Digital imaging in medicine has come a long way from mid of the 1980’s when the first standards for interoperability were drafted by the American College of Radiology since today where we see a true exchange of images in many technological and also regional areas.
Very many terms are in vogue that deal with the growing needs to have all types of images available for more and more clinical areas and even consolidated across multi-site clinics and of course the different vendors. “Vendor neutral archives” (VNA’s), PACS 2.0 and the image-enabled EHR are just a few of the terms that try to indicate the direction where medical images and information are going to. The nature of this is always the independence of the contained information and the availability for a big audience of interested parties.
In digital pathology true interoperability and standardization were very hard to achieve in the last decade because of the challenges that come with the images and the complex workflows that had to be tackled. With the DICOM supplement 145 a very important prerequisite is now available and adopted by some of the vendors, especially the scanner manufacturers. This provides the opportunity to connect to the existing infrastructure in terms of existing applications such as LIMS, PACS or HER’s as mentioned above. What we have to keep in mind here is that all those key features that enable a quick and broad adoption of digital pathology need to be prepared for this new area which is very different from the existing one that was driven by radiology.
In order to accelerate the adoption of the new standards by the existing (radiology) PACS vendors, an enormous level of transparency is helpful, yet required. The resources in the web are very scarce or do not even exist. The options to enable this transparency are manifold and could be among others:
- Discussions, articles and papers on the current status of adoption
- Your experience with DICOM and HL7 implementations so far
- Descriptions of typical clinical workflows and use cases including the different types of applications
- DICOM and HL7 compliance claims
- Sample files and messages, especially of the encoded images
- Publicly available implementations of key elements such as DICOM Modality Worklists, DICOM MPPS, DICOM toolkits covering supp. 145
- Regular meetings to test the implemented features à la IHE Connectathons
What do you think?