tag:blogger.com,1999:blog-4384692836709903146.post3331292687805694321..comments2024-03-27T09:55:23.143-07:00Comments on Dispatch from the Digital Health Frontier: Enterprise Image ManagementJohn Halamkahttp://www.blogger.com/profile/04550236129132159307noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-4384692836709903146.post-59853268558934853222009-05-14T12:15:00.000-07:002009-05-14T12:15:00.000-07:00John great post. I have seen this issue with many ...John great post. I have seen this issue with many healthcare organizations. Image unification across specialties and departments have proved very challenging. We have partnered with many of the aforementioned image management solution vendors to help unify enterprise storage and image archive from top to bottom. I think this is an important point to unify and virtualize up and down the entire stack and not just the client facing layers/protocols. When looking at the backend supporting your image management solution consider storage virtualization, disaster recovery, and cloud storage as part of your strategy. Unified image management with storage stovepipes only solves half the problem.<br /><br />Contact me at dko,at,bycast,dot.com or 416-728-6346 if you want to talk further about this.Doug Kohttps://www.blogger.com/profile/16135449114220056227noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-9063322062101448802008-07-31T12:09:00.000-07:002008-07-31T12:09:00.000-07:00I confirmed that the images on your CD are uncompr...I confirmed that the images on your CD are uncompressed DICOMJohn Halamkahttps://www.blogger.com/profile/04550236129132159307noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-17019920788266530012008-07-30T20:06:00.000-07:002008-07-30T20:06:00.000-07:00> typical CT is 200 MBHuh - that suggests that ...> typical CT is 200 MB<BR/><BR/>Huh - that suggests that I actually got all the data on my CD! Would that be correct? And if so, would that make it diagnostic quality, as they say? <BR/><BR/>Obviously, in light of the recent Doc Searls story, what I'm exploring is the portability of my image data. If I actually have the whole magilla on my laptop, well, I'm pleased as punch!e-Patient Davehttps://www.blogger.com/profile/11608258246509102466noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-11242924716518834372008-07-30T19:45:00.000-07:002008-07-30T19:45:00.000-07:00BIDMC uses 1:25 Wavelet compression for its compre...BIDMC uses 1:25 Wavelet compression for its compressed images. DICOM object size is a function of the modality, grey scale, number of slices etc. A typical CT is 200 megabytes. A typical MRI is a few gigabytes.John Halamkahttps://www.blogger.com/profile/04550236129132159307noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-68123747814061601002008-07-28T20:21:00.000-07:002008-07-28T20:21:00.000-07:00John, you mentioned large DICOM objects. Having re...John, you mentioned large DICOM objects. Having received my own scan images on CD from BIDMC (thank you!), I'm wondering, how down-sampled are they? How much data does one of my CT scans generate?<BR/><BR/>Each of my scans seems to occupy <200MB on my PC. Now that I think of it, I'm sure that's very downsampled, but how much?<BR/><BR/>And here's the zillion dollar question: how big does it have to be, to qualify as diagnostic quality?<BR/><BR/>In my case, with inch-plus lesions, it's not hard to play Find the Goober in the Guts. But now that my goobers is gettin' tiny (and disappearing), my POV on this subject has shifted a bit.e-Patient Davehttps://www.blogger.com/profile/11608258246509102466noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-68878917711465911402008-06-08T05:41:00.000-07:002008-06-08T05:41:00.000-07:00John,I would like to support this strategic discus...John,<BR/>I would like to support this strategic discussion, as a solid promoter of standards and their effective adoption, not as a GE employee. <BR/>The fundamental issue about imaging interoperability is not about the image pixels but about standardized metadata related to these images. This is where DICOM may have the upper hand having harmonized the common metadata as well as addressed the modality specific elements for imaging in cardiology, dentistry, endoscopy, mammography, nuclear medicine, ophthalmology, orthopedics, pathology, pediatrics, radiation therapy, radiology, ultrasound, surgery, veterinary, etc. Whether the encoding format is XML, DICOM, moves in Web Services or not, is really a secondary point (although it will be a an interoperability barrier if left unspecified). <BR/>The metadata semantic standardization is the heart of the issue, to reach interoperability beyond a few IT systems in a single hospital project. <BR/>So choosing a strategy with an active, expert and forward looking standardization community that address both medical metadata and workflow standardization issues is most critical to making this type of decision.<BR/><BR/>Charles ParisotUnknownhttps://www.blogger.com/profile/05912079372291029205noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-41889484978860381902008-06-07T09:03:00.000-07:002008-06-07T09:03:00.000-07:00Typically practice management systems, EMRs and im...Typically practice management systems, EMRs and image management are seamlessly interfaced or integrated. In the case of our work at BIDMC, the practice management system and EMR are built on the same platform and share data completely. The Image management system is a separate platform but is available in the EMR with a single click on a URL.John Halamkahttps://www.blogger.com/profile/04550236129132159307noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-84999016537217517002008-06-06T20:47:00.000-07:002008-06-06T20:47:00.000-07:00sorry John, just got back to the comment. so the...sorry John, just got back to the comment. so the scheduling is seperate from the EMR? For us, having the two linked is a major efficiency item (most of our action buttons are schedule based). the way you describe it is three systems??? practice mngt, EMR, image mngt???Ian Furst https://www.blogger.com/profile/11795888117578055704noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-16154063813945818042008-06-04T18:54:00.000-07:002008-06-04T18:54:00.000-07:00Doctor's office automation consists of a practice ...Doctor's office automation consists of a practice management system for registration and scheduling, plus an electronic health record. Thus, I view all scheduling info as part of the administrative practice management system. Of course, the EHR would contain the documentation of each visit including diagnosis.John Halamkahttps://www.blogger.com/profile/04550236129132159307noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-45349543353312847472008-06-04T06:21:00.000-07:002008-06-04T06:21:00.000-07:00Hey John,This is a huge issue for the small office...Hey John,<BR/><BR/>This is a huge issue for the small office. A unified platform for image management (scanned documents and radiology) would seem logical but it's not easy. We've looked at AGFA but it's cost prohibitive for even a large group practice. Do you have any advice for smaller groups on this front?<BR/>BTW - do you considering scheduling data (clinics/appts, etc...) a significant part of the patients chart?Ian Furst https://www.blogger.com/profile/11795888117578055704noreply@blogger.com