Teleradiology Brochure

TELERADIOLOGY
Available Technologies in Remote Diagnostics
THE WORLD
IN YOUR
HANDS
TELERADIOLOGY SOLUTIONS
ACCESS YOUR MEDICAL IMAGES
ANYTIME AND ANYWHERE
Selecting the right solution for teleradiology is crucial. Therefore, we offer you a comprehensive review
w of the available technologies to make your decision easier and more accurate.
Thanks to the ongoing technology
Unfortunately, the number of radiol-
Besides, if a second opinion is re-
development and the sinking costs
ogist and specialists trained to read
quired, the shipping of images to
of medical diagnostic equipment,
those medical images is not growing
another specialist may involve very
examinations based on medical im-
at the same rate as the studies being
high costs and even the quickest
ages are becoming increasingly
currently produced. This generates a
means of transport can be too slow
common and accessible to a large
serious bottle-neck, which becomes
if a human life
f depends on it.
part of the population. Even remote
even more complicated as most
regions are nowadays in possession
of sophisticated imaging equipment.
tend to settle in metropolitan areas.
2
TELERADIOLOGY SOLUTIONS
By implementing teleradiology sys-
Technically seen, there are two
At present, teleradiology programs
tems, many hospitals and imaging
main parameters that must be tak-
can be implemented by using one
centers can solve these key issues.
en into account for any teleradiol-
of the following technologies:
Radiologists do not have to be pres-
ogy project:
DICOM email using PGP encryp-
ent at the same location as the pa-
tion
tients and even the largest images
1. The transmitted and received
DICOM email basic
can be transferred in a matter of
minutes. This way, hospitals and imaging centers increase their indesavings in time and resources. Additionally, they can outsource pos-
data must be consistent.
2. The privacy of the patient’s data
Web-based access using data
compression
must be ensured either by using
Simple web-based access
high-asymmetric encryption or
DICOM communication, using im-
by pseudonymizing/anonymizing
age compression and VPN
the data.
Direct DICOM communication using VPN
sibilities for sub-specializations while
keeping high standards and elimi-
-
nating bottle-necks.
priate teleradiology solution, we
prepared a helpful guide explaining
these available technologies for remote diagnostics.
3
DICOM EMAIL USING PGP ENCRYPTION
This is the most secure and dynam-
ed DICOM objects or even for com-
DICOM email using PGP encryption
ic one of the available solutions for
plete studies of unlimited size.
is also ideal for bidirectional DICOM
teleradiology.
communication. This means that
This technology requires DICOM
Among its major advantages are
reading physicians can return their
its versatility, the possibility of a fully
protocols via email using the same
email servers at each facility. The
platform.
data is automatically encrypted
vendor support with high interoperability. Additionally, thanks to its
Reliant Medical Systems offers
or connection and the transmission
state-of-the-art
a product with these character-
takes place using standard POP3/
rithms, the system offers the highest
SMTP protocols.
security standards.
At the destination, the data will be
This solution is optimized for the trans-
automatically decrypted. Then, the
mission of medical images among
physician can hand it over to a local
independent healthcare providers.
PACS or view it with an integrated
Since it uses standard email proto-
DICOM viewer.
cols, it may be easily integrated with
encryption
algo-
istics called RPACS-MAIL.
This system can be used for select-
1
1 Either the email message (includ-
4
ing attachments) is composed
on a workstation or images are
transferred directly between the
PACS and RPACS-MAIL.
Workstations
PACS
RPACS-MAIL
2
3
2
RPACS-MAIL encrypts the message
and sends it to the centrally located email provider via SMTP.
3 The email message is transferred
to the receiving site. There, it will
be either decrypted and forEmail Provider
Mobile Workstations
incl. RPACS-MAIL
warded to the local RPACS-MAIL
client or rerouted to additional
destinations.
4 Since RPACS-MAIL can even handle
1
ers can receive emails at any
time.
Workstations
RPACS-MAIL
4
DICOM EMAIL BASIC
DICOM email basic is a solution to
There is medium-level privacy pro-
DICOM viewers like RPACS do
send emails manually from a DI-
tection when using DICOM email
already include DICOM email as one
COM node. This system can be used
basic; the system does not show
of their features.
for any selected DICOM object.
standardized regulations for signatures.
A standard email infrastructure supports the transmission, which makes
DICOM email basic is optimal for
the system fast, secure (when using
the transmission of medical images
encryption), cost-saving and also
between low frequented point-to-
very stable when working through
multipoint independent healthcare
providers, like small imaging cenDICOM email basic it is further possible to enable bidirectional DICOM
communication.
CD
Mail Server
using DICOM Email
RPACS
PACS
RPACS
Windows
5
®
Printer
WEB ASED ACCESS USING DATA COMPRESSION
This solution can be connected to
Web-based access using data com-
any existing PACS, which distrib-
pression allows the possibility to link
utes the respective medical imag-
selected studies/reports with full in-
es either through a DICOM proxy
teractivity. The system is compara-
This solution is recommended for
or directly to the web server. The
ble to in-house access and is gener-
emergency support provided by
function of the DICOM proxy is to
ally very fast.
remote physicians, for remote read-
SSL web ports.
precompress the images before
-
handing them over to the web serv-
Access to the system involves me-
er and, if necessary, to perform a
dium security. Additionally, the pa-
pseudonymizing/anonymizing pro-
tients’ privacy protection level is
The products offered by Reliant
cedure on the studies.
very good and remote storage of
Medical Systems. for web-based
images is not required.
access using data compression are
The studies are then available on
the web via SSL (https web-link).
bution of studies in large facilities.
RPACS-WEBX for the PACS and
Users should be aware that image
RPACS-ROUTER for the optional DICOM
data compression may limit the di-
proxy.
agnostic quality depending on the
selected method.
Modality
RPACS-X
RPACS-ROUTER (optional)
RPACS-WEBX + WADO
Firewall
Viewing Station
RPACS-X Viewing Station
Medical Information System
6
WEB ASED ACCESS
The web-based access solution is
The protection of the patients’ pri-
based on an existing PACS, which
vacy is very good and remote stor-
takes place in pull-mode, i. e. there
distributes the respective studies via
age of images is not required.
are waiting times for the images to
http or https web-links.
be loaded. The DICOM communication is unidirectional, i. e. it is opti-
Using web-based access, a secure
or SSL should be open.
mized for querying of data.
cess rights and methods) can be es-
Web-based access is recommend-
iQ-WEBX, the PACS of IMAGE Infor-
tablished giving the user the possi-
ed for in-house reading or transmis-
mation Systems Ltd., is ideal for web-
bility to link selected studies/reports
sion to referring physicians, e. g. in a
based access.
with full interactivity.
hospital.
connection (depending on the ac-
iQ-X
Modality
iQ-WEBX + WADO
iQ-X Viewing Station
Viewing Station
Medical Information System
7
TELERADIOLOGY SOLUTIONS
By implementing teleradiology sys-
Technically seen, there are two
At present, teleradiology programs
tems, many hospitals and imaging
main parameters that must be tak-
can be implemented by using one
centers can solve these key issues.
en into account for any teleradiol-
of the following technologies:
Radiologists do not have to be pres-
ogy project:
DICOM email using PGP encryp-
ent at the same location as the pa-
tion
tients and even the largest images
1. The transmitted and received
DICOM email basic
can be transferred in a matter of
minutes. This way, hospitals and imaging centers increase their indesavings in time and resources. Additionally, they can outsource pos-
data must be consistent.
2. The privacy of the patient’s data
Web-based access using data
compression
must be ensured either by using
Simple web-based access
high-asymmetric encryption or
DICOM communication, using im-
by pseudonymizing/anonymizing
age compression and VPN
the data.
Direct DICOM communication using VPN
sibilities for sub-specializations while
keeping high standards and elimi-
-
nating bottle-necks.
priate teleradiology solution, we
prepared a helpful guide explaining
these available technologies for remote diagnostics.
3
TELERADIOLOGY SOLUTIONS AT A GLANCE
DICOM EMAIL
DICOM EMAIL
USING PGP
BASIC
WEB-BASED
WEB-BASED
ACCESS USING
ACCESS
COMPRESSION
Principal
Selected DICOM
Functionality
objects or complete
studies transferred
with dedicated
(Supp 113)
Selected DICOM
DICOM COMMUNICATION USING IMAGE
COMPRESSION & VPN
Distribution of
Image distribution
objects zipped,
c ompressed images
via https web-link
incl. DICOMDIR
via https web-link
C
dard DICOM parameters (IP, AET) on both
sides,
infrastructure
C ommunication
of DICOM protocol
using a compression
proxy between the
modalities
Advantages
Easy to handle,
Standard mail-
Secure connection,
Secure connection,
Can be 2-4 times
Fully automated,
infrastructure can
Links to selected
Links to selected
faster than the band-
studies and reports
be used,
studies/reports with
Multi-vendor
Fast,
full interactivity,
and 10-50 times faster
support with high
Low costs
Comparable with
using lossy compression,
in-house access,
Transfer in push-mode,
Very fast
Objects available at
interoperability
width using lossless
distant site when needed
Possible issues
Security
Some overhead
No standardized
due to mail-protocol
regulation for
Transfer in pull-mode
Complex work to install
(waiting for images)
networks with many
High
High
High
State-of-the-art
(Depending on access
(Depending on access
encryption
rights / method)
rights / method)
High
High
(No storage at remote
(No storage at remote
and near inly-transfer
signature
Very high,
High
Patient’s Privacy
Very high,
protection level
Includes a dvanced
Medium
signatures
Firewall integration
Best for
DICOM
Image compression
nodes
Medium
site required)
site required)
Easy
Easy
Can be complex
Moderate
Can be complex
(standard email)
(standard email)
(VPN support)
(SSL)
(VPN support)
Transfer of DICOM
Low frequented
Emergency support,
A ccess for in-house
A ny highly frequented
objects between
p oint-to-multipoint
H
reading or referring
a nd/or time-critical
independent
teleradiology
physician
connection between
Unidirectional
Bidirectional
healthcare providers
solutions
Bidirectional
Bidirectional
Unidirectional
imaging centers
RPACS
RPACS-WEBX + optional RPACS-WEBX
Communication
Products that support RPACS-MAIL
this technology
RPACS-ROUTER
9
RPACS-ROUTER