Upgrading legacy systems for the integrating the Healthcare Enterprise (IHE) initiative

As technology vendors have adopted standardized communication protocols, in cluding Digital Imaging and Communications in Medicine (DICOM) and Health L evel 7 (HL7), interconnectivity between various devices has been simplified . The recent Integrating the Healthcare Enterprise (IHE) initiative will fu rther promote the use of standards for interconnectivity. Until these stand ards are universally accepted, we must live in a transitional world where s ome components will communicate without any modification, while others requ ire upgrades to allow them to meet the new standards. In designing and impl ementing the network at University of California Los Angeles (UCLA) Medical Center, some integration problems were found that are common to the indust ry. Creating departmental workflow with only a limited number of acquisitio n devices supporting the DICOM worklist was the initial problem addressed. Although many manufacturers provide this function for their new scanners, u pgrading existing equipment is often cost-prohibitive. To ensure the qualit y of the demographic information in the image data and the workflow of the system, third-party worklist components were required to upgrade the legacy acquisition devices. These worklist components provided a standards-compli ant facade on top of the legacy equipment, allowing seamless integration wi th the remainder of the network. To support the distribution of worklist in formation and the feedback of procedure status, a bidirectional HL7/DICOM p rotocol bridge was required. Although many radiology information system (RI S) manufacturers will be providing native DICOM capabilities in future prod uct releases, the majority of current RIS installations have no DICOM funct ionality. Similar to the legacy scanners, the HL7/DICOM bridge provided a D ICOM-compliant facade to the non-DICOM RIS. The additional use of web-based technology for worklist display further extended flexibility of this facad e. We have demonstrated standards-compliant facade technology allowing lega cy components to operate seamlessly in an IHE environment at a fraction of the cost of upgrading to new equipment. Copyright (C) 2000 by W.B. Saunders Company.