Picture archiving and communication systems (PACS) perform the systematic acquisition, archiving, and presentation of large quantities of radiological image and text data. In the UCLA Radiology PACS, for example, the volume of image data archived currently exceeds 2500 gigabytes. Furthermore, the distributed heterogeneous PACS is expected to have near real-time response, be continuously available, and assure the integrity and privacy of patient data. The off-the-shelf subsystems that compose the current PACS cannot meet these expectations; therefore fault tolerance techniques had to be incorporated into the system. This paper is to report our first-step efforts towards the goal and is organized as follows: First we discuss data integrity and identify fault classes under the PACS operational environment, then we describe auditing and accounting schemes developed for error-detection and analyze operational data collected. Finally, we outline plans for future research.