Mastering DICOM with DVTk

The Digital Imaging and Communications in Medicine (DICOM) Validation Toolkit (DVTk) is an open-source framework with potential value for anyone working with the DICOM standard. DICOM’s flexibility requires hands-on experience in understanding ways in which the standard’s interpretation may vary among vendors. DVTk was developed as a clinical engineering tool to aid and accelerate DICOM integration at clinical sites. DVTk is used to provide an independent measurement of the accuracy of a product’s DICOM interface, according to both the DICOM standard and the product’s conformance statement. DVTk has stand-alone tools and a framework with which developers can create new tools. We provide an overview of the architecture of the toolkit, sample scenarios of its utility, and evidence of its relative ease of use. Our goal is to encourage involvement in this open-source project and attract developers to build off and further enrich this platform for DICOM integration testing

Secure Integration of Information Systems in Radiology

Medical Imaging is an industry where distinctive imaging protocols such as Digital Communications in Medicine (DICOM) and Health Level 7 (HL7) are used to transmit patient data across multiple information systems relaying possible life-saving data their providers. These information systems, unique to radiology departments require proper integration and workflow to achieve the CIA triad of confidentiality, integrity, and availability. This paper discusses the challenges of integrating disparate healthcare radiology information system with particular emphasis on protocol security

A Platform for Innovation and Standards Evaluation: a Case Study from the OpenMRS Open-Source Radiology Information System

Open-source development can provide a platform for innovation by seeking feedback from community members as well as providing tools and infrastructure to test new standards. Vendors of proprietary systems may delay adoption of new standards until there are sufficient incentives such as legal mandates or financial incentives to encourage/mandate adoption. Moreover, open-source systems in healthcare have been widely adopted in low- and middle-income countries and can be used to bridge gaps that exist in global health radiology. Since 2011, the authors, along with a community of open-source contributors, have worked on developing an open-source radiology information system (RIS) across two communities-OpenMRS and LibreHealth. The main purpose of the RIS is to implement core radiology workflows, on which others can build and test new radiology standards. This work has resulted in three major releases of the system, with current architectural changes driven by changing technology, development of new standards in health and imaging informatics, and changing user needs. At their core, both these communities are focused on building general-purpose EHR systems, but based on user contributions from the fringes, we have been able to create an innovative system that has been used by hospitals and clinics in four different countries. We provide an overview of the history of the LibreHealth RIS, the architecture of the system, overview of standards integration, describe challenges of developing an open-source product, and future directions. Our goal is to attract more participation and involvement to further develop the LibreHealth RIS into an Enterprise Imaging System that can be used in other clinical imaging including pathology and dermatology

Information Technologies for the Healthcare Delivery System

That modern healthcare requires information technology to be efficient and fully effective is evident if one spends any time observing the delivery of institutional health care. Consider the observation of a practitioner of the discipline, David M. Eddy, MD, PhD, voiced in Clinical Decision Making, JAMA 263:1265-75, 1990, . . .All confirm what would be expected from common sense: The complexity of modern medicine exceeds the inherent limitations of the unaided human mind. The goal of this thesis is to identify the technological factors that are required to enable a fully sufficient application of information technology (IT) to the modern institutional practice of medicine. Perhaps the epitome of healthcare IT is the fully integrated, fully electronic patient medical record. Although, in 1991 the Institute of Medicine called for such a record to be standard technology by 2001, it has still not materialized. The author will argue that some of the technology and standards that are pre-requisite for this achievement have now arrived, while others are still evolving to fully sufficient levels. The paper will concentrate primarily on the health care system in the United States, although much of what is contained is applicable to a large degree, around the world. The paper will illustrate certain of these pre-requisite IT factors by discussing the actual installation of a major health care computer system at the University of Rochester Medical Center (URMC) in Rochester, New York. This system is a Picture Archiving and Communications System (PACS). As the name implies, PACS is a system of capturing health care images in digital format, storing them and communicating them to users throughout the enterprise

PACS de patologia: uma plataforma centralizada para a gestão de imagem médica de patologia

The clinical area of digital Pathology is still giving its first steps in the development of interoperable solutions that enable the distributed acquisition, storage, and visualization of medical images, including diagnostic support tools. Nowadays, digital management solutions use proprietary image formats and communication protocols that are not compatible with the DICOM standard. Moreover, the available technologies are not mature enough to support the practice of medicine in an area where scanned images can reach several gigapixels, requiring new engineering approaches to support huge volumes of data, in the order of gigabytes per study, that need to be consumed in real time. This dissertation aims to research and develop new technologies and associated information systems, capable of supporting the digital acquisition of pathology images, their centralized archive, sharing, and collaborative review with decision support tools. The result is an innovative web solution, focused on increasing productivity, with safe diagnostics and based on normalized protocols. A common web browser was transformed into a professional workstation that is able to access the image repository at any place and time, regardless of the operating system and without any prior installation.A área de Patologia clínica digital ainda se encontra a dar os primeiros passos no desenvolvimento de soluções interoperáveis que permitam a aquisição, arquivo e visualização distribuída da imagem, incluindo ferramentas de suporte ao diagnóstico. Os atuais cenários de revisão à distância usam aplicações proprietárias que não são interoperáveis com a norma DICOM. Isto deve-se ao facto de a tecnologia não estar suficientemente madura para apoiar a prática clínica numa área em que uma imagem digitalizada pode atingir vários giga-pixels, requerendo novas soluções de engenharia para suportar grandes volumes de dados, da ordem de gigabyte por estudo, que necessitam de ser consumidos remotamente em tempo real. Esta dissertação teve como objetivo estudar e desenvolver tecnologias e sistemas de informação que permitam a aquisição digital da imagem de patologia, o seu arquivo centralizado, a partilha e revisão colaborativa com ferramentas de suporte à decisão. O resultado é uma solução Web inovadora, de elevada produtividade, diagnóstico seguro e baseada em processos e protocolos normalizados. Um Web-browser comum foi transformado numa estação de trabalho capaz de aceder ao arquivo em qualquer altura e qualquer lugar, independentemente do sistema operativo, computador ou dispositivo móvel.Mestrado em Engenharia Informátic

Guidelines Digital Pathology for Diagnosis on (and Reports of) Digital Images Version 1.0 Bundesverband deutscher Pathologen e.V. (Federal Association of German Pathologist)

Digitalization is entering the medical fields with increasing velocity and impact on diagnostic and therapeutic actions. In addition, it matures to a mandatory tool of quality assurance, reliable inter-disciplinary communication, and promotion of research. The Professional Association of German Pathologists wants to support their members in their thoughts and potential implementation of virtual microscopy and related issues. It founded a committee of digital pathology. Colleagues experienced in routine surgical pathology, information technology and practice have been asked to investigate prerequisites, actual technology stages and financial considerations, and to formulate their recommendations and guidelines. Herein, the official guidelines of the Professional Association of German Pathologists are presented. The guidelines focus on practical issues, Pathologists as well as IT experts or interested researchers are invited to make use of these guidelines. Our readers are also invited to inquire specific tasks or discuss their ideas and experiences. They might either contact the committee directly, or discuss specific points of view by writing a letter to the editor, or by submission of, and to formulate a corresponding interactive publication

Filmless Hospital with PACS as a Workflow Controller, Case Study: National Hospital Surabaya

Traditionally radiology produces a visual representation of medical images in film format for further clinical analysis. While some healthcare providers still used films to display scan results, others are embracing the advancing technology of digital medical images. In radiology, this medical imaging technique is generally equated to filmless radiology. However, modern technology has enabled other clinical areas beyond radiology to use digital imaging, including cardiology, pathology, obstetric and gynecology, orthopedic and dentistry. This widely implementation of filmless system in hospital is known as filmless hospital. This paper discusses filmless hospital using picture archiving and communication system (PACS) as workflow controller as a case study at National Hospital Surabaya

Filmless Hospital with PACS as a Workflow Controller, Case Study: National Hospital Surabaya

Traditionally radiology produces a visual representation of medical images in film format for further clinical analysis. While some healthcare providers still used films to display scan results, others are embracing the advancing technology of digital medical images. In radiology, this medical imaging technique is generally equated to filmless radiology. However, modern technology has enabled other clinical areas beyond radiology to use digital imaging, including cardiology, pathology, obstetric and gynecology, orthopedic and dentistry. This widely implementation of filmless system in hospital is known as filmless hospital. This paper discusses filmless hospital using picture archiving and communication system (PACS) as workflow controller as a case study at National Hospital Surabaya