This study was conducted to improve performance flow of PACS registration and output of external medical images by developing or adding File Transfer Protocol(FTP) Module on Order Communication System(OCS) and to upgrade efficiency of performance. The numbers of requests for examination of external medical images from January 2004 to December 2007 were investigated and the numbers of cases of examinations and losses were done respectively from January to June, 2007 as a period before the improvement and from July to December, 2007 as a period after it. Satisfaction of persons inputting external medical images of CD was asked directly before and after the improvement. When the numbers of requests for examination of external medical images from 2004 to 2007 2004 were investigated, they were 12,783, 16,774, 21,613 and 27,487 cases in 2004, 2005, 2005 and 2007 respectively. For the numbers of the requests from January to December, 2007 it was the lowest in February by recording 1846 and it was 2800 in October. While the number of loss of external medical images was averagely 3.6 before using FTP Module on OCS, it reduced to 0 and satisfaction increased to 98% after it. By utilizing FTP Module on OSC for PACS registration of external medical images, the images were delivered simultaneously with occurrence of order, PACS registration of many patients was conducted together and CDs were returned to patients immediately after sending images from outpatient clinics or wards to remove possibility of losing them. In addition, because the module was established on OCS and data were sent associated with order, problems related with order were decreased. By eliminating movement distance it was turned out to be very effective in terms of time and space.