ENTERPRISE-SCALE IMAGE DISTRIBUTION WITH A WEB PACS

The integration of images with existing and new health care informatio n systems poses a number of challenges in a multi-facility network: im age distribution to clinicians; making DICOM image headers consistent across information systems; and integration of teleradiology into PACS , A novel, Web-based enterprise PACS architecture introduced at Massac husetts General Hospital provides a solution. Four AMICAS Web/Intranet Image Servers were installed as the default DICOM destination of 10 d igital modalities, A fifth AMICAS receives teleradiology studies via t he Internet, Each AMICAS includes: a Java-based interface to the IDXra d radiology information system (RIS), a DICOM autorouter to tape-libra ry archives and to the Agfa PACS, a wavelet image compressor/decompres sor that preserves compatibility with DICOM workstations, a Web server to distribute images throughout the enterprise, and an extensible int erface which permits links between other HIS and AMICAS. Using wavelet compression and Internet standards as its native formats, AMICAS crea tes a bridge to the DICOM networks of remote imaging centers via the I nternet. This teleradiology capability is integrated into the DICOM ne twork and the PACS thereby eliminating the need for special teleradiol ogy workstations. AMICAS has been installed at MGH since March of 1997 . During that time, it has been a reliable component of the evolving d igital image distribution system. As a result, the recently renovated neurosurgical ICU will be filmless and use only AMICAS workstations fo r mission-critical patient care. Copyright (C) 1998 by W.B. Saunders C ompany.