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1, A pediatric radiology department at an institution such as Minneapolis Children's Medical Center is a true microcosm of the gigantic radiology department of a general hospital. Our positive experiences with IMACS discussed above should be even more profound and profitable for the larger medical institutions. 2, IMACS did improve service and communications among radiologists, referring clinicians and the hospital staff. Both the old and new images needed for review and comparison are presently available for the clinicians on the nursing stations as soon as the current studies have been completed. 3, IMACS allowed us to reduce the number of films lost, misplaced or misfiled and reduced the interpretation delays by keeping all the films in the radiology department. This has resulted in improvement in the overall productivity of the radiology staff and the referring clinicians. 4, The cost of IMACS was paid for through additional revenue capture, increased productivity and a decrease in the expenses in the radiology department in less than one year. These benefits should continue for several more years without the need for any additional expenses. 5, Despite these initial successes, there are several issues which must be addressed before total computerization of the radiology services and a "filmless" radiology department can be created. A. The speed of an available workstation is totally inadequate for the day to day clinical use.(ABSTRACT TRUNCATED AT 250 WORDS)