A hospital-wide distributed PACS based on intranet

A hospital-wide Picture Archiving and Communication System (PACS) is currently under development at the University Hospital of Geneva. After a first implementation including two oneterabyte optical libraries, the system is expanded to integrate all the imaging modalities of the hospital. The new storage requirement is 10 terabytes to cover three year archive. A large distributed image archive has been designed including new archive servers for long-term storage and display servers for medium-term storage. The acquisition, archive and distribution cycles are performed using separated networks combining Fast Ethernet and Ethernet. Image files are distributed to the wide-hospital using a prefetching strategy or an Intranet server, RADIOLAB. The first mode takes advantage of the fully integrated hospital information system DIOGENE 2 to allow the automatic retrieval of studies in advance. The second mode provides a convivial study selection from any conventional WWW (World Wide Web) browser. Image files are then transmitted to the user's display station using HTTP (HyperText Transfer Protocol) and handled by OSIRIS software, which acts as a helper or viewer. Such a system is expected to meet the time requirement, which is less than three seconds per image.

Multimedia image and data navigation workstation

World Wide Web (WWW) standards have been established for the transmission of and remote consultation on medical information and records, including medical images, extracted from an existing hospital information system. A software package called Osiris is being used for the display and manipulation of medical images in a hospital-based picture archiving and communication system. Recent extensions of Osiris, through the integration of WWW navigational tools, allow easy access to a variety of clinical data from patient records. A special interface allows access to radiologic images, laboratory results, and related textual information through public-domain software programs. These technologic advances offer medical professionals the convenience and ease of use that have made WWW and Internet navigation so popular in the academic community.

In-house access to PACS images and related data through World Wide Web

The development of a hospital wide PACS is in progress at the University Hospital of Geneva and several archive modules are operational since 1992. This PACS is intended for wide distribution of images to clinical wards. As the PACS project and the number of archived images grow rapidly in the hospital, it was necessary to provide an easy, more widely accessible and convenient access to the PACS database for the clinicians in the different wards and clinical units of the hospital. An innovative solution has been developed using tools such as Netscape navigator and NCSA World Wide Web server as an alternative to conventional database query and retrieval software. These tools present the advantages of providing a user interface which is the same, independent of the platform being used (e.g. Mac, Windows, UNIX), and an easy integration of different types of documents (e.g. text, images). A strict access control has been added to this interface. It allows user identification and access rights checking, as defined by the in-house hospital information system, before allowing the navigation through patient data records.

Unimage, a new RIS for the DIOGENE 2 environment at Geneva Cantonal University Hospital

The effective management of a radiology department depends on adequate computing tools for imaging specialists--radiologists and technicians--and administrators. The rapid evolution of imaging techniques in radiology requires flexible systems for describing the daily operation of a service and accessing data generated by every possible source. In order to compensate for the insufficiencies of our current radiology information system (RIS), and within the framework of the migration towards the DIOGENE 2 hospital information system, a new RIS, named Unimage, has been implemented at the Cantonal University Hospital of Geneva. Unimage has been designed not only to fit the current and future needs of the radiology department, but also to operate in different services, i.e. diagnostic radiology, nuclear medicine and therapy radiology. Among its functionalities, Unimage offers a simple two-way data communication with the PACS world. The technical choices we have made in the design of the new RIS include a distributed environment, as well as a graphical (X/Motif) user interface. The main functionalities and the technical implementation of Unimage are described in this paper.