| The world is growing and fruiting with the help of | | | | transmission of imaged information in medical |
| technological conceptual advancements. These | | | | imaging. This common standard or the common |
| improvements in technology, has brought a | | | | format for the images is known as DICOM. |
| change that all the sectors now use to serve with | | | | DICOM is the abbreviation for Digital Imaging and |
| modern facilities and maintain the best | | | | Communications in Medicine. The Picture Archiving |
| coordination among these facilities. The | | | | and Communication System or simply PACS |
| introduction of medical software like EMR and EHR | | | | which is a system, uses this standard for the all |
| is the advancement in medical sector which | | | | the medical imaging. DICOM includes a file format |
| coordinates with the areas of clinical decision | | | | definition and a network communication protocol. |
| making, drug prescribing etc. The clinical decision | | | | And this network communication protocol uses |
| making, and drug and treatment prescribing are | | | | TCP/IP for communication in between the |
| the first hand uses of EHR data. But there are | | | | systems. DICOM enables the integration of |
| some alternate uses of EHR data also. We better | | | | scanners, printers, workstations, computer |
| can say it to be the re-use of EHR data. Mostly in | | | | systems and other network hardware into PACS. |
| case of clinical and other drug related researches | | | | DICOM supportive devices come with the |
| and studies the reuse of EHR/EMR data is | | | | capacity to support different DICOM classes |
| incorporated. A clinical research is geared by the | | | | separately. DICOM is developed by American |
| need to provide reliable data to support safety | | | | College of Radiology (ACR) and National Electrical |
| and efficacy. And the data from EHR lays the | | | | Manufacturers Association (NEMA). The present |
| foundation for the reliability of the data from a | | | | DICOM is the third version of this standard. The |
| clinical research which is to be used in furtherance. | | | | first version was released in the year 1985. It |
| Data retrieved from medical software systems | | | | was ACR/NEMA 300. The second version came in |
| like EHR should be of such a quality that it | | | | the year 1988 by the name ACR/NEMA V2.0. |
| improves the efficiency of patient care. This | | | | DICOM bears some very necessary information |
| quality concern should not be there only from the | | | | along with the images like the patient ID, which is |
| point of first use of EHR data but also from the | | | | inseparable from this information even by mistake. |
| re-uses of data mostly by researchers to support | | | | While handling DICOM data different medical |
| healthcare. But the re-use of EHR data must be | | | | software products are used. Software tools for |
| treated with caution, because the data protection | | | | the transfer, organizing of DICOM data, for image |
| issue is always pertained to reuse of data like the | | | | supports etc. are very widely used. Trial Wire is a |
| EHR data. So, we need a system that can help us | | | | very useful medical software used in DICOM data |
| in achieving a proper balance in between the | | | | transfer, de-identify and handling. There are other |
| protection of data in one hand and more | | | | software products like GDCM, OsiriX, ImageVis3D, |
| optimized reuse of data on the other. | | | | VRRender, ImageJ, MicroDicom, Medstrat, kPacs, |
| The use and re-use of EHR data in the healthcare | | | | UniPACS etc. which are very commonly used in |
| information segment is always accompanied by | | | | DICOM interpretation. |
| various drawbacks. These drawbacks | | | | Trial Wire is a medical software product used to |
| accompanying re-use of data vary from lack of | | | | transfer DICOM image from one to another web |
| legal and technical standards to uniformity of use. | | | | enabled computer. It is a java based tool |
| We need proper standards and protocols of data | | | | available free of cost. The use of a medical |
| collection and the re-use. Only a properly collected | | | | software product like Trial Wire reduces the cost |
| piece of information whether primary or | | | | associated with the couriers used to transfer |
| secondary can help in achieving research | | | | DICOM data from one location to the other. Trial |
| objectives. The re-use of data, generated by a | | | | Wire also provides an audit trail for any changes |
| medical software be it an EHR or any other | | | | made to the DICOM data in order to comply with |
| record keeping system, should be cost-effective. | | | | the HIPAA regulations. |
| Clinical experiments or trials done with re-use of | | | | 3 Medical Software in HIS sphere: |
| EHR data is a cost effective way than collecting | | | | Automated health practice management systems, |
| the data afresh. The uniformity in approach in | | | | e-prescribing, CAT scanners, heart rate monitoring |
| re-use of data from medical software (EHR) is | | | | with software are a few of the names from the |
| another point of concern in our discussion. The | | | | medical area in the 21st technology driven |
| present situation in health care requires | | | | century. From the patient’s personal data to |
| researches to carry out research studies in | | | | the cardiographs everything has got the driving |
| isolated fashion at different locations. The use of | | | | force of technological advancement. Introduction |
| the EHR which is the common medical software in | | | | of PACS or Picture Archiving and Communication |
| use varies widely across different nations | | | | System and DICOM or Digital Imaging and |
| worldwide and so challenges the re-use of EHR | | | | Communication in Medicine has changed the way |
| data in clinical researches and other uses. Other | | | | of imaging in the medical practices. Similarly the |
| issues like the maintenance of patient | | | | introduction of EMR/EHR medical software has |
| confidentiality, requirement of time and cost | | | | changed the way of medical record keeping. In |
| effective resources are a few to requiring | | | | most of the hospitals and clinics in EU, US or |
| attention in the field of re-use of EHR data. A | | | | Canada you would notice the use of medical |
| qualitative control on re-use of EHR data can lead | | | | software like an EMR system in practice very |
| to a sustainable, beneficial and commercial impact | | | | well. Likewise the introduction of medical software |
| on treatment and drug development which | | | | for billing purpose is another important contribution |
| ultimately will lead to better healthcare system in | | | | of modern technology. Medical billing software |
| a viable economy. | | | | used in billing has introduced the comfort of |
| With the increased focus on HIT (Health | | | | coordination among other medical services like lab |
| Information Technology), the situations in US and | | | | report of patients and its coordination with proper |
| EU in re-use of EHR data is changing positively. | | | | insurance claims etc. |
| Introduction of HITECH act in US is an initiative in | | | | Medical Software is the modern technological term |
| the direction of Health Information Technology. | | | | that has driven the medical sector to an |
| The European Seventh Framework Program for | | | | unalterable stage of advancement. The |
| research and technological development is the | | | | introduction of various medical software products |
| initiative by EU to focus on HIT. The use of | | | | has changed the way of management and even |
| proper EHR systems in place is growing fast in | | | | the administration concerned with hospitals and |
| US. The vision of the EFPIA EHR task force is | | | | clinics across EU and US. Medical software use |
| another forcing factor that will help in attaining the | | | | even in health informatics like HIS is of great help. |
| standards for re-use of EHR data. | | | | HIS or Hospital Information System is the |
| And in future with such a huge amount of efforts | | | | platform covering all the medical related clinical as |
| we surely will have a proper system with proper | | | | well as administrative sections. From the simple |
| medical software in place which will coordinate in | | | | hospital discipline management to the |
| re-use of EHR or any such data with satisfaction. | | | | management of health records, financial records, |
| 2 Imaging the medical business: DICOM | | | | and other medical reports all are covered under |
| The efficiency in every sphere of life due to the | | | | this single umbrella named HIS. |
| technological and scientific advancements includes | | | | Hospital Information System or simply HIS is the |
| the health sector also. With the technological and | | | | information system assisting all the administrative, |
| scientific progress the people are becoming more | | | | financial and clinical aspects of a hospital or a clinic. |
| aware of their health and nutrition. And due to this | | | | HIS also known as CIS or Clinical Information |
| growing importance on health, the medical sector | | | | System comprises of a comprehensive, |
| is also experiencing a huge growth. This growth in | | | | integrated information system covering all the |
| the medical sector is accompanied by the | | | | papered and non-papered software based clinical |
| technological improvements as in the cases of | | | | as well as administrative medical areas of concern. |
| other sectors. Almost all the hospitals and clinics | | | | A simple HIS construction can be understood as |
| are using technological advancements in their | | | | the sphere covering the entire medical aspects |
| practices. Be it the medical software for billing or | | | | from EMR systems to the software based billing |
| the EMR software system they are using. It is | | | | services. A proper HIS is always aimed at |
| estimated that the use of an appropriate medical | | | | achieving best possible support towards the health |
| software product in place has the potential to | | | | care of patients and an adequate management by |
| increase the earnings by a considerable amount of | | | | deploying either medical software products or |
| more than or equal to 30%. So, simply you | | | | machineries along with responsible technicians |
| cannot neglect the importance that a right medical | | | | persons. Radiology information system, |
| software product bears in medical industry. | | | | Laboratory Information System, PACS, etc. are |
| And in this age of advancement any medical | | | | the sub categories of Hospital Information |
| business unit without the imaging division is just | | | | System. EMR, EHR, software based billing |
| incomplete. Imaging in medical business is of a | | | | services, insurance claims, patient care, profit |
| great importance that nobody can ignore and | | | | drive, hospital management, administrative works |
| even alter. The image reports like cardiographs, | | | | all belong to the sphere of HIS. |
| biomagnetic imaging, computer radiography, | | | | The advantage from HIS includes well maintained |
| tomography, diaphanographs, microscopy, | | | | decision support system in healthcare, exchange |
| endoscopy, mammography, spectroscopy, radio | | | | of information towards the betterment of the |
| fluoroscopy, thermographs, ultra sound, x-ray | | | | healthcare services, coordinating the standards of |
| angiography are a few of the imaging services to | | | | ancillary services with the primary one, enabling |
| name that comes into the scene when we talk | | | | referring physicians and doctors to access all the |
| about medical imaging reports. Today’s | | | | studies and reports via a single user interface etc. |
| treatment of a patient is incomplete if no one of | | | | In a nut shell a proper HIS with adequate medical |
| these images accompanies his records. And with | | | | software support is the demand of the time, |
| these imaging services there is a common | | | | conforming to which can rise your business in the |
| standard for the handling, storage, printing and | | | | medical sector to an incredible level. |