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Shiokawa Y, Mori N, Sakusabe T, Imai T, Watanabe H, Kimura M. Medical Image Sharing in Japan. J Digit Imaging 2022. [PMID: 35995897 DOI: 10.1007/s10278-022-00675-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 03/24/2022] [Accepted: 04/04/2022] [Indexed: 11/12/2022] Open
Abstract
This paper reports the history, background including politics, current status of Japan’s health imaging study and other information sharing. Its realization was slow until the Ministry of Health, Labour and Welfare (MHLW) started paying digital image storage at the same rate as films in 2008. Information sharing was initiated in early 2010s, which was before vendors became ready for Integrating the Healthcare Enterprise (IHE) cross-enterprise document sharing (XDS), with the result that most of 34 large regional sharing systems are in non-standardized protocol. One standardized example is the Hamamatsu area where inexpensive online PDI (portable data for imaging) was introduced.
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Persons KR, Nagels J, Carr C, Mendelson DS, Primo H“R, Fischer B, Doyle M. Interoperability and Considerations for Standards-Based Exchange of Medical Images: HIMSS-SIIM Collaborative White Paper. J Digit Imaging 2021; 33:6-16. [PMID: 31768898 PMCID: PMC7064628 DOI: 10.1007/s10278-019-00294-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This white paper explores the considerations of standards-based interoperability of medical images between organizations, patients, and providers. In this paper, we will look at three different standards-based image exchange implementations that have been deployed to facilitate exchange of images between provider organizations. The paper will describe how each implementation uses applicable technology and standards; the image types that are included; and the governance policies that define participation, access, and trust. Limitations of the solution or non-standard approaches to solve challenges will also be identified. Much can be learned from successes elsewhere, and those learnings will point to recommendations of best practices to facilitate the adoption of image exchange.
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Affiliation(s)
| | - Jason Nagels
- Manager Clinical Program at HDIRS, Ontario, Canada
| | - Chris Carr
- Director of Informatics at RSNA, Chicago, IL USA
| | | | | | - Bernd Fischer
- ITH Icoserve Technology for Healthcare GmbH, Innsbruck, Austria
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Schwind F, Münch H, Schröter A, Brandner R, Kutscha U, Brandner A, Heinze O, Bergh B, Engelmann U. Long-term experience with setup and implementation of an IHE-based image management and distribution system in intersectoral clinical routine. Int J Comput Assist Radiol Surg 2018; 13:1727-39. [PMID: 29998400 DOI: 10.1007/s11548-018-1819-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Sharing of medical data is crucial for the proper treatment of patients as it could reduce the risk of duplicated medical tests and speed up the care process if all documents are readily available. Despite great technical progress, sharing patient data while maintaining full control over the process in an intersectoral (in Germany, this describes the different actors in the healthcare system consisting of clinic, ambulatory care, etc.) setting remains a particular challenge. This paper focuses on the successful implementation of a privacy compliant, standards-based image-management component of a personal electronic health record. METHODS Over a 5-year period, a sharing system based on readily available IHE profiles constructed around XDS has been built. It was necessary to create interfaces for the existing hospital sub-systems to become part of the network. Specifically, the imaging workflow had to be adapted to allow for fast and easy access to DICOM images utilizing a flexible web-based image viewer. In addition to the standard XDS workflow, an Imaging Cache was established which combines the Imaging Document Source and Consumer to guarantee fast and streaming-based access to all images in the network observing the high security standards of the hospital network. RESULTS The authors of this paper have proven that it is possible to build a fast and reliable sharing system based on IHE profiles using most of the transactions of XDS-I with some adaptions to the clinical workflow. Primary hospital systems were enabled by building adapters to overcome lack of IHE compatibility. The established system embraces the existing security mechanisms in hospital networks while connecting patients and referring physicians from outside in a secure and convenient manner. CONCLUSIONS A state-of-the-art sharing system that is used in a productive clinical environment has been established and is ready to grow with more partners. The system is the basis for an elaborated interdisciplinary collaboration where data, and in particular images, can now be shared between medical professionals.
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Abstract
This white paper explores the technical challenges and solutions for acquiring (capturing) and managing enterprise images, particularly those involving visible light applications. The types of acquisition devices used for various general-purpose photography and specialized applications including dermatology, endoscopy, and anatomic pathology are reviewed. The formats and standards used, and the associated metadata requirements and communication protocols for transfer and workflow are considered. Particular emphasis is placed on the importance of metadata capture in both order- and encounter-based workflow. The benefits of using DICOM to provide a standard means of recording and accessing both metadata and image and video data are considered, as is the role of IHE and FHIR.
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Affiliation(s)
- David A Clunie
- Pixelmed Publishing LLC., 943 Heiden Rd, Bangor, PA, 18013, USA.
| | - Don K Dennison
- Don K Dennison Solutions Inc., 205 Fern Cres, Waterloo, ON, N2V 2P9, Canada
| | - Dawn Cram
- Department of Information Technology, University of Miami Health System, Miami, FL, 33136, USA
| | - Kenneth R Persons
- Mayo Clinic and Foundation, 200 First St. SW, Pb 2-58, Rochester, MN, 55905, USA
| | - Mark D Bronkalla
- Merge Healthcare, 900 Walnut Ridge Drive, Hartland, WI, 53029, USA
| | - Henri Rik Primo
- Digital Health Services, Siemens Healthineers, 65 Valley Stream Parkway, Malvern, PA, 19355, USA
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Vreeland A, Persons KR, Primo HR, Bishop M, Garriott KM, Doyle MK, Silver E, Brown DM, Bashall C. Considerations for Exchanging and Sharing Medical Images for Improved Collaboration and Patient Care: HIMSS-SIIM Collaborative White Paper. J Digit Imaging 2016; 29:547-58. [PMID: 27351992 PMCID: PMC5023527 DOI: 10.1007/s10278-016-9885-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The need for providers and patients to exchange and share imaging has never been more apparent, yet many organizations are only now, as a part of a larger enterprise imaging initiative, taking steps to streamline an important process that has historically been facilitated with the use of CDs or insecure methods of communication. This paper will provide an introduction to concepts and common-use cases for image exchange, outline challenges that have hindered adoption to date, and describe standards for image exchange that show increasing promise of being adopted by vendors and providers.
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Affiliation(s)
- Amy Vreeland
- Imaging Strategies, 30 Locke Road, Waban, MA, 02468, USA.
| | | | - Henri Rik Primo
- Siemens Medical Solutions USA, Inc., Digital Health Services, 60 Valley Stream Parkway, Malvern, PA, 19355, USA
| | - Matthew Bishop
- UnityPoint Health IT, 4500 Utica Ridge Road, Bettendorf, IA, 52722, USA
| | - Kimberley M Garriott
- Logicalis, Inc, Healthcare Strategies Division, 9225 Priority Way, Suite 115, Indianapolis, IN, 46240, USA
| | | | - Elliott Silver
- McKesson Imaging and Workflow Solutions Division, 475 Allendale Road, King of Prussia, PA, 19406, USA
| | - Danielle M Brown
- Aspirus IT, 2800 Westhill Drive, Suite 102, Wausau, WI, 54401, USA
| | - Chris Bashall
- Sir Charles Gairdner Hospital Radiology Dept, 1 Hospital Avenue, Nedlands, 6009, WA, Australia
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Aryanto KY, van Kernebeek G, Berendsen B, Oudkerk M, van Ooijen PM. Image De-Identification Methods for Clinical Research in the XDS Environment. J Med Syst 2016; 40:83. [PMID: 26811074 DOI: 10.1007/s10916-016-0431-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/07/2016] [Indexed: 12/05/2022]
Abstract
To investigate possible de-identification methodologies within the Cross-Enterprise Document Sharing for imaging (XDS-I) environment in order to provide strengthened support for image data exchange as part of clinical research projects. De-identification, using anonymization or pseudonymization, is the most common method to perform information removal within DICOM data. However, it is not a standard part of the XDS-I profiles. Different methodologies were observed to define how and where de-identification should take place within an XDS environment used for scientific research. De-identification service can be placed in three locations within the XDS-I framework: 1) within the Document Source, 2) between the Document Source and Document Consumer, and 3) within the Document Consumer. First method has a potential advantage with respect to the exposure of the images to outside systems but has drawbacks with respect to additional hardware and configuration requirements. Second and third method have big concern in exposing original documents with all identifiable data being intact after leaving the Document Source. De-identification within the Document Source has more advantages compared to the other methods. On the contrary, it is less recommended to perform de-identification within the Document Consumer since it has the highest risk of the exposure of patients identity due to the fact that images are exposed without de-identification during the transfers.
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Hagiwara H, Nemoto A, Inoue T. Burden on university hospitals of handling portable data for imaging (PDI) media. Appl Clin Inform 2014; 5:46-57. [PMID: 24734123 DOI: 10.4338/aci-2013-07-ra-0052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/19/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Portable Data for Imaging (PDI) is regularly used as a guideline for sharing medical imaging data between hospitals and other medical institutions. When a patient is referred to another location, the patient almost always brings PDI media on a CD or DVD. However, problems often occur when trying to view images on PDI discs inserted into computer terminals, and it is more efficient to view images on the hospitals' own picture archiving and communication system (PACS). On the request of doctors, it has become a routine practice to import PDI data to the PACS of the referred hospital. OBJECTIVE The aim of this study was to analyze the increase in PDI image importing and investigate methods for reducing the burden caused by importing images. METHODS We compiled representative data on image importing over time and analyzed the test modalities, number of images, volume of data, and referring hospital or medical clinic from which the data originated. RESULTS The amount of PDI images imported to the PACS has risen despite no large increase in the number of patients. Currently, images imported from PDI media make up 22.8% of the total number of images stored in the PACS. The images come from a diverse array of hospitals (184 hospitals) and 82% are essential for medical care. The total annual expenditure associated with PDI data management is estimated to be 98,300 USD. CONCLUSION The spreading use of the PDI guideline has led to a dramatic increase in data image sharing in the field of healthcare. While this has great benefits for patients and doctors, it is also associated with a greater cost and an overall burden for hospitals. These results indicate the need for a system to enable many hospitals and clinics to participate in image sharing at a cheaper cost.
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Affiliation(s)
- H Hagiwara
- Department of Radiology, Yokohama City University Hospital , Yokohama, Japan
| | - A Nemoto
- Department of Medical Informatics, Yokohama City University Hospital , Yokohama, Japan
| | - T Inoue
- Department of Radiology, Graduate School of Medicine, Yokohama City University , Yokohama, Japan
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