Choosing a PACS can shape the next 10 years of your imaging department. Yet many leaders still rely on gut feel, vendor hype, or checklists that do not reflect real clinical operations. In this episode of Imaging Informatics Unplugged, I sit down with Dr. Alex Towbin, Professor of Radiology and the Neil D. Johnson Chair of Radiology Informatics at Cincinnati Children’s Hospital, to break down the complete PACS selection process behind his team’s widely referenced study. The PACS Selection Blueprint: What Every Imaging Leader Gets Wrong | with Dr. Alex TowbinWe cover every stage of the journey. The politics, the data, the shortcomings of vendor demos, and the real-world constraints that most hospitals underestimate. Dr. Towbin explains how his team evaluated 10 PACS vendors, how they neutralized bias within the committee, why radiologists often remain attached to their first PACS, and what PACS 3.0 will require as AI-driven workflows mature.If you are a PACS admin, enterprise imaging strategist, IT architect, radiology leader, or anyone preparing for an upcoming procurement, this episode will give you a clear and practical blueprint to follow.📝 Read the full published paperhttps://link.springer.com/article/10.1007/s10278-025-01672-7⸻In This Episode• How Cincinnati Children’s designed a transparent and data-focused PACS selection process• Why radiologists become “imprinted” on their first PACS and how that shapes department culture• The hidden cost of switching PACS and why minor improvements may not justify a complete replacement• How real anonymized data exposed significant weaknesses in vendor demos• What to expect in the shift toward PACS 3.0 with AI-enabled and automated workflows• Why database access, technologist workflows, and support models often matter more than shiny features• How to scale your procurement approach based on the impact of the system• What imaging leaders should rethink heading into their next PACS evaluation cycleChapters0:00 When your PACS feels tired – episode setup2:09 Meet Dr. Alex Towbin and the PACS selection study2:39 Why Cincinnati Children’s re-evaluated their PACS3:41 How radiologists get “imprinted” on their first PACS5:32 Alex’s journey across three generations of PACS6:14 Principles for a fair and transparent PACS selection8:53 Equal voice for radiologists, technologists, and IT11:24 Balancing data, emotion, and gut feel in decisions14:03 Sticking with the incumbent and the real cost of switching17:42 Asking vendors to load real anonymized pediatric data24:22 Lessons learned and how they would run the next RFP25:42 Support models, database access, and working with vendors30:50 Final advice⸻🎓 Advance your Imaging Informatics Skills• Courses: https://learn.nagelsconsulting.com• Consulting and Solutions: https://nagelsconsulting.com• Spotify: • LinkedIn: https://www.linkedin.com/company/nagels-consulting⸻🎧 Listen on Spotifyhttps://open.spotify.com/show/4DAxDXd0kpvRh6NwvSJiVF📺 Watch on YouTubehttps://www.youtube.com/@NagelsConsulting