Securing Picture Archiving and Communication System

Current Status

The NCCoE has finalized the Securing Picture Archiving and Communication System Project Description for the Healthcare Sector. Once the Federal Register Notice (FRN) has been published, we encourage technology providers to submit a Letter of Interest should they have a commercially available product suited for the build. Please continue to check this page for updates. Read our two-page fact sheet for an overview of this project.


The National Cybersecurity Center of Excellence (NCCoE) at NIST is proposing a project to provide guidance on securing the Picture Archiving and Communication System (PACS) ecosystem in Healthcare Delivery Organizations (HDOs). This project will include the development of a reference design and use commercially available technologies to develop an example solution that will help healthcare sector organizations implement more secure PACS solutions through the use of stronger security controls.

PACS is nearly ubiquitous in hospitals, prompting the Healthcare Sector to identify its security as a critical need. HDOs face many challenges securing a PACS. These challenges include:

  • asset management
  • access control, user identification and authentication
  • data security
  • security continuous monitoring
  • response planning, recovery and restoration

PACS requires controls that provide significant integrity, availability, and confidentiality assurances because it ties into doctor-patient workflow management. The results are based on image interpretation which aids in deciding a patient’s next step such as determination of health condition, follow-on visits, patient care, and other actions.

This project focuses on providing increased security benefits while minimizing the impact and availability to PACS and other components. Improved control and management of PACS can limit exposures to a threat vector that could act as a point where an attack may be performed or serve as a pivot point into an integrated healthcare information system, thereby improving a HDOs cybersecurity posture. The scope of the project will include the PACS ecosystem to allow storage, retrieval, management, distribution, and presentation of medical images. It will result in a publicly available NIST Cybersecurity Practice Guide, a detailed implementation guide of the practical steps required to implement a cybersecurity reference design that addresses this challenge.

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