Regardless of the exact type of open source tool, PACS administrators really need to “get their hands dirty” and learn these systems, said Paul G. Nagy, PhD, assistant professor of Radiology, director, Information Research, University of Maryland in the “Open Source PACS Tools” session today at the Society for Imaging Informatics in Medicine (formerly SCAR) annual meeting in Austin, Texas.
There are tons of HL7 and DICOM tools that should be considered ( www.openrad.com has a repository that can be perused). It’s possible to go beyond basic DICOM and to even build your own archive to truly becoming a “PACS Jedi,” he said. This can be done using open source tools.
DICOM is like a Swiss Army Knife in that different portions can be used for different problems, said Nagy. However, DICOM tools alone might not cut it and you really need something more to have true interoperability in your systems, and IHE is one such tool. IHE is an open standards approach to lowering the costs of integration of healthcare, he added.
IHE Workflow focuses on finding ways to prevent data from being corrupted with different IHE components being used for specific problems. IHE goes beyond Modality Worklist, with capabilities such as return receipt to confirm that images are going where they need to be going and are safe getting there. Also, modality procedure step (MPS) can identify when certain procedures are done and provides details regarding the amount of images that were generated. Thus you have many more layers of functionality and closed loops that make sure all information and steps are being completed correctly, Nagy said.
Nagy suggested tools that he feels are essential to any “Open Source Toolbelt,” including: DCM4JBOSS, DICOM Validation Toolkit (DVTK), and HL7Brower. Here is a breakdown:
- DVTK was developed by Agfa & Philips for DICOM conformity testing. It provides a scripting language, includes good documentation, and also has a strong community site for user support via a website. In general, DVTK can be used as a standalone validator of DICOM objects which lets you know if data conforms to other pieces of information in the same class, said Nagy. The tool also can identify instances when communication transfer goes wrong within a system. DVTK does have some workflow components are what he called the cornerstone of IHE.
- Another open source tool of note is DCM4JBOSS for scheduled workflow and other capabilities that is a JAVA-based implementation of DICOM originally developed by Gunter Zeilinger at Agfa.
- HL7Brower allows you to take HL7 code and pop it into a browser that makes it a readable XML file.