Design Of Small Field PACS Based On Web

Objective: With the improvement of technology in computer, internet andinformation, and the rapid development of regional medical service, remoteconsultation and the construction of information system at the local medicalinstitutions, PACS system has found wide application in medical institutions, whoseevolvement can be recognized in the expansion of image transmission and sharingfrom between a couple of equipment at the beginning to the entire hospital level, thento the cross-regional level. Against this backdrop, PACS gradually found its way intofield medical units. However, in the operation of PACS, users have found there aremany conspicuous defects in the mainstream PACS, the client-based and server-basedPACS, severely undermining the medical support of the field medical units. Thedefects of C/S based PACS manifest themselves as follows: first, the structure of C/Shas determined the client must be installed with the graphical-browser authorized bythe software vendor, and the client, which is charged in accord with the nodes, isexorbitantly high in price; second, the structure of C/S results in the poor circulation ofdata sharing, critically compromising efficiency of remote consultation; third, theunreasonably large size of the client leads to the overload of the client, gravelylowering the efficiency of remote consultation. When the connected number of clientswithin the system soar, the balance of the performance load will be upset, drasticallydecreasing the efficiency; fourth, as far as the traditional C/S-based PACS is concerned,the increasingly higher requirements can not be satisfied unless application programsare updated at both the client-side and the server-side, bringing about significantinconvenience to the maintenance and update. In order to remedy the defects of thetraditional C/S-based image transmission and management, the thesis proposes anddesigns a web-based image transmission and management system for field medicalclinicsMethods:①The major content and constitution of the DICOM3.0standard areexplored and the DICOM web communication protocol and the structure and theconstitutive units of the DICOM medical documents are analyzed.②The content andapplication of WADO are studied and its role in e-health documents and medicalinformation integration system are analyzed.③In accord with the features of WADO grammar, a data view that suits query is constructed.④The approach of DICOMdocument analysis and transmission by WADO standard is proposed.⑤Twoapproaches to realizing the Web interface in the original PACS.⑥The model and therequirement of the systematic function of MVC are analyzed and a designing plan in fitwith the web-based image transmission and management platform is put forward. Thefunctions of the system are designed, which involve the user verification, informationlist, the patient information viewing, image viewing and editing and informationretrieval.Content: the system builds a web communication protocol that fits the DICOMstandard to realize the acquisition of image data of the imaging devices with standardDICOM interfaces and is compatible with the PACS image of the traditional C/Sstructure; B/S structure design is adopted and the web module is integrated so that theimage can be displayed and edited in the web browser. The following is more detailedelaboration:①The storage of DICOM medical images and relevant data base ismaterialized and DICOM archive management server is built. Attempt has been madeto allow access to the image data of DICOM via web without altering the originalDICOM data server.②The remote query, display and management of medicalimages can be implemented through browsers; the user interface and the correspondingprogram for the server are compiled; research has also been done to explore the way inwhich the request of WADO can be integrated to the user page and sent to the archiveserver.③Application server is configured and the WADO interface of the archiveserver is employed for connection allowing fast and flexible access for users andexpanding the application field and range of the traditional PACS.④Thebrowser-based function of image editing is achieved, inclusive of the vital digitalimage editing functions such as windowing technique, zoom free, rotation, negativeand translation.Results: the study transforms the traditional PACS structure and achieves theapproach of the web-based image transmission and management. Through theutilization of JSP page technology and the web server, etc., the project succeeds in thebuilding of a web-based image transmission and management system for field medicalclinics. Not only can the system be compatible with the image information of thePACS, but it also enables the medical staff to can invoke and execute images viabrowsers that have access to nets because the system is loaded with the controls for themedical image display and editing that can run on the web clients compiled through Java technology, which facilitates more medical application.Conclusion: The web-based medical images transmission and management system hasovercome the defects of PACS that is based on C/S structure and possessed theadvantages of B/S structure system:①The adoption of a web-based PACS allows allthe computers that have access to internet to be work stations and the image data in thePACS server can be accessed through browsers. It is a merit that guarantees medicalstaff can obtain the image data in need in complicated and variable medical setting.②The web-based PACS is characterized by its client-freeness. The client does not requireany additional configuration in either software or hardware but can afford the operationof a browser.③The medical image data are not stored in the client, instead, all thedata change and editing will be sent back to the server for storage eventually. Theadvantage of this form is that the data security is guaranteed because the user separatesthe data and the client by the service provided by web server. The system satisfies therequests of field medical clinics for the image transmission and management. In thefield hospital, the system can pick up data provided by various imaging equipment(DR,CT,MR, nuclear medicinal equipment, ultrasound examining equipment and filmscanning equipment) that are equipped with standard DICOM interfaces, and it is alsocompatible with the PACS and can afford data storage and sharing. Apart from itsapplication in the field hospital, the system with integrated web module can be used inlive remote image data browsing. In the peaceful period, the system can be used in liveremote instruction and synchronized demonstration, while in the war time, the systemcan be used in effective remote consultation and report, etc.. In conclusion, theestablishment of this system not only affords a data communication and exchangeplatform for the construction of the medical web but also provide an data interface forthe integration between heterogeneous platforms such as PACS and the informationsystems of other hospitals, which play an significant role in promoting the efficiency ofour PLA’s remote consultation.