Implementation methods of medical image sharing for collaborative health care based on IHE XDS-I profile

Abstract

Abstract. IHE XDS-I profile proposes an architecture model for cross-enterprise medical image sharing, but there are only a few clinical implementations reported. Here, we investigate three pilot studies based on the IHE XDS-I profile to see whether we can use this architecture as a foundation for image sharing solutions in a variety of health-care settings. The first pilot study was image sharing for cross-enterprise health care with federated integration, which was implemented in Huadong Hospital and Shanghai Sixth People's Hospital within the Shanghai Shen-Kang Hospital Management Center; the second pilot study was XDS-I-based patient-controlled image sharing solution, which was implemented by the Radiological Society of North America (RSNA) team in the USA; and the third pilot study was collaborative imaging diagnosis with electronic health-care record integration in regional health care, which was implemented in two districts in Shanghai. In order to support these pilot studies, we designed and developed new image access methods, components, and data models such as RAD-69/WADO hybrid image retrieval, RSNA clearinghouse, and extension of metadata definitions in both the submission set and the cross-enterprise document sharing (XDS) registry. We identified several key issues that impact the implementation of XDS-I in practical applications, and conclude that the IHE XDS-I profile is a theoretically good architecture and a useful foundation for medical image sharing solutions across multiple regional health-care providers.

Design of the Integrated Health Information System in the District of Bangli

“…Reference [11] implemented a method for sharing medical images data to provide collaborative medical services based on XDS for imaging (XDS-I) profiles. XDS-I itself is a variant of the XDS profile that is focused on the problem of medical image transfer.…”

Easy transfer of digital image data: Principle vs implementation

“…1 Subsequently, RSNA has been working on developing an image share network (ISN) for sharing medical images along with the accompanying radiology reports. 1,2 Transfer between out-of-network clinical practices without the use of physical media such as CDs can occur through a virtual private network or through cross-enterprise document sharing (XDS). 1 Because the latter method is more amenable to impromptu data transmission, RSNA has collaborated with LifeIMAGE Inc (Newton, MA, USA) to develop a cloud-based method of transferring image data from a server located on a clinical site to a personal health record system accessible to the patient or to another unrelated clinical site.…”

“…1 Because the latter method is more amenable to impromptu data transmission, RSNA has collaborated with LifeIMAGE Inc (Newton, MA, USA) to develop a cloud-based method of transferring image data from a server located on a clinical site to a personal health record system accessible to the patient or to another unrelated clinical site. 1,2 To improve interoperability, the Integrating Healthcare Enterprise (IHE) XDS standards are used. 1 IHE XDS is a set of policies and specifications, basically integration profiles, for exchanging medical documents.…”

“…1 IHE XDS is a set of policies and specifications, basically integration profiles, for exchanging medical documents. 2 XDS-I (where "I" stands for imaging) adds digital imaging and communications in medicine (DICOM)based transactions and can be used for exchange of imaging data. 1 XDS allows for exchange of DICOM-formatted image data for importing into the receiving site's software, and it can be packaged with an embedded viewer, which is necessary in the case of image data transmission to the patient.…”

“…1 XDS allows for exchange of DICOM-formatted image data for importing into the receiving site's software, and it can be packaged with an embedded viewer, which is necessary in the case of image data transmission to the patient. 2 The LifeIMAGE cloud-based transfer system is referred to as the clearing house and is HIPAA-compliant. 2 The clearing house is based on the IHE XDS-I.b profile (I.b is the current version in use) and serves multiple roles that include document registry and repository, imaging document source, DICOM image manager, and Patient Identifier Cross Referencing manager.…”