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17 March 2015 Design challenges and gaps in standards in developing an interoperable zero footprint DI thin client for use in image-enabled electronic health record solutions
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Abstract
The deployment of regional and national Electronic Health Record solutions has been a focus of many countries throughout the past decade. A major challenge for these deployments has been support for ubiquitous image viewing. More specifically, these deployments require an imaging solution that can work over the Internet, leverage any point of service device: desktop, tablet, phone; and access imaging data from any source seamlessly. Whereas standards exist to enable ubiquitous image viewing, few if any solutions exist that leverage these standards and meet the challenge. Rather, most of the currently available web based DI viewing solutions are either proprietary solutions or require special plugins. We developed a true zero foot print browser based DI viewing solution based on the Web Access DICOM Objects (WADO) and Cross-enterprise Document Sharing for Imaging (XDS-I.b) standards to a) demonstrate that a truly ubiquitous image viewer can be deployed; b) identify the gaps in the current standards and the design challenges for developing such a solution. The objective was to develop a viewer, which works on all modern browsers on both desktop and mobile devices. The implementation allows basic viewing functionalities of scroll, zoom, pan and window leveling (limited). The major gaps identified in the current DICOM WADO standards are a lack of ability to allow any kind of 3D reconstruction or MPR views. Other design challenges explored include considerations related to optimization of the solution for response time and low memory foot print.
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Arun Agrawal, David Koff M.D., Peter Bak, Duane Bender, and Jane Castelli "Design challenges and gaps in standards in developing an interoperable zero footprint DI thin client for use in image-enabled electronic health record solutions", Proc. SPIE 9418, Medical Imaging 2015: PACS and Imaging Informatics: Next Generation and Innovations, 94180M (17 March 2015); https://doi.org/10.1117/12.2082805
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