The Web Access to Digital Imaging and Communication in Medicine (DICOM) Persistent Objects (WADO) service is standardized as the Web extension to DICOM. This paper analyzes the operational specifications of the WADO service and extends its access capability to the whole DICOM hierarchy (patient, study, series, and object). The proposed Web Access to DICOM Archives (WADA) service, as opposed to WADO, also includes an extrainternal query mechanism and support of medical reports submission. A pilot implementation of WADA as software components and their integration into a three-tier architecture are also presented. Advanced security mechanisms are augmented to ensure communication encryption, user identification, and access restriction to data according to user roles. The proposed service is a simple approach, and can be embedded in any system managing medical images and reports. WADA can also be integrated into the Cross-Enterprise Document Sharing-Imaging (XDS-I) standard, which is considered to be the most likely future standard for medical imaging exchange.
Multiprotocol medical imaging communication through the Internet is more flexible than the tight DICOM transfers. This paper introduces a modular multiprotocol teleradiology architecture that integrates DICOM and common Internet services (based on web, FTP, and E-mail) into a unique operational domain. The extended WADO service (a web extension of DICOM) and the other proposed services allow access to all levels of the DICOM information hierarchy as opposed to solely Object level. A lightweight client site is considered adequate, because the server site of the architecture provides clients with service interfaces through the web as well as invulnerable space for temporary storage, called as User Domains, so that users fulfill their applications' tasks. The proposed teleradiology architecture is pilot implemented using mainly Java-based technologies and is evaluated by engineers in collaboration with doctors. The new architecture ensures flexibility in access, user mobility, and enhanced data security.
Early and specialized pre-hospital patient treatment improves outcome in terms of mortality and morbidity, in emergency cases. This paper focuses on the design and implementation of a telemedicine system that supports diverse types of endpoints including moving transports (MT) (ambulances, ships, planes, etc.), handheld devices and fixed units, using diverse communication networks. Target of the above telemedicine system is the pre-hospital patient treatment. While vital sign transmission is prior to other services provided by the telemedicine system (videoconference, remote management, voice calls etc.), a predefined algorithm controls provision and quality of the other services. A distributed database system controlled by a central server, aims to manage patient attributes, exams and incidents handled by different Telemedicine Coordination Centers (TCC).
All users of informatics applications need rapid and reliable access to the kind of information that they are interested in. Web technology provides these capabilities. DICOM standard committees recognized the necessity of a Web medical standard. They specified WADO (Web access to DICOM object) service, so that system interaction takes place through Web, in a standarized way, allowing interoperability and proper information management inside PACS. The advantages of a Web PACS comparatively with a compatible PACS are multiple and they are detected in different fields of functionality. The authors have run a project of a WADO compatible Web PACS development. A Web portal platform with enhanced security has been implemented. Over it, DICOM applications have been developed. JavaServer Pages (JSP) technology is mainly used to satisfy design specifications and dynamic data exchanges. Furthermore, Java applets have been developed and introduced in the whole project to serve specific demands. Evaluation results confirmed our considerations about the improvement of DICOM services, when they are provided through web.
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