Abstract
This paper describes why and how DICOM, the standard that has been the basis for medical imaging interoperability around the world for several decades, has been extended into a full web technology-based standard, DICOMweb. At the turn of the century, healthcare embraced information technology, which created new problems and new opportunities for the medical imaging industry; at the same time, web technologies matured and began serving other domains well. This paper describes DICOMweb, how it extended the DICOM standard, and how DICOMweb can be applied to problems facing healthcare applications to address workflow and the changing healthcare climate.
Highlights
Medical imaging plays a critical role as a diagnostic tool
Because imaging is key to so many clinical workflows, if imaging exists, but is not accessible, clinicians may need to re-image the patient [2], which adds risk from ionizing radiation, creates unnecessary cost, causes delays in treatment, increases stress and discomfort for the patient and their families, and increases strain on hospital resources
In order to address these challenges, all applications that touch upon medical imaging—be they Picture Archive and Communication Systems (PACS), Electronic Medical Records (EMR), Electronic Health Records (EHR), Radiology Information Systems (RIS), Vendor Neutral Archives (VNA), imaging acquisition devices, network gateways, and proxies— must agree to communicate information in a standard way and in a standard format
Summary
Medical imaging plays a critical role as a diagnostic tool. Reynolds concluded back in 2003, Bwhile written descriptions of lesions and infectious processes may be detailed, the visual presentation of these conditions is much more accurate and effective for diagnosis and treatment^ [1]. DICOM is the standard for retrieving, storing, printing, and transmitting information in medical imaging, and includes both a file structure and communication protocol [3]. DICOM defines formats for images, waveforms, and derived structured data to provide the entire dataset necessary for clinical use It enables imaging department workflow management, media exchange and printing, and it achieves this using service-based network protocols over TCP/IP and HTTP. DICOM defines significant meta-data, for example, for patient identification and demographics, ordering information, acquisition parameters, and workflow context This metadata is used to query, sort, route, display, and manage the images. DICOMweb makes it possible to render DICOM instances into widely used consumer-friendly formats suitable for web browsers on both desktops and mobile devices, without requiring a mass conversion of the existing historic data or information model. Many of the concepts from MINT were later re-worked and adopted into the development of the DICOMweb *-RS services, with input from the user and vendor communities alike
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