Modern hospitals have been greatly facilitated with information technology (IT) such as hospital information system (HIS). One of the most prominent achievements is medical imaging and image data management so-called Picture Archiving and Communication Systems (PACS). Due to inevitable use of diagnostic images (such as X-ray, CT, MRI), PACS made tremendous impact not only on radiology department but also nearly all clinical departments for exchange and sharing image related clinical information. There is no doubt that better use of PACS leads to highly efficient clinical administration and hospital management. However, due to rapid and widespread acceptance of PACS storage and management of digitized image data in hospital introduces overhead and bottleneck when transferring images among clinical departments within and/or across hospitals. Despite numerous technical difficulties, financing for installing PACS is a major hindrance to overcome. In addition, a mirroring or a clustering backup can be used to maximize security and efficiency, which may not be considered as cost-effective approach because of extra hardware expenses. In this study therefore we have developed a new based on grid of distributed PACS in order to balance between the cost and network performance among multiple hospitals.