Virtual PACS, open systems, and the National Information Infrastructure

Dennis L. Wilson; Fred W. Prior; Robert A. Glicksman

doi:10.1117/12.208823

12 May 1995 Virtual PACS, open systems, and the National Information Infrastructure

Dennis L. Wilson, Fred W. Prior, Robert A. Glicksman

Proceedings Volume 2435, Medical Imaging 1995: PACS Design and Evaluation: Engineering and Clinical Issues; (1995) https://doi.org/10.1117/12.208823
Event: Medical Imaging 1995, 1995, San Diego, CA, United States

Abstract

Teleradiology and telemedicine move images and related patient data from one medical treatment facility to another. Higher speed communication systems are rapidly being deployed as the national information infrastructure evolves. Demonstration projects have shown that higher performance networks permit an expanded scope of capabilities beyond simple image transmission to full PACS services at a distance. A virtual PACS that ties together several local PACS services is considdred. The interchange of informtion such that each of the local PACS knows about activity around the system is required. The database that tracks the acquisition of new medical exams may be distributed or may be centralized. A distributed database is proposed. Ramifications of the distributed virtual PACS include the possibility of restricting some services to be local and other services to be global. The virtual PACS will enable such things as a virtual radiology department with radiology specialists located at different places through the system. Sharing of specialists will increase their utilization, improve patient outcomes and reduce overall costs by reducing the need for every subspecialty at every location. Virtual PACS may be seen as a set of applications and services within the broader telecommunications framework of the national information infrastructure (NII). As such virtual PACS must be `open systems.' As defined here, an open system in the narrow sense requires a software platform that is widely supported and hardware independent. An open system is based on standards that are widely accepted and for which software is readily available from multiple sources. In the broader sense an open system is a set of services with standard interfaces distributed on a network and sharing common communication facilities. The NII depends on global consensus on appropriate standards. It is vital that medical image and information service components of the NII be carefully defined. The DICOM standard has been shown to be a key component of a global medical communication strategy and capable of forming the basis for constructing a virtual PACS. It is one of several complimentary standards that will be required for global open systems. To be useful in supporting radiology groups the NII should provide economical 2 to 10 megabyte per second services, considerably beyond the data rates available on the Internet today. Communication rates as low as 200 kilobytes per second (1.6 megabits per second) will introduce delays in service, but may be acceptable. Rates below about 64 kilobits per second destroy the utility of a radiology group serving a large area.

Citation Download Citation

Dennis L. Wilson, Fred W. Prior, and Robert A. Glicksman "Virtual PACS, open systems, and the National Information Infrastructure", Proc. SPIE 2435, Medical Imaging 1995: PACS Design and Evaluation: Engineering and Clinical Issues, (12 May 1995); https://doi.org/10.1117/12.208823

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