Case Study

Accelerating Quality: Test Automation in PACS

A Page-Object-Model automation framework for a multi-platform PACS viewer, built for scale and regulatory traceability.

PACS DICOM Test Automation Selenium QA
70% Reduction in regression testing time
Web + Desktop One framework, two PACS viewer platforms
Page Object Model Modular, maintainable automation architecture

Client & Context

The healthcare industry is undergoing a significant transformation with the integration of software test automation into medical imaging systems. Our client runs a highly specialized, multi-platform PACS Viewer built for large hospitals managing immense volumes of medical imaging data — available in both Web and Desktop versions, with smooth imaging functionality including effortless scrolling, image analysis, and 3D rendering. Validating that viewer by hand, across two platforms and every imaging workflow, was no longer sustainable.

The Problem

Manual testing in PACS environments runs into hard limits: complex workflows spanning multiple imaging modalities and systems, high volumes of heterogeneous medical image data, and repetitive regression and compliance checks that don't scale with release cadence. PACS (Picture Archiving and Communication System) software has to keep proving conformance to DICOM, HIPAA, and FDA requirements on every release — and doing that by hand across a Web viewer and a Desktop viewer meant slow feedback cycles, human error in repetitive tests, and gaps in coverage.

What We Built

We built a modular, layered test automation framework around the Page Object Model (POM) for the client's Multi-Platform PACS Viewer:
  • Abstraction layer — Page Classes abstract the UI elements and interactions of the PACS application, decoupling test logic from UI details; Test Classes define the actual test scenarios by calling methods on those Page Objects.
  • Driver layer — Selenium WebDriver acts as the interface to both target applications, translating automation commands into browser and UI actions.
  • Application-under-test layer — covers PACS Web (browser-based) and PACS UI (desktop/native), including multi-resolution monitor scenarios for the desktop viewer.
  • Data/resource layer — a centralized image repository provides test-specific DICOM data for every scenario.
  • Reporting layer — NUnit drives execution and Allure Report visualizes outcomes for auditable, compliance-ready documentation.

Key Areas Covered

  • DICOM compliance testing — file structure, metadata, SOP class conformance, transfer syntaxes, encoding, and compression.
  • Imaging workflow automation — simulated modality uploads (CT, MRI, ultrasound), PACS archival/routing/retrieval, and automated validation of image display in diagnostic viewers.
  • Integration testing — HL7 message exchange with HIS/RIS, order entry and scheduling, and cross-vendor interoperability.
  • Performance and load testing — stress testing under high user load and monitoring latency during simultaneous uploads and retrievals.
  • Security and access control testing — RBAC validation, encryption/anonymization checks, and audit logging.

Automation Architecture

PACS test automation architecture showing the Page Object Model, Selenium, test data, web and desktop PACS targets, and the reporting path.
The model separates test abstraction, execution, target applications, and auditable reporting.

The Result

  • Reduced regression testing time by 70%.
  • Detected critical bugs immediately after deployment.
  • Enhanced test coverage across multiple imaging workflows.
  • Automated image comparison, validating complex imaging functionality such as scrolling and 3D rendering.
DCMTK dcm4che pynetdicom pydicom Selenium WebDriver Robot Framework Cypress Squish JMeter K6 NUnit Allure Report ReportPortal Azure DevOps

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