Overview:
As real-time Radiology becomes more of a reality in a filmless environment, utilization of PACS workstations to perform specific tasks such as for diagnostic, review/consult, or quality assurance purposes become more and more crucial. However, in parallel to these specific tasks is the need to perform study management workflow. For this reason, we have implemented a web application that allows the user to remotely send exams between two DICOM nodes in Stand Alone architecture. The ease-of-use of the application simplifies PACS exams distribution by allowing the user to perform remote control distribution from a PDA (Personal Digital Assistant), making it a very attractive option especially when dealing with many DICOM nodes added to a clinical environment with PACS.
This application includes the following features:
1) Web accessible from PDAs and PCs
2) Real DICOM Viewing capabilities for PDAs only
3) Alternative JPEG Image conversion for PCs and PDAs without the DICOM viewer
4) Remote Medical Image distribution in a PACS network
5) Suitable for Disaster Recovery Scenarios.
Secure communication using HTTPS (Hyper Text Transfer Protocol Secure) standard.
Challenges:
The major challenges to the deployment of this project include:
1) Developing a DICOM Viewer for a PDA: Even though great advances have been made to recent versions of PDAs, they do not have all the power that a regular PC has. The Viewer is an ActiveX component.
2) Integrating the DICOM Viewer into a Web Application: After developing the DICOM viewer for the PDA then we had to incorporate it into the SMT tool. The interaction between the Viewer and the browser is achieved using Javascript. This task requires intensive processing taking it hard to balance it with the limited resources of a PDA.
Wireless Communication and Security: The transfer speed over a wireless link and security are among the top requirements you will expect from this kind of applications. The security of the application comes from making it work on a secure Web Server with restricted access to the contents; and the transfer speeds for the wireless communication can be overcome by putting close Wireless Access Points in the environment. Currently we are also testing it to work on Metropolitan Wireless Broadband networks.
Implementations:
Pictures 1 thru 9 show the Graphical User Interface (GUI) of the application.
Clinical Evaluation & Results
The SMT-PDA application has been tested in a clinical environment for more than 3 years now. Currently Saint Johns Health Center (SJHC) has one installation and promptly it will be upgraded to the new version of the system that includes the display of the images. Also, Health Care Consultation Center II (HCCII), an outpatient facility, will be provided with a PDA server for testing purposes.
Publications
Documet J, Liu BJ, Documet L, Huang HK, Wireless Remote Control Clinical Image Workflow: Using a PDA for Off-Site Distribution and Disaster Recovery, Journal of American College of Radiology, Volume 3, Issue 7, pages 520-527, July 2006.
Liu BJ, Documet L, Documet J, Huang HK, Muldoon J, Clinical Experiences Utilizing Wireless Remote Control and an ASP Model Backup Archive for a Disaster Recovery Event, Proceedings of SPIE Medical Imaging, 5371:288-296, 2004.
Erberich SG, Documet J, Zhou MZ, Cao F, Liu BJ, Mogel GT, Huang HK, Wireless PDA Controlled Image Workflow from PACS: The Next Trend in the Health Care Enterprise?, Proceedings of SPIE Medical Imaging, 5033:181-186, 2003