Our institution (San Francisco VA Medical Center) is a VA pilot center for total digital imaging and PACS. Quantitative information about PACS impact on health care is limited, because no centers have done rigorous preimplementation studies. We are gathering quantitative service delivery and cost data before, during, and after stepwise implementation of computed radiography and PACS at our institution to define the impact on imaging service delivery. We designed a simple audit method using the x-ray request and time clocks to determine patient waiting time, imaging time, film use, image availability to the radiologist, matching of current with previous images, image availability to clinicians, and time to final interpretation. Our department model is a multichannel, mulitserver patient queue. Our current radiograph file is space limited, containing only one year of images; older images are kept in a remote file area in another building. In addition, there are 16 subfile areas within the Radiology Service and the medical center. Our preimplementation audit showed some long waiting times (40 minutes, average 20) and immediate retrieval of prior films in only 42% of cases, with an average retrieval time of 22 hours. Computed radiography and the optical archive have the potential to improve these figures. The audit will be ongoing and automated as implementation of PACS progresses, to measure service improvement and learning curve with the new equipment. We present the audit format and baseline preimplementation figures.