Portable Data for Imaging - implementing in Australia


Patient care is being adversely affected as images on CDs are not always accessible to those without the technology and skills to use them. In many cases, examinations have to be repeated. The RANZCR, ADIA and other medical professional organisations all agree that treating clinicians should be able, where appropriate, to view diagnostic quality images in order to plan clinical care. During the transition phase to digital imaging, radiology practices have an obligation to provide images on film as an option if requested by a treating doctor. When producing digital images on CD, it is important to produce an image CD which is compliant with the IHE-Portable Data for Imaging profile and the RANZCR standards.

The RANZCR Standards of Practice Version 9.0 (clause 3-8-2) requires that “the practice has implemented, or is working toward implementation by 1 January 2010, systems that ensure that all portable media issued by the practice are compliant with the IHE-PDI profile”.

IHE requires the use of standard CD and portable media formats which mean that the media will run and display on any workstation (Windows, Mac, and Unix). The imaging content must use a strict implementation of uncompressed DICOM for image creation and viewing. The location of the files on the disk is defined to support systems to load, and there is a (currently) optional approach to include lower quality compressed image formats for viewers who do not need diagnostic quality (many GPs and patients). Vendors are encouraged to implement this feature and to enable the content of the disk to be managed from the index.htm page on the portable media. This will support patients and clinicians who would prefer to examine key images using a web browser, rather than the full image set requiring the mastery of a DICOM viewer.

In addition to the IHE PDI profile the RANZCR has developed a set of standards that deal with the labelling and storage of image CDs.
Download a copy of the RANZCR Standards

Note:
While the delivery of digital images on portable media in a standard IHE and RANZCR format is a major step for vendors and clinicans, these media have significant practical limitations in some circumstances, and the radiology IT industry, services and end users are advised to consider the practical steps needed to implement systems to load and manage images in many different clinical environments.

The RANZCR imaging website provides copies of a number of reports on digital imaging transfer which deal with these issues and are recommended for consideration.

Vendors implementing or upgrading PDI implementation are recommended to participate in the IHE connectathon process and to publish an IHE conformance statement for the products concerned.


References:


Radiology Technical Framework http://www.ihe.net/Technical_Framework/index.cfm#radiology

IHE Radiology Technical Framework Vol. 1 : Section 15 p 160-168

RANZCR Digital Imaging website

RANZCR introduction to IHE

RANZCR Practice Standards dealing with imaging


Implementation suggestions:


Consider implementing both Portable Media Creator and Portable Media Importer profiles

The IHE pre-connectaton test tooling for PDI can be download from the iHE Wiki. This may help with testing during development.

The provision of a DICOM viewer on the CD is optional, and if present will support access to the DICOM image set for the occasional user of digital images or when a standard clinical imaging enabled workstation is not available (containing a DICOM viewer that is familiar to the clinical user). This should not be regarded as the primary or preferred viewing tool .

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