Performance of asynchronous transfer mode (ATM) local area and wide area networks for medical imaging transmission in clinical environment

Digital Imaging and PACS: An Update

The instant and simultaneous availability of radiologic examinations has long been of interest to referring clinicians, and certainly to radiologists, within and outside of the hospital. In daily clinical routine, the term “film management problem” has been used to describe a lack of access to this essential part of clinical information. Comprehensive picture archiving and communication systems (PACSs) have been proposed and implemented only within few institutions. This article discusses some of the most important standards, and technical and practical aspects of digital imaging and PACS.

Medical image security in a HIPAA mandated PACS environment

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information.

Iterative interim techniques for reduced costs and a better mammography workstation: an opinion

The promise of digital mammography has focused considerable resources on the challenges of mammography workstations, but the risk of wasted time and resources in such efforts is very high. Although final testing of the workstation's image quality and ergonomics is common, a number of interim evaluation and refinement techniques can be applied throughout the design and development process. The use of such techniques holds potential not only to save time and money but also to produce a superior workstation.

Telemedicine and its impact on cancer management

The latest dramatic progress in the technologies of the computer industry is likely to increasingly influence the oncologist's daily routine. Besides well known and established telemedical services such as videoconferencing, the most influential trends are the spread of digital hospital infrastructures with unlimited, secured access to all relevant patient information. This article seeks to summarise the most imminent influences of telemedical developments on the future of the oncologist: the effects of telemedical services and electronic infrastructures on clinical workflow and on medical quality management. In addition, the history of telemedicine, recent technologies and the performance of electronic patient records are described.