Radiology IT: Applications Integration vs. Consolidation

Abstract

The question of whether Radiology IT systems should be composed of multiple applications integrated using standard data exchange protocols, such as DICOM and HL7, or implemented using consolidation of applications and systems has been debated for the past 30 years. The adequacy of the former approach has become a burning issue because the demands on Radiology IT systems have increased greatly. We report here on the experience of the Radiology Information Technology (IT) implementation at the Memorial Sloan-Kettering Cancer Center (MSKCC) over the past 11 years; during this time, the weekly image accumulation rate increased from 100,000 to 2,000,000 images. During the implementation period, major difficulties were encountered, largely as a result of the inadequacies of the Radiology IT architecture widely used in the healthcare industry. The approach we chose to correct some of these difficulties has been consolidation of some of the multiple systems and applications. Three examples of systems consolidation are discussed: (1) converting a dual-tier image storage system to a single tier, (2) consolidation of Mammography reading into PACS, and (3) enabling 3D visualization and analysis on the PACS workstation. Nevertheless, substantial research and development are needed in order to proceed with more extensive systems consolidation and, thus, a more manageable IT installation.

Cloud computing in medical imaging

“…Cloud storage prices have been dropping faster than enterprise storage prices, and this trend will likely lead to faster cloud adoption for medical image storage. [17][18][19][20] An important driver of cloud storage is the observation that as CTs and MRI studies increase in size, longer times are required to transfer them to imaging workstations. Rendering imaging studies from the cloud to zero footprint viewing applications (considered in more detail in Sec.…”

Obstacles and Solutions Driving the Development of a National Teleradiology Network

“…Technical limitations repressing and slowing the rise of teleradiology were identified in display technique, processor speed, data transmission, and data storage infrastructure [ 10 ]. Gradual adaptation and stepwise integration of technological communication standards such as Digital Imaging and Communications in Medicine (DICOM) or Health Level 7 (HL7) and the need to preserve medical records and imaging at any cost account for variable depths of integration of teleradiological sites into radiology and hospital information systems (RIS and HIS) [ 11 ]. At certain points in time, inhomogeneous networks can therefore appear as patchwork solutions, which ultimately require heightened efforts to facilitate and accelerate the management of cases [ 12 ].…”