if the evaluating office is not listed in the notes below.

Release/Version Information:

VA decisions for specific versions may include a ‘.x’ wildcard, which denotes a decision that pertains to a range of multiple versions.

For example, a technology approved with a decision for 7.x would cover any version of 7.(Anything) - 7.(Anything). However, a 7.4.x decision would cover any version of 7.4.(Anything), but would not cover any version of 7.5.x or 7.6.x on the TRM.

VA decisions for specific versions may include ‘+’ symbols; which denotes that the decision for the version specified also includes versions greater than what is specified but is not to exceed or affect previous decimal places.

For example, a technology approved with a decision for 12.6.4+ would cover any version that is greater than 12.6.4, but would not exceed the .6 decimal ie: 12.6.401 is ok, 12.6.5 is ok, 12.6.9 is ok, however 12.7.0 or 13.0 is not.

<Past

CY2023

CY2024

CY2025

Future>

Release

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

4.2.x

Approved w/Constraints
[1, 3, 7, 8, 9]

Approved w/Constraints
[1, 3, 7, 9, 10]

Approved w/Constraints
[1, 3, 10, 11, 12]

Divest
[3, 10, 11, 12, 13, 14]

Unapproved

5.0.x

Unapproved

Divest
[3, 10, 11, 12, 13, 14]

Unapproved

5.1.x

Unapproved

Divest
[3, 10, 11, 12, 13, 14]

Unapproved

5.2.x

Approved w/Constraints
[1, 3, 7, 8, 9]

Approved w/Constraints
[1, 3, 7, 9, 10]

Approved w/Constraints
[1, 3, 10, 11, 12]

Divest
[3, 10, 11, 12, 13, 14]

Unapproved

5.3.x

Unapproved

Approved w/Constraints
[3, 10, 11, 12, 13, 14]

Decision Constraints


[1]	Users must ensure that Microsoft .Net Framework, Microsoft Internet Information Services (IIS), and Microsoft Structured Query Language (SQL) Server, and Microsoft Internet Explorer (IE) are implemented with VA-approved baselines. (refer to the ‘Category’ tab under ‘Runtime Dependencies’)

[2]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

[3]	Technology must remain patched and operated in accordance with Federal and Department security policies and guidelines in order to mitigate known and future security vulnerabilities.

[4]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 compliant encryption to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 compliant full disk encryption (FOE) must be implemented on the hard drive where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information Security Officer (ISO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP).

[5]	Due to potential information security risks for cloud-based technologies, users should coordinate closely with their facility ISSO for guidance and assistance on cloud products. If further guidance is needed contact the Enterprise Cloud Solution Office (ECSO), which is the body responsible for new software development in and migration of existing systems to the VA Enterprise Cloud (VAEC) and ensuring organizational information, Personally Identifiable Information (PII), Protected Health Information (PHI), and VA sensitive data are not compromised within the VAEC. For information about Software as a Service (SaaS) products or to submit a SaaS product request with the Project Special Forces (SPF) team, please use their online form. (Ref: VA Directive 6004, VA Directive 6517, VA Directive 6513 and VA Directive 6102).

[6]	Due to potential information security risks for cloud-based technologies, users should coordinate closely with their facility ISSO for guidance and assistance on cloud products. If further guidance is needed contact the Enterprise Cloud Solution Office (ECSO), which is the body responsible for new software development in and migration of existing systems to the VA Enterprise Cloud (VAEC) and ensuring organizational information, Personally Identifiable Information (PII), Protected Health Information (PHI), and VA sensitive data are not compromised within the VAEC. For information about Software as a Service (SaaS) products or to submit a SaaS product request with the Project Special Forces (PSF) team, please use their online form. (Ref: VA Directive 6004, VA Directive 6517, VA Directive 6513 and VA Directive 6102).

[7]	Due to potential information security risks for cloud-based technologies, users should coordinate closely with their facility ISSO for guidance and assistance on cloud products. If further guidance is needed contact the Enterprise Cloud Solution Office (ECSO), which is the body responsible for new software development in and migration of existing systems to the VA Enterprise Cloud (VAEC) and ensuring organizational information, Personally Identifiable Information (PII), Protected Health Information (PHI), and VA sensitive data are not compromised within the VAEC. For information about Software as a Service (SaaS) products or to submit a SaaS product request with the VA OIT Product Engineering team, please use their online form. (Ref: VA Directive 6004, VA Directive 6517, VA Directive 6513 and VA Directive 6102).

[8]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISSO (Information System Security Officer) to ensure compliance with VA Handbook 6500.

[9]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 compliant encryption to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 compliant full disk encryption (FOE) must be implemented on the hard drive where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information System Security Officer (ISSO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP).

[10]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISSO (Information System Security Officer) to ensure compliance with both VA Handbook 6500 and VA Directive 6500.

[11]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 or its successor to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 or 140-3 compliant full disk encryption (FOE) must be implemented on the storage device where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information System Security Officer (ISSO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP). By September 22, 2026, all FIPS 140-2 certificate validations will be placed on the Historical List, please refer to FIPS Transition Effort for further guidance and timeline of changes.

[12]	Due to potential information security risks for cloud-based technologies, users should coordinate closely with their facility ISSO for guidance and assistance on cloud products. If further guidance is needed contact the Enterprise Cloud Solution Office (ECSO), which is the body responsible for new software development in and migration of existing systems to the VA Enterprise Cloud (VAEC) and ensuring organizational information, Personally Identifiable Information (PII), Protected Health Information (PHI), and VA sensitive data are not compromised within the VAEC. For information about Software as a Service (SaaS) products or to submit a SaaS product request, visit the Product Marketplace. (Ref: VA Directive 6004, VA Directive 6517, VA Directive 6513 and VA Directive 6102).

[13]	Users must ensure that Microsoft Internet Information Services (IIS), Microsoft Structured Query Language (SQL) Server, Google Chrome, and Microsoft Edge are implemented with VA-approved baselines. (refer to the ‘Category’ tab under ‘Runtime Dependencies’) Users must not utilize the Secure Sockets Layer (SSL) protocol, as it is unapproved for use on the TRM. Users must not utilize Bitmap Image File (BMP), as it is at the time of writing, in a divested state within the TRM.

[14]	The Federal Information Processing standards (FIPS) 140-2 certification status of this technology was not able to be verified. This technology will require a 3rd party FIPS 140-2 or 140-3 certified solution for any data containing PHI/PII or VA sensitive information, where applicable. More information regarding the Cryptographic Module Validation Program (CMVP) can be found on the NIST website.

Note:

At the time of writing, version 5.3.2 is the most current version.

References

The following reference(s) are associated with this entry:
Type	Name	Source	Description
*NOTE: Vendor provided information is subject to the accuracy of the manufacturer.

Technology Components

Note: This list may not be complete. No component, listed or unlisted, may be used outside of the technology in which it is released. The usage decision for a component is found in the Decision and Decision Constraints.
Name	Description
Electronic Health Record (EHR) Gateway	EHR Gateway provides a simple and cost-effective solution that enables departments across the health system to integrate DICOM content with the EMR. This easy-to-implement solution captures images from multiple DICOM devices, converts them to a native format and makes them available for ingestion by the EMR.
Gear View Quality Control (QC)	Gear View QC is a simple and powerful quality control tool that solves day-to-day issues and makes workflow easier for PACS and EMR administrators and technologists. With intuitive functionality for viewing, importing, editing, printing and sharing, Gear View QC lets you fix common demographic errors in any DICOM field, as well as visually edit studies to split/combine exams or add/remove images.
Image Link	Image Link (formerly PACS Connect) is a proven workflow solution for hospitals and imaging centers. Built on open standards such as DICOM and HL7, Image Link enables Integrating Healthcare Enterprise (IHE) workflow for interoperability with your existing PACS. Simple and powerful software delivers data accurately and efficiently throughout your enterprise. Most importantly, PACS administrators can monitor and configure the application from any location on the network.
Media Writer	Media Writer is a low-maintenance, cost-effective and intuitive solution for outlying departments, hospitals, and imaging facilities. It delivers scalable, affordable, and reliable DICOM CD or DVD burning wherever images are created. From the desktop to the film room, Media Writer meets all of your image distribution needs. Now, image-intensive departments such as radiology, cardiology, gastroenterology, dermatology, orthopedics and pathology have a distribution system that is easy to configure, deploy, and maintain.
Medical Videoe Capture	Video Touch 4K lets you capture videos and images from visible light modalities and easily associate them with the correct patient record. It`s an ideal solution for c-arms, speech pathology, x-ray fluorography, angiography, ultrasound, endoscopy and vascular imaging systems. Video Touch 4K uses industry standards such as DICOM, Extended Data Services (XDS) and HL7 to connect images to a PACS, Vender Neutral Archive (VNA), XDS repository or EMR.
ModLink	ModLink is a software solution that uses DICOM Structured Report (SR), Extended Data Services (XML) or HL7 measurement data from modalities such as ultrasound, DEXA and CT. Radiological reports are auto-populated with the SR measurement data, saving valuable radiologist dictation time and reducing potential human error.
PACS Scan	PACS Scan lets you view screening forms, dose information, clinical images, patient studies and other important documents at the point of care. Electronically import JPEG/AVI/MPEG files and DICOM CDs/DVDs from any department to any EMR, PACS or VNA. Eliminate paper, improve workflow and provide easy access to important clinical documentation.
PACS Scan Film	The simple user interface allows anyone to scan documents and digitize film, and support for the DICOM Digital Mammography standard is included. Prior films and mammograms can be viewed in PACS, along with CR and DR images at the point of diagnosis.
PACS Scan Film for Mammography	Unique Dynamic Contrast Algorithm (DCA) enhances film-based mammography priors for easier comparison with digital images. PACS Scan Film for Mammography supports the VIDAR CAD PRO Advantage film digitizer. Built especially for digitizing mammography priors, the VIDAR CAD PRO has a robust, 50-sheet feeder tray and can digitize a four-film study in less than 120 seconds.
PACS Scan Web	PACS Scan Web supports enterprise-wide capture of clinical content by providing web-based capture tools to meet the needs of your various imaging departments.
Picture Archiving And Communication System (PACS) Scan Mobile	With PACS Scan Mobile, your organization can streamline the capture of vital patient images and video. This product leverages the mobile devices you have on hand to route content into your core systems from anywhere, any time. PACS Scan Mobile reduces delays, improves accessibility and speeds the sharing of patient content for more informed decisions and enhanced quality of care.
Video and Image Enablement Workflow for Epic	Video and Image Enablement Workflow (VIEW) for Epic brings together industry-leading, standards-based technology for image capture, management and viewing into a cost-effective and easy-to-implement solution. It is a pre-configured bundle, based on the Specialty Clinical Image Management (SCIM) solution, created to allow Epic clients to start small and then grow to support the enterprise imaging of the entire organization over time. With Video and Image Enablement Workflow, specialty departments across the health system can capture any image format, including video, into a centrally managed clinical archive and deliver it to clinicians through the enterprise viewer within Epic.

VA Categories View the VA Categorization Framework

Domain Area	Category	Customer Guidance	Category Locked By ELT Date
Health Care Health Services	Imaging

Operating Systems Supported by the Technology

Windows Client - Approved w/Constraints
Windows Server - Approved w/Constraints

Technologies/Standards Relationships

Runtime Dependencies:

Active Server Pages (ASP).NET Core
Microsoft .NET Framework
Microsoft Edge. - (required for some configurations)
Microsoft Internet Information Services (IIS)
Microsoft Structured Query Language (SQL) Server
Structured Query Language (SQL) Server Management Studio (SSMS)

Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

This is a well-documented technology.
At the time of writing, no National Institute of Standards and Technology (NIST) vulnerabilities had been reported and no VA Cyber Security Operations Center (CSOC) bulletins had been issued for the latest versions of this technology.
This technology supports a number of industry standard file formats.
This technology utilizes built-in Authentication and Authorization (A&A) capabilities.

Adoption Risks

This technology can integrate with and alter database technologies.
The potential exists to store Personally Identifiable Information (PII), Protected Health Information (PHI) and/or VA Sensitive data and proper security standards must be followed in these cases.
Due to the rapid release schedule of this technology, the VA may be unable to update to the most recent patch and may require a deployment model requiring the use of specific versions.
Bitmap Image File (BMP), an optional dependency of this technology, is in a divested state at the time of writing.
This technology can potentially use Secure Sockets Layer (SSL), an unapproved protocol.
There is no indication based on either the vendor documentation or the Cryptographic Module Validation Program (CMVP) that this technology is Federal Information Processing Standard (FIPS) 140-2 compliant.

Architectural Benefits

This technology is compatible with virtual machines, therefore consistent with the enterprise Server Virtualize First Policy (VAIQ 7266972 08-27-2012).
This technology supports Health Level 7 (HL7) and Digital Imaging and Communications in Medicine (DICOM) options to reduce transcription errors.
This technology can use a VA-preferred database.

Architectural Risks

This technology is not portable as it runs only on Windows platforms.
This technology includes cloud-based functionality which has potential information security risks.

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Technology Components

VA Categories View the VA Categorization Framework

Operating Systems Supported by the Technology

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Comparable Technologies:

Companion Technologies/Supported Standards:

General Analysis

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Architectural Benefits

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