Radiology information systems, picture archiving and communication systems, teleradiology - Overview and design criteria

Information technology (IT), long taken for granted in commercial settings, is now being utilized for healthcare applications. Medical imaging has tag ged comparatively due to the extremely vast data content of each frame; thu s, the requirement for expensive high-end components. Further, IT in radiol ogy has evolved from two distinctly separate camps-information systems, kno wn as RIS (radiology information systems) and PACS (picture archiving and c ommunications systems). Both RIS and PACS applications have migrated to the PC environment, enabling cost-effective implementation, but from two backg rounds: RIS from vendors using conventional information systems platforms a nd products, and PACS from radiographic film and modality vendors. The radi ology department at Texas Tech University has assembled a seamlessly integr ated, enterprise-wide RIS/PACS/teleradiology intranet. The design criteria include user-friendliness, flexibility to respond to changing needs, and op en modular architecture to assure interoperability, cost-effectiveness, and future-proofing of investment. Since no single venor could provide an inte grated system meeting our specifications, we decided to assume the burden o f constructing our own system. As the system integrator, we embrace open ar chitecture, thus enabling the incorporation of industry-standard-compliant, COTS (commercially off the shelf) products as modules. Microsoft Windows N T operating system, Visual C++ programming language, TCP/IP (transmission c ontrol protocol/internetworking protocol), relational SQL (structured query language) database, ODBC (open database connectivity), HL-7 (health level seven) and DICOM (digital imaging and communications in medicine) interface s are utilized. The usage of COTS components reduces the cost to very affor dabte levels. With this approach, any module in our system can be replaced when outmoded, without affecting other modules in our system, making it tru ly future-proof. Construction and evolution of our system (TECHRAD) is revi ewed. Copyright (C) 1998 by W.B. Saunders Company.